CMS-0057-F Ready Built for PT, Cardiology & Behavioral Health
THE FUTURE OF REVENUE CYCLE

The denial, prior-auth & eligibility brain for specialty practices.

Adulis gives independent Physical Therapy, Cardiology, and Behavioral Health practices the same payer intelligence a hospital system has — at a price they'll actually pay.

56%of denials start with an eligibility error, before the patient is even seen
7 daysnew CMS deadline for payers to answer a standard prior auth
65%of denied claims are never reworked — written off as lost revenue
3-5 secfor Adulis AI to draft a payer-aware appeal letter
5–100Provider practices served
3Specialty verticals
10+CARC codes auto-classified
< 30 minTo your first audit dashboard
THE PROBLEM

Every denial is paid for twice

Once in the staff hours to rework it — and again in the revenue written off when no one does. Multiply that across hundreds of claims a month.

56%

Eligibility errors

Coverage inactive, deductible unmet, visit limits hit, wrong plan — the largest and most preventable leak.

32%

Coding errors

Wrong CPT/ICD-10, mismatched diagnosis, or a missing modifier — quietly leaking revenue every billing cycle.

12%

Prior auth failures

Missed windows, incomplete documentation, or a payer rule that changed without anyone noticing.

WHY NOW

The regulatory and financial pressure has never been higher

Regulatory Pressure

  • CMS-0057-F requires payers to respond to standard prior auth requests within 7 calendar days starting 2026
  • Urgent requests now capped at 72 hours
  • Payers must publish denial reasons and approval rates publicly

Financial Pressure

  • Independent practice margins are being squeezed by rising labor costs and flat reimbursement
  • Denial rates are climbing across nearly every specialty and payer type
  • Practices under 100 providers can't afford enterprise RCM software built for hospitals
"The practices that win the next five years will be the ones who treat denial prevention as a data problem, not a paperwork problem."
THE PLATFORM

Three modules. One source of truth.

Built specifically for the denial, prior-auth, and eligibility patterns unique to specialty practices.

✓

Eligibility Verification

Real-time coverage checks before the patient is even seen — catching inactive plans, unmet deductibles, and visit-cap issues upfront.

⚡

Prior Authorization Tracking

Automated status tracking against the new CMS 7-day and 72-hour deadlines, with proactive alerts before a window closes.

◆

Denial Command Center

Every denial automatically classified by CARC code, payer, and root cause — so your team knows exactly what to fix first.

AI-Drafted Appeals

Adulis AI reads the denial reason, pulls the relevant payer policy, and drafts a submission-ready appeal letter in 3–5 seconds.

  • Payer-specific language and citation formatting
  • Clinical documentation auto-attached where available
  • Editable draft — your team reviews before sending
  • Built from a growing library of successful appeals that closes deals
HOW IT WORKS

From audit to recovered revenue in three steps

1

Free Denial Audit

We analyze your last 90 days of claims data and show you exactly where revenue is leaking — no commitment required.

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2

Connect & Automate

Adulis connects to your EHR/billing system and starts classifying denials, tracking prior auths, and flagging eligibility issues automatically.

→
3

Recover & Prevent

AI-drafted appeals go out fast, root causes get fixed at the source, and your monthly payer intelligence report shows the trend line improving.

Built for practices between 5 and 100 providers

The revenue cycle intelligence hospitals have had for years — finally sized and priced for independent practices.

"You send a report export. We do the analysis. First insights in days, not a six-month implementation."

No IT project. No long-term contract required to start. Just your export and 30 minutes.

Stop writing off revenue you already earned.

Send us a claims export. We'll show you what's leaking in under a week.

Book Your Free Denial Audit
FAQ

Common questions

Our biller already handles denials. Why do we need this? +
Great — Adulis makes them faster and shows the patterns they can't see by hand. It's a force multiplier, not a replacement.
We're too small for software like this. +
That's exactly who we built it for. Enterprise tools ignore practices your size — we start free and scale with you.
We don't have time to set this up. +
You send a report export; we do the analysis. First insights in days, not a six-month implementation.
How do I know it's worth it? +
We start with a free denial audit and show recovered or preventable dollars before you commit to anything.
Is my patient data safe? +
We follow minimum-necessary and de-identification practices wherever possible, use BAA-eligible vendors, and keep a human in the loop on anything sent to a payer.