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Claim scrubbing and denial resolution

Scrub the claim before you send it. Resolve the denial after you get it.

Enter a payer, a date of service and your billed lines. See which lines will bundle, which exceed a medically unlikely edit, which modifier would legitimately resolve it, and the CMS citation behind each verdict. Free to scrub one claim at a time in your browser. Pro adds batch scrubbing, saved history, appeal letters and the API.

The claim scrubber, every CARC and RARC page, and the API are free, need no account, and cite the source behind every verdict.

What you get

A cited verdict, a private free tool, and an API for agents

Scrub before you submit

Enter a payer, a date of service and your billed lines. See which lines an NCCI procedure-to-procedure edit will bundle, which exceed a medically unlikely edit, which modifier would legitimately resolve it, and the CMS citation and edit quarter behind every verdict.

See how the engine works

Resolve the denial after it lands

Give it a CARC and any RARCs off the remittance. It explains what actually happened in plain terms, ranks the corrective actions, tells you whether an appeal is worth filing, and drafts the appeal letter with the citations that support it.

See what is free vs paid

Claim data never leaves your browser

The free scrubber runs entirely client-side. Your payer, date of service and billed lines are never transmitted to a server. That is a deliberate architecture choice, not a policy promise: there is no network call to make.

Read the security page

Open JSON API and hosted MCP

The same engine is a single-key REST API and an MCP server, so an autonomous medical billing agent can scrub a claim or resolve a denial mid-task and get a cited answer back, not a guess.

Read the API docs

No edit in our dataset is not a pass

Our NCCI PTP and MUE datasets are curated subsets of much larger CMS files, and every row carries the source it came from and a confidence flag. When a code or pair is not in our loaded dataset, the verdict says exactly that: not checked, no edit in our dataset. It is never rendered as a pass, and it is never coloured green. See the methodology page for our real coverage, stated plainly.

Agents & developers

The claim edit and denial layer, callable by an agent

An autonomous medical billing agent can scrub a claim or resolve a denial mid-task and get a cited answer back. The same engine behind this site is a single-key REST API and a hosted MCP server.

  • Single-key REST API and MCP over the same engine and datasets
  • Every endpoint free at the anonymous rate: claim or denial in, cited verdict out
Explore the API & MCP server

denialpath api

$ curl -X POST https://denialpath.vercel.app/api/v1/scrub \
  -H "Content-Type: application/json" \
  -d '{"dateOfService":"2026-05-12",
       "lines":[{"code":"80053","modifiers":[],"units":1},
                {"code":"80048","modifiers":[],"units":1}]}'

{
  "data": {
    "editQuarter": "2026 Q2",
    "findings": [{
      "kind": "ptp",
      "status": "fail",
      "codes": ["80053", "80048"],
      "citation": { "source": "CMS NCCI PTP Edits",
                     "confidence": "verified" }
    }]
  },
  "request_id": "req_..."
}

Pricing

Free to scrub one claim. $49/mo when you work claims every week.

A real free tier: the single-claim scrubber, every CARC and RARC page, a test API key. Pro adds batch scrubbing, saved claim history, appeal letters and a production API key.

Free

Scrub a claim, look up any denial code. No card, no signup.

$0forever

  • Single-claim scrubber, runs in your browser so claim data is never transmitted
  • Every CARC and RARC denial page, with cited corrective actions
  • NCCI PTP and MUE verdicts with the CMS citation and edit quarter
  • Test API key for developers (throttled, never bills)

+1 more

Scrub a claim free

Pro

Recommended for billers

For the biller or practice working denials every week.

$49/mo

  • Batch scrubbing, up to 250 claims per run
  • Saved claim history with the verdict and the CMS quarter it was checked against
  • Appeal letter generation and download, with the citations that justify it
  • Denial analytics by payer across your saved claims

+2 more

Opens at launch

Scale

For billing companies and products built on the API.

$149/mo

  • Everything in Pro
  • 10,000 API calls/mo
  • 300 requests/minute burst
  • Batch scrubbing up to 2,000 claims per run

+1 more

Opens at launch

See full pricing and plan comparison

FAQ

Common questions

What does DenialPath actually do?

Two jobs. Before you submit a claim, it checks the billed lines against CMS NCCI procedure-to-procedure edits and medically unlikely edits in force on the date of service, and tells you which lines will bundle, which exceed a unit limit, and which modifier would legitimately resolve it. After a denial arrives, give it the CARC and any RARCs off the remittance and it explains what happened, ranks the corrective actions, and can draft the appeal letter.

How do you avoid reporting a false pass?

Every PTP pair and MUE code we hold comes from a CMS file with a source link and a confidence flag. Where we hold no edit for a code or pair, the finding status is "no data", never "pass". A claim with unchecked lines is reported as unchecked, not clean, because a biller acting on a false green light loses real money.

Is the free scrubber really private?

Yes. The scrubbing engine is plain, dependency-free TypeScript that runs in your browser tab. Scrubbing one claim in the free tier makes no request to our servers, so there is nothing to intercept and nothing stored unless you choose to save the result on a paid plan.

Is it free?

Yes to start. The single-claim scrubber, every CARC and RARC denial page, and a throttled test API key are free with no card. Pro ($49/mo) adds batch scrubbing, saved claim history, appeal letter generation and a production API key, because a working biller processes claims in volume, not one at a time.

Can an autonomous billing agent use it?

Yes, that is a first-class use case, not an afterthought. The REST API and hosted MCP server expose the same engine as check_claim, explain_denial, get_ncci_edits, get_mue, draft_appeal and get_timely_filing tools, so an agent can scrub a claim or resolve a denial mid-task with a citation it can show its user.

Is this medical or legal advice?

DenialPath provides billing and administrative guidance based on published CMS and X12 sources. It is not medical advice, not a coverage determination, and not a guarantee of payment. NCCI and MUE edits are republished quarterly and payer policies vary by contract. Always confirm against the payer's own current policy before submitting or appealing.

Scrub a claim, no card, no signup

Runs entirely in your browser. Every verdict cites the CMS or X12 source it came from.