Winning Denied Claims with AI: Why Aegis Is the Future of Medical Billing

In the labyrinthine world of U.S. healthcare billing, insurance denials are a costly, chronic problem. Healthcare providers collectively lose more than $260 billion annually due to denied insurance claims. Despite this staggering figure, fewer than 15% of these denials are appealed—largely because the process is excruciatingly manual, complex, and time-intensive. Yet, more than 50% of appeals, when submitted, are successful. That gap between potential and reality is where Aegis steps in.

Aegis was founded on the understanding that medical billing teams and providers are overwhelmed, working against a system that is evolving faster than they can react. With AI-generated denials on the rise, the current system is simply unsustainable. Filing an appeal traditionally takes over two hours per claim and is filled with administrative bottlenecks—from detecting the denial, to collecting documentation, to crafting and submitting compliant appeal letters.

How Does Aegis Reimagine the Insurance Appeal Process?

Aegis automates the entire appeals process—from denial detection to resolution—by using intelligent AI agents specifically trained on healthcare billing scenarios. It plugs into a provider’s existing software ecosystem, including Electronic Health Records (EHRs), Practice Management Systems (PMS), payer portals, and clearinghouses, and completely revamps how billing teams interact with denied claims.

Here's a breakdown of how the platform works:

• Denial Detection: Aegis continuously monitors claim data from clearinghouses, instantly flagging denials. It also prioritizes these by deadline and financial value, so billing teams can focus where it counts.
• Automatic Data Collection: It pulls patient records, Explanation of Benefits (EOBs), and payer correspondence automatically from integrated systems, eliminating hours of manual data retrieval.
• AI-Generated Appeals: Trained on a corpus of successful appeals and customized for specific payers, the system drafts compliant, well-structured appeal letters and assembles complete documentation packages.
• Submission & Tracking: Appeals are submitted directly through the appropriate channel—fax, portal, or clearinghouse. The platform also provides real-time updates on appeal status.
• Denial Analytics: Over time, Aegis gathers valuable insights about patterns in denials by payer, code, provider, and procedure, helping organizations preempt future rejections.

With Aegis, the cost of appealing a denial is reduced by 80%, and submission time is cut from over two hours to under two minutes. This is not just automation—it’s transformation.

Who Are the Founders Behind Aegis?

Aegis was born at Carnegie Mellon University by three ambitious co-founders with diverse but complementary backgrounds in AI, finance, and full-stack engineering. Their deep domain knowledge and commitment to solving hard, systemic problems are what give Aegis its technical edge and mission-driven foundation.

• Krishang Todi (CEO & Co-Founder): With a background in economics and computational finance, Krishang understands the stakes in both healthcare and financial systems. He previously worked on fixed-income risk modeling for one of India’s leading funds. At Aegis, he leads the charge in turning denied claims into recovered revenue.
• Aarav Bajaj (Founder): A computer science and AI graduate, Aarav has co-authored AI research and worked at Palantir, where he helped design enterprise-grade platforms. His expertise lies in deploying scalable AI agents for real-world, high-stakes use cases. He ensures Aegis’s AI logic is both robust and intuitive.
• Dhanya Shah (Founder): Also from Carnegie Mellon, Dhanya brings a practical, engineering-first mindset. With full-stack experience across multiple companies, she’s built custom stock platforms, games, and machine learning tools. At Aegis, she’s the architect making sure everything works seamlessly at scale.

Together, this trio is building Aegis not just as a tool, but as a paradigm shift—bringing clarity, speed, and results to a notoriously inefficient sector.

Why Is AI the Right Tool for This Job?

The rise in AI-generated denials by insurance companies calls for AI-powered solutions on the provider’s side. Denials are increasingly complex, and human billing teams simply can’t keep up. Aegis’s AI agents aren’t just reactive—they’re proactive, learning over time to identify risk patterns, optimize appeal language, and predict successful outcomes.

Unlike traditional rule-based systems, Aegis uses natural language processing (NLP) and machine learning models trained on real-world data, meaning it understands not only the letter of payer policies but also their spirit. It mimics the best human billers—only faster, more consistently, and at scale.

Furthermore, the AI engine constantly refines itself by analyzing the outcomes of submitted appeals, allowing it to self-optimize for each payer, code type, and procedure category. That means better results and a higher ROI over time.

How Does Aegis Integrate With Existing Workflows?

One of the platform’s greatest strengths lies in its low-friction implementation. Aegis was designed from the ground up to integrate with the systems providers already use, not to replace them.

• It connects to EHRs and PMSs, automatically ingesting claims data without disrupting current workflows.
• It works with clearinghouses and payer portals to gather and submit information in formats insurers recognize.
• Its dashboard is built for medical billing teams, giving them actionable insights without requiring data science expertise.

This means providers can start seeing value almost immediately, without overhauling their existing tech stack or undergoing months of training.

What Is the Bigger Vision Behind Aegis?

Aegis is not just solving a technical bottleneck; it’s tackling a systemic imbalance in healthcare finance. As insurers lean more heavily on automation to deny claims, providers have been left behind—until now. Aegis is building the AI-first infrastructure that enables providers to fight back with equal technological sophistication.

The long-term vision is to create a self-healing revenue cycle, where systems detect, appeal, and even prevent denials before they impact cash flow. By surfacing trends and denial insights, Aegis doesn’t just treat the symptom—it addresses the root cause.

Ultimately, Aegis represents a shift toward equity and efficiency in healthcare administration. For providers, this means more recovered revenue. For patients, it means fewer billing errors and delays in care due to financial bureaucracy.

Why Does Aegis Matter Now?

Timing is everything, and Aegis enters the market when it’s most needed. The U.S. healthcare system is buckling under administrative weight, and AI-powered denials are increasing in both volume and complexity. Billing teams are under-resourced and overworked, leading to billions in unrecovered revenue.

At the same time, the tools and data to fight back have never been more accessible. With modern AI capabilities and increasingly open healthcare APIs, a platform like Aegis can plug in, scale fast, and turn a liability into an opportunity.

It’s not just a product—it’s an inflection point in healthcare operations.

Conclusion

Aegis is redefining how healthcare providers handle one of their biggest challenges: denied insurance claims. With a powerful blend of AI, smart integrations, and a passionate founding team, it offers more than automation—it delivers a path to financial resilience and operational clarity in one of the most complex sectors in the U.S. economy.

As the healthcare industry continues to evolve, platforms like Aegis won’t just be helpful—they’ll be essential.