5 Best Appeals Tracking Software for Medical Billers 2027

Key Takeaways

• The category decision comes first: appeals tracking is either a layer added to the system you already run or a module inside a platform you are choosing anyway.

• Judge every tool by what it can read and where it sends work. The first test is whether it ingests your remittance (ERA or 835) data without manual re-keying.

• Five products make this shortlist: Waystar, AdvancedMD, eTactics AppealsPlus, Solum, and Tebra. AdvancedMD is the only one that publishes a per-provider price, and its pricing page does not name an appeals module, so the other four are settled in a sales conversation.

• Vellix's DenialIQ is not a buy-now option. The vendor's own site describes it as a pilot.

• Ask every vendor the same three questions in writing: how deadlines are tracked, where a person approves a letter before it is sent, and what business associate agreement terms apply.

What appeals tracking software has to do

Appeals tracking software records each denied claim, the reason the payer gave, the appeal deadline, the letter that was sent, and the payer's response until the claim is paid or written off. A useful tool answers three questions at the start of each day: which denials are still open, which are close to a deadline, and which were overturned.

The pressure to track them well is rising. Medical group leaders reporting higher denials: 60% in 2024 according to MGMA (2024 poll). That March 2024 MGMA Stat poll compared early 2024 with early 2023, so it measures change in denial rates, not their level.

Start with the category decision

The first decision is whether you are replacing your practice management system or adding an appeals layer to the one you already use. That choice changes the shortlist more than any feature list does. If you keep your current system, an appeals tool has to read the remittance files your system already produces and sync claim status back, so the questions are about intake and export. If you switch systems, appeals tracking is one module among billing, scheduling, and reporting, so compare the denial module inside each platform. If you are also choosing the system itself, our guide to medical billing software for healthcare in 2026 covers that decision.

Our read: a practice already on a platform with e-claims denial features should test that module first. A practice on a different system should shortlist one dedicated appeals tool and one platform with a built-in module, then compare their quotes side by side.

Who this is for

This guide is written for an owner or operations lead at a small healthcare business who is close to choosing and needs to know which tool fits the practice's systems and staff. It assumes you already submit claims and receive remittance files.

Red flags: your clearinghouse or practice system cannot export remittance (ERA or 835) data, nobody on staff can approve an appeal before it is sent, or the business cannot sign a business associate agreement with the vendor. Any one of these rules out most of the tools below before a demo starts.

How we evaluated these tools

The weights below reflect where a small billing office most often loses time or money: appeals that cannot be traced back to a remittance line, deadlines that live in someone's memory, and prices that stay unknown until late in a sales process. Scores are our judgment, applied to what each vendor's own pages describe.

We did not combine the scores into a single ranking, because the vendor pages do not describe the same features. Facts in each profile come from the page cited beside them. Our read follows each fact and is labelled as analysis. Where a page is silent, the tables say "Not described," which means the page read for this guide did not say so.

Feature matrix across the five shortlisted tools

Read the matrix as a list of questions for each demo, not as a verdict. Where a cell says "Not described," the next step is a sample run on your own remittance file.

Vendor-by-vendor profiles

Each profile separates what the vendor publishes from our read.

Waystar Denials and Appeals

What the vendor publishes: Waystar says customers can "secure more revenue while improving and streamlining the appeals process," and that its algorithms "track valuable data and identify unpaid or underpaid line items," according to Waystar. The page offers a "Request Pricing" option and publishes no price.

Best fit: groups that want a vendor-run denial platform and are willing to go through a sales process before buying.

Limitations: the page does not describe payer-specific templates, deadline tracking, or status tracking, and it names no integrated systems. It links to supported-system and payer-list pages that were not part of this review.

Implementation: before a demo, ask for the supported-systems list and the payer list the page links to, then ask for written confirmation of deadline and status features.

Our read: a strong candidate only if the sales team puts the missing features in writing. Without them, the page alone cannot tell a small office what it would receive.

AdvancedMD

What the vendor publishes: AdvancedMD prices its core software per provider per month and lists RCM services as a share of collections. Its RCM service description includes denial management, but the pricing page does not mention appeals. Prices are in the pricing table below.

Best fit: small groups that want their practice management system and denial work under one contract, and that are comfortable with per-provider billing.

Limitations: appeal letters and deadline tracking are not described on the pricing page. The RCM fee scales with collections, so denial work costs more as revenue grows, and that cost should be modeled before signing.

Implementation: confirm whether appeal letters and deadline tracking are included in the bundle or only available through the RCM service. Also confirm which data migration tier applies to your records.

