Warris Bokhari, the founder of Claimable, aims to address the issue of insurance claim denials in the US healthcare system using AI technology. The system has led to fear among patients about seeking medical help.
According to Bokhari, an 85% success rate in overturning claim denials is achieved by Claimable’s platform. He started working on Claimable two years ago after noticing that claim denial was a major issue in American healthcare.
Bokhari’s experience as an ICU doctor in the UK and his work at insurance company Anthem, gave him insight into the system’s flaws. The US has no guarantee of getting necessary medical care due to insurance companies, creating fearfulness about seeking help.
The insurance industry is facing renewed scrutiny amid the fatal shooting of UnitedHealthcare CEO Brian Thompson. Bokhari condemned violence toward individuals, instead advocating for appealing claims through Claimable’s platform.
Claim-denial rates have been increasing for over a decade, with 17% of in-network claims denied in 2021. However, only less than 1% of consumers go through the appeals process. Claimable has helped file hundreds of appeals and achieved an 85% success rate in overturning denials.
The platform uses AI to analyze data points from clinical research, appeal precedents, policy details, and individual medical history to generate customized appeals within minutes. Most claims cost patients $39.95, plus shipping. Claimable supports over 70 FDA-approved treatments for autoimmune and migraine sufferers.
Bokhari emphasized the importance of patients having a right to be heard, saying that Claimable helps legitimize their stories. The company has closed its seed round with backing from Walkabout Ventures, Humanrace Capital, and others, and is part of Nvidia’s startup program with an 11-employee team.
Source: https://www.businessinsider.com/ai-claim-startup-ceo-appeals-productive-for-pushing-change-2024-12