The front page shows one letter. This page keeps the rest: the paper day sheet run, the checked superbill, both prior authorization appeals, the school excuse note, and the nine claim checks in full. Everything is fictional, labeled as such, and shown word for word.
Built for paper practices: photograph your day sheet, and the engine extracts every visit and builds the superbills. Where the checker is not certain, it says so. It never fills a gap by guessing, because a guessed minute on a claim is how you eat a recoupment.
Honesty note: the sheet on this page is a typeset illustration, and the flags shown are the engine's actual output from the real run: the staged sheet image, the extraction with nothing guessed, the flags, and the human confirm step. Checks beyond the engine's, like modifier 25 pairing, come from the practice rule file. Not yet proven on real handwriting; that run happens when a real practice says yes.
Every superbill is checked against all nine before your patient sees it. You know these; now you can check that we do too.
The nine are the universal floor. Practice-specific rules, interactive complexity add-ons, family therapy codes, a plan that wants something other than modifier 95, live in your practice's own rule file and are checked the same way.
Not a spreadsheet row. A document built from the 9:00 line of the day sheet above, carrying the core fields a claim asks for. Fictional practice, fictional patient, fictional plan and addresses, labeled as such. See the same visit as a filled CMS-1500, boxes numbered, assignment marked, rendering and billing NPI as separate boxes.
Rows the checker flagged never make it this far. The 10:00 telehealth visit stays held until the modifier question is answered.
An IEP letter is not proof the engine can write an appeal, so here is one. The full request, exactly as typed: "R.S., member ID AB1111111, Anthem, denial dated August 21 2026 of guanfacine ER step therapy, completed clonidine ER 0.2 mg for 9 weeks stopped for sedation and orthostatic dizziness, atomoxetine 60 mg for 12 weeks inadequate response, guanfacine ER is the only agent that controlled both tics and ADHD symptoms, peer-to-peer available Wednesday afternoons."
Facts the draft added beyond the request: one, the phrase "Both trials are documented in the medical record," carried from the phrasing of her prior appeal letter. The engine cannot see a chart; that sentence is an attestation only the clinician can make, which is exactly why every draft ends at your signature.
What a stronger appeal adds before sending: the plan's policy number and criteria document, the target dose requested, and, in a patient with tics, one sentence on why stimulants were not preferred. None of those were in the one-line request, so none are in the draft; the engine drafts from what you give it and does not invent the rest.
Fictional patient and plan. Unedited output, from the same three source letters.
Anthem, Pharmacy Appeals Re: R.S., Member ID AB1111111, denial of guanfacine ER I am appealing the step-therapy denial dated August 21, 2026. Per the plan's criteria, coverage is appropriate after failure of preferred agents at adequate dose and duration. R.S. completed clonidine ER 0.2 mg for 9 weeks, which was discontinued for sedation and orthostatic dizziness, and atomoxetine 60 mg for 12 weeks with inadequate response. Both trials are documented in the medical record. Continued treatment with guanfacine ER is medically necessary; it is the only agent that has controlled both tics and ADHD symptoms. I request reversal of the denial and am available for peer-to-peer review Wednesday afternoons. Sincerely, Maya Chen, MD (fictional)
The appeal above came from a one-line request, and it shows. So we ran the same engine again with the request a careful clinician would type: the plan's policy document number, the target dose (guanfacine ER 3 mg nightly), and why stimulants were skipped (a co-occurring tic disorder, tics worsened on a brief 2025 methylphenidate trial).
What changed, and why it matters: the policy number and dose now anchor the letter, the stimulant question a reviewer would ask is answered before it is asked, and the chart attestation the thin draft invented is gone, because this request carried the facts and the engine did not have to reach for a template's phrasing.
Fictional patient and plan. Unedited output, same three source letters. Request shown condensed above; the letter carries every fact from it verbatim.
August 28, 2026 Anthem, Pharmacy Appeals Re: R.S., Member ID AB1111111, denial of guanfacine ER I am appealing the step-therapy denial dated August 21, 2026 under policy criteria document PA-ADHD-2026-04. Per the plan's own criteria, coverage is appropriate after failure of preferred agents at adequate dose and duration and when the requested medication is medically necessary. R.S. completed clonidine ER 0.2 mg nightly for 9 weeks, discontinued for sedation and orthostatic dizziness, and atomoxetine 60 mg daily for 12 weeks with inadequate response. Stimulants were not preferred as first-line treatment here because the patient has a co-occurring tic disorder, and tics worsened during a brief methylphenidate trial in 2025 that was stopped after 3 weeks. Continued treatment with guanfacine ER 3 mg nightly is medically necessary; it is the only agent that has controlled both tic symptoms and ADHD symptoms. I request reversal of the denial and am available for peer-to-peer review Wednesday afternoons. Sincerely, Maya Chen, MD CA License A123456 (fictional)
Sold on this page, so here it is. The full request, exactly as typed: "School absence excuse note. J.T., DOB 4/22/2013, out of school 8/25 through 8/27/2026 for treatment-related reasons, may return 8/28/2026, no detail beyond medically excused, half-day PE restriction through 9/5 while a medication dose settles, seen in office 8/25."
What the draft withheld, which is the whole product: no diagnosis, no medication name, no clinical detail. "Treatment-related reasons" and "medically excused" are the only explanations a school receives, because that is all the request authorized.
Fictional patient. Unedited output from the same three source letters, drawn mostly from her signed work-excuse note.
Maya Chen, MD Child and Adolescent Psychiatry 2140 Examplewood Ave, Suite 300, Sacramento, CA 95899 August 25, 2026 To Whom It May Concern, Re: J.T., DOB 4/22/2013 J.T. was seen in my office on August 25, 2026. This patient was under my care and is medically excused from school from August 25 through August 27, 2026 for treatment-related reasons. They may return to school on August 28, 2026. Upon return, J.T. should participate in physical education for half-days only through September 5, 2026 while a medication dose settles. Please contact my office if verification is needed. Sincerely, Maya Chen, MD CA License A123456 (fictional)
Example letters, superbills, and clinical exchanges on this page are illustrations, not real patient records. Snowpine produces drafts for review by a licensed clinician. Front page · Security · Privacy