Startup Takes on Insurance Denials for Patients
Reading Time: 4 minutes
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Summary:
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Startup Claimable helps patients fight health insurance denials
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Uses generative AI to automate and personalize appeal letters
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Over 80% of appeals via Claimable are successfully overturned
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Startup part of growing wave of tech tools targeting denial rates
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In the U.S. health care system, a major challenge for patients isn’t accessing treatment but convincing insurers to cover it. Denials of medically necessary care are so frequent that about one in five in-network claims are rejected annually, yet fewer than 1% of these denied claims are appealed by patients because they didn’t know who to contact, didn’t have the time, or didn’t know they had a right to challenge the denial.
To help people overcome this obstacle, a new wave of startups is leveraging artificial intelligence and technology to streamline the appeal process. And some early players are proving that a little digital assistance can make a big difference.
One of the earliest entrants in this space is Claimable, an AI-driven platform founded by physician-entrepreneur Warris Bokhari in late 2023 and launched in October 2024. Bokhari’s experience within the U.S. insurance system and as a clinician revealed how often—and arbitrarily—insurers deny coverage for vital treatments. His solution was to develop a tool that empowers patients to fight back.
Claimable’s main goal is simple: to make it easier for patients to submit successful insurance appeals without the usual bureaucratic hurdles or legal costs that discourage many from trying. Since its launch, the platform has focused on helping individuals contest denials for various conditions and treatments, including autoimmune medications, migraine therapies, asthma drugs, and newer treatments that often encounter administrative resistance.
How Claimable Works
Claimable uses generative AI to turn the often-complex requirements of insurance appeals into a clear, evidence-based letter customized for each patient.
Patients (or their clinicians) start by uploading the denial notice and answering questions about their medical situation. Claimable’s system then scrapes together information from millions of data points—including clinical research, insurer policies, legal precedents, and medical guidelines—to craft a convincing, personalized appeal. The company also ensures submissions reach the appropriate decision-makers and regulators overseeing insurer conduct.
According to Claimable’s data, over 80% of its appeal letters lead to overturned denials, with many resolved in about 10 days. These outcomes significantly surpass industry averages and highlight how digital tools can improve patients’ chances.
Appeals made through Claimable cost around $39.95 plus shipping. While modest compared to potential medical bills that run to the thousands, the company emphasizes that its goal isn’t profit but to give patients a fighting chance.
A Growing Ecosystem of Solutions
Claimable isn’t alone in this space. Recent years have seen a surge of startups and tools designed to lessen the administrative load from insurance denials. For instance, Fight Health Insurance offers a free chatbot system that helps users navigate the appeal process. Meanwhile, Counterforce Health, a startup based in Durham, North Carolina, launched in early 2025, provides free AI-powered appeal drafting tools for patients and clinics, supported by grants and nonprofit funding.
These initiatives show a broader effort to use technology to address one of healthcare’s most persistent issues. Although insurers rely increasingly on automated, algorithm-driven systems to review claims, newer tools aim to “level the playing field” by offering similarly advanced tech to patients.
Experts see this as part of a larger race between automated denial systems and AI-assisted appeal solutions. But critics argue that without broader policy changes, digital appeal tools are merely a temporary fix for a fundamentally flawed system.
Looking Ahead
The continuing rise of these technologies clearly addresses a longstanding issue: health insurance denials persist, but the obstacles to appealing them are finally being challenged. With options such as Claimable and grant-funded platforms like Counterforce Health, patients now have more resources and support to access the care they need.
In a time when nearly 20% of in-network claims are denied, and less than 1% are appealed, providing patients with the tools to contest insurer decisions offers significant empowerment that can be life-changing.
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