Complaint Playbook
The Regulator Moves Faster Than The Appeal Queue.
The Maryland Consent Order changed what a downcoding response looks like — in one filing, not one appeal at a time. Maryland fined Cigna $80,000 and ordered six months of claims reprocessed. This is the field guide and tool kit for when the Insurance Commissioner is the right channel.
- The filing decision framework
- 50-state authority matrix
- Complaint templates
What's inside
The Playbook is the read. The Workbook is the tool kit.
Built to be used together, from the filing decision to the evidence pack and templates.
The Filing Decision
A five-criterion table plus a weighted decision tree. Internal appeal versus regulatory complaint, decided per case.
The Maryland Precedent
Consent Order MIA-2026-03-009 broken into trigger, remedy, and legal anchor — the structure that travels to 49 other states.
50-State Authority Matrix
Commissioner, filing channel, and recent enforcement notes for every state. Seven high-volume offices flagged in the Playbook; full directory in the Workbook.
Evidence Pack Checklist
Twelve items across pattern, claim-level, and policy evidence. A live readiness score out of twelve. Ten is file-ready.
Complaint Templates
Three letters anchored to Maryland: downcoding pattern, processing delay, and payment dispute. Customize the bracketed fields per filing.
Readiness Scorecard
Twelve quarterly questions. A live panel maps the score to one of five readiness levels, from no infrastructure to mature.
Why RapidClaims
Built for the hardest coding challenges in healthcare.
While other vendors chase high-volume, low-complexity work, RapidClaims is built for the coding that actually moves your net collection.
>98%
Coding accuracy
Across 25+ specialties, including the complex ones competitors avoid.
40%
Fewer denials
Documentation gaps caught at the point of code, before submission.
170%
Coder productivity
More charts per coder — without adding a single FTE.
25+
Specialties supported
Depth in the hardest specialties, not just the easy volume.
82.5%
Charts auto-coded
Autonomous at an enterprise-grade accuracy threshold.
11k+
Organizations of signal
Operational data behind every coding recommendation.
Results
The numbers speak for themselves.
Trusted by Leading Healthcare Organizations
Connectivity
Works with your existing systems
RapidClaims integrates with all major EHRs. No rip-and-replace. No disruption.
Integration Capabilities
Security
Built for Healthcare. Secured for Enterprise.
SOC 2 Type II
Independently audited security controls
HIPAA
Full adherence to healthcare's most rigorous framework
HITRUST Ready
Aligned with healthcare's most rigorous framework
256-bit Encryption
Data encrypted at rest and in transit