Our read: the strongest choice here if you are already moving to a new practice system, and the weakest if you only need an appeals tool.

eTactics AppealsPlus

What the vendor publishes: the page calls AppealsPlus "A cloud-based solution that automates denial identification, streamlines appeal workflows, and delivers real-time insights." It also reports a 99% denial acceptance rate with no method given, according to eTactics. The page describes the product as software rather than a managed service, and it lists ERA analysis with custom routing rules, KANBAN boards for tracking, and a CARC and RARC library.

Best fit: billing companies and larger offices with heavy remittance volume that want a dedicated appeals queue with reporting by user and by denial code.

Limitations: the page names hospital systems, medical billing companies, long-term care pharmacies, and commercial companies as its audiences, and it does not name a small practice. It says the product "integrates seamlessly with most practice management systems and hospital information systems" without naming partners. No pricing is published.

Implementation: request the list of supported practice systems and a sample run on a real remittance file before committing.

Our read: the tracking features are specific and suit a queue-based workflow. The 99% figure is a vendor claim with no method, so treat it as a question to ask rather than a result.

Solum

What the vendor publishes: Solum's page says its software "scans electronic remittance files or explanation of benefit documents" to find denial codes such as CO-197 and CO-50. It retrieves clinical notes and authorization forms from the EHR, submits appeals by "secure fax, payer portal, or encrypted email," and "tracks the appeal's progress, from submission through resolution," with staff alerts. The page describes denial rates as "hovering around 10 to 15 percent across many specialties," according to Solum. The page lists no price, and its calls to action are "Get a Free Assessment" and "Calculate Your ROI."

Best fit: practices with EHR access and remittance files that want drafted letters and status alerts without changing their practice system.

Limitations: the page does not mention appeal deadline tracking. It says complex denials "might still require human oversight," and it describes integrations only as "simple interfaces or APIs" without naming any partner.

Implementation: confirm how the EHR and clearinghouse connection works, and whether the free assessment includes a sample run on your own data.

Our read: the footer lists SOC 2 Type II, AES-256 encryption, penetration testing, and HIPAA business associate status. Ask for the SOC 2 report itself rather than relying on the badge.

Tebra

What the vendor publishes: Tebra's pricing page describes custom bundles and says buyers can "request a personalized quote." Its e-claims module is listed as "E-Claims Management: Submissions, Rejections, & Denials." The EPCS add-on on Tebra is about $75 per provider, one-time, and the page says lower-tier pricing applies to providers who bill 100 claims or less per month, according to Tebra.

Best fit: solo or small practices with lower claim volume that want one system for e-claims, denials, and records.

Limitations: the pricing page does not describe appeal letters or deadline tracking, and the bundle price depends on provider count and claim volume, so there is no list price to compare.

Implementation: a demo should show the denial queue and how an ERA posts into it. Ask whether appeals are a separate charge.

Our read: a practical choice when denials are only one part of the workflow, but it needs a demo to confirm appeals depth.

Not ready to buy: Vellix DenialIQ

A Capterra listing for DenialIQ shows a free trial. The vendor's own site describes DenialIQ as a pilot product, says a person on the billing team approves every letter, and lists no integrations as available today. It also says "Patient health information is not allowed in Standard Edition," and it describes a healthcare edition as planned, with "no HIPAA compliance claim" for it yet. A practice that handles patient data should not rely on it for now.

What the public price pages show

Pricing checked October 30, 2026. Among the five products, only AdvancedMD publishes a per-provider price, and Tebra publishes only add-on fees. The other products are quote-based on the pages read for this guide.

Multiplying out the Medical Specialties range from the pricing table gives the monthly base cost at small provider counts, before any RCM fee:

This arithmetic is not a quote. The pricing page does not say which specialty tier fits which practice, and it does not say whether denial work is inside the base bundle or billed on top. Ask both questions before comparing AdvancedMD with a quote-based tool.

Benchmarks that size the workload

Benchmarks tell you where to look, not what your practice will see. First-submission denials: 8% of claims, single-specialty aggregate according to MGMA (2023 data). MGMA's 2023 DataDive put that aggregate for claims denied on first submission, and the article notes the same level in 2019. It is an aggregate across practices, not a target.

Experian Health's 2025 State of Claims survey of 250 healthcare professionals, fielded in June and July 2025, asked how often claims were denied. Providers reporting denials above 10%: 41% in 2025 according to Experian Health (2025 survey). The same report shows the share reporting denials of at least 10% rising from 30% in 2022 to 38% in 2024, according to Experian Health.

Solum's range is wider and vendor-stated, and it measures a different thing from MGMA's first-submission aggregate. Treat the two as different lenses on the same problem, and use your own first-submission count to size the queue.

