Claimable launches an AI-powered appeals platform to combat unjustified denials in healthcare

What you should know:

– Claimable, an innovative healthcare technology provider, addresses the pervasive problem of healthcare claim denials with the launch of its AI-powered appeals platform.

– This solution leverages advanced AI to analyze clinical research, policy details, appeals data, and patients’ individual medical circumstances to create and submit customized appeals in just minutes.

Fighting a broken system

The U.S. healthcare system is plagued by an alarming number of claim denials. Each year, a staggering 850 million out of 5 billion health claims are rejected, with significant consequences for patients:

• Delayed care: 60% of patients experience delays in receiving necessary treatment.
• Deteriorated health: 47% report a deterioration in their health due to denied claims.
• Financial burden: Medical debt contributes to 66% of personal bankruptcies in the United States

Claimable aims to address this crisis by empowering patients to defend themselves against unwarranted denials. The platform simplifies the appeals process, making it faster and more accessible for patients to secure the vital treatments they need.

Exceptional results in the pilot program

Claimable's pilot program showed impressive results and significantly exceeded industry standards:

• 80% success rate for appeals: 1.6 times higher than average.
• Solution in less than 10 days: 3 times faster than average.
• Appeals submitted in minutes: Eliminating the lengthy delays associated with traditional appeals processes.
• Recovered nearly $3 million for patients: Demonstrating the platform's potential to alleviate financial stress.

Focus on critical needs

Currently, Claimable is supporting calls for 60 life-changing treatments, with a focus on commonly rejected medications for autoimmune diseases and migraines. These conditions affect approximately 65 million Americans, with women being disproportionately represented at 80-85%.

Claimable plans to rapidly expand its support to more than 100 treatments by early 2025, including treatments for multiple sclerosis, heart disease, diabetes, obesity, asthma and certain cancers.

A personalized and efficient approach

Claimable's platform offers an easy-to-use, guided app builder with features such as:

• Intelligent document scanning: Simplifying the process of collecting necessary information.
• Dynamic health questionnaire: Tailor the appeal to the patient's specific circumstances.
• Immediate comparison of evidence: Identify relevant clinical research and policy details to support the appeal.

Unlike traditional form-based tools, Claimable provides a personalized experience that adapts to responses in real-time and generates compelling, fact-based narratives for each appeal.

Nationwide availability and affordability

Claimable is available to patients throughout the United States and accepts denials from all insurance providers, including Medicare, Medicaid, and major private insurers. The platform prioritizes affordability and charges a fee of $39.95 per appeal plus shipping.

“At Claimable, we are leveraging the power of AI to give patients a voice in a system that too often drowns them out,” said Warris Bokhari, MD, CEO and co-founder of Claimable. “Our mission is to level the playing field and ensure every patient can take back control of their health care and receive the treatment they deserve.”