Fighting for Providers One Appeal at a Time
Insurance denials are one of the most frustrating barriers in healthcare. Providers spend hours — sometimes days — manually writing appeals requiring deep familiarity with Medicare guidelines, payer policies, and clinical documentation. Many valid claims are simply abandoned.
Project Linda was built to change that. Named in honor of dedicated healthcare advocates everywhere, our platform harnesses Microsoft Azure AI Foundry, Semantic Kernel, GPT-4o, and a curated Medicare guidelines knowledge base to generate professional, citation-backed appeal letters in minutes — not days.
Accuracy First
Every claim is grounded in the patient's actual medical chart and official Medicare guidelines — not hallucinated boilerplate.
Speed Matters
Insurance appeals have strict deadlines. Our AI processes even 1,000-page charts in minutes, giving providers time back for patient care.
Privacy by Design
All processing occurs within Microsoft Azure's compliant infrastructure. Patient documents are never persisted beyond your session.
The LINDA Appeal Process
A simple, step-by-step approach to turn a Medicare denial letter and medical chart into a strong, professional appeal letter.
Locate the Denial Details
Carefully read the Medicare denial letter (the redetermination notice or whatever level you're at). Highlight and extract:
- Exact reason for denial (medical necessity, not covered service, coding issue, etc.)
- Specific policy or LCD/NCD referenced
- Deadline to file the appeal and appeal level
- Claim number, date of service, and patient info
Identify Supporting Evidence
Go through the medical chart and pull the strongest evidence that directly counters the denial reason. Look for:
- Physician notes showing medical necessity
- Test results, imaging, and progress notes
- Relevant history, physicals, and specialist consultations
- Prior treatments tried and failed (if required)
Flag the most powerful 2–4 pieces of documentation and make copies for attachment.
Nail the Medical Necessity Argument
Write a clear, concise statement (1–2 sentences) explaining why the service was medically necessary — using the denial letter's own language against it.
Draft the Formal Appeal Letter
Structure the letter as follows (keep it to 1 page when possible):
- Header: Patient name, Medicare #, date of service, claim #
- Introduction: "I am writing to appeal the denial of [service] on [date]."
- Body: State the denial reason, present your necessity argument, reference attached evidence
- Conclusion: Request approval and offer to provide additional information
- Signature: Patient or authorized representative
Attach & Assert (Submit)
Compile your packet and submit before the deadline:
- Copy of the denial letter
- All highlighted supporting chart notes
- Any additional forms required by Medicare
- A cover/index page listing everything attached
Submit via certified mail or Medicare's portal. Keep copies of everything and proof of mailing.
Get in Touch
Questions about Project Linda or an enterprise deployment?