A worked example for a three-provider practice

This example is illustrative and does not describe a customer. Assume a practice with three providers, 1,200 claims a month, and an assumed rate of one denial for every 12 claims. That is 100 denials a month. If a biller spends 0.25 hours per appeal on drafting and submission, the queue needs 25 staff hours a month before any follow-up. In a HubSpot Tickets pipeline, each denial becomes one ticket, and its hs_pipeline_stage property moves from a "Needs review" stage to a "Submitted" stage. HubSpot's documentation says to set that property to the stage's internal ID rather than its label, which keeps each move traceable (HubSpot Tickets API). Those 25 hours are the number to test against each demo: how much drafting and tracking the tool removes, and who still reviews each letter.

Where a configured workflow fits in the appeal queue

A proposed design for the appeal queue starts with a trigger that a biller can see: a new 835 remittance file or a payer denial letter arrives in a shared folder or in the clearinghouse export. The configurable workflow then reads each denial line, pulls the reason code and the paid-versus-billed amount, and creates one record per denial in a HubSpot Tickets pipeline. The output is a biller's queue with a deadline field, not a letter sent automatically. This design is proposed, not running for any customer, and it needs read access to the remittance export, a HubSpot account whose plan fits your data-handling rules, and written confirmation that each vendor touching patient data will sign a business associate agreement. A proposed US Tech Automations design would keep the approval step and the deadline field in front of a biller at all times.

Human review points stay in the design. A biller approves each drafted appeal before it goes out, a clinician or coder reviews any clinical narrative, and an operations lead reviews any ticket that is past its deadline. When a payment posts, the workflow writes the outcome back, which requires a second export from the practice system. Someone must also own the duplicate-ticket check, access controls, and maintenance when a payer changes its forms.

The fair comparison for a do-it-yourself build is not a spreadsheet against software. Zapier, Make, and n8n can support run histories, retries, error branches, and audit logs when someone configures them. What a stitched build leaves to the buyer is the design of observability, idempotency, escalation paths, access controls, and ongoing maintenance. A proposed design by US Tech Automations would name those controls up front, but it still needs your remittance export, your approval rules, and an inventory of the payer forms you use before it can run.

When NOT to use US Tech Automations: if your practice system already has a denial module that reads your remittance files and tracks deadlines, a second layer adds cost without new data. If you file only a handful of appeals a month, a shared tracker with the standard reason-code list can be enough. If you need a vendor to be the system of record for payer correspondence, a vendor-run platform such as Waystar or AppealsPlus fits that role better than a configured workflow.

Decision checklist before a demo

• Can the tool read your remittance (ERA or 835) data without manual re-keying?

• Does it show each appeal's deadline and status on one screen?

• Is a person required to approve each letter before it leaves?

• Does it name your practice system, EHR, and clearinghouse as supported?

• Is a business associate agreement available, and is a SOC 2 report available on request?

• Does the quote include appeal letters, payer forms, and any RCM or per-claim fee?

Glossary of appeal terms

• ERA (835 file): the electronic remittance advice a payer sends with payment and adjustment detail for each claim.

• EOB: the explanation of benefits, the payer's line-level account of what was paid or denied.

• CARC and RARC: the claim adjustment and remittance advice reason codes that explain why a line was adjusted or denied.

• Denial: a payer's refusal to pay all or part of a claim.

• Appeal deadline: the window a payer allows for contesting a denial, which varies by payer and must come from that payer's rules.

• Overturn: a payer reverses a denial after an appeal.

• Write-off: the practice removes an unpaid balance from its books.

Questions buyers ask

Which tool should a small practice choose if it already runs a practice management system?

Start with the denial module in the system you already run, and add a separate appeals layer only if that module misses deadlines or payer forms. A separate layer is worth a quote when it can read the same remittance files your system already produces.

Does AdvancedMD or Tebra include appeals tracking in the price?

Neither pricing page names appeal letters or deadline tracking as a priced line. Both mention denials, so confirm appeals depth in a demo before assuming it is included.

Can I see prices for Waystar, eTactics, or Solum before a demo?

No, the pages read for this guide publish no price for them, so the figure comes from a quote. Ask for the quote to list appeal letters, payer forms, and any per-claim or percentage fee separately.

Is Vellix DenialIQ ready for patient data?

Not on the evidence its own site gives: the site describes DenialIQ as a pilot and says patient health information is not allowed in the standard edition. Do not put patient records into a pilot tool.

Do I need a business associate agreement before a trial?

Yes, if a vendor will handle patient information during the trial, so get the agreement terms in writing before any sample claims are shared. Confirm the terms with your own compliance contact rather than relying on a sales summary.

How many appeals should I plan for?

Plan from your own first-submission denial count rather than an industry average, because an average shows where to look and not what your practice will see.

Choosing between a shortlist and a build

For most small practices, the decision is short: pick the tool that reads your remittance data, keeps a person in the approval step, and matches your practice system, then ask for a written quote that includes deadline and status features. If the fit is poor, a configured workflow with logged approvals is the alternative, and it carries its own maintenance. To see how the design would look for your queue, see how US Tech Automations configures this.