Insurance companies are using artificial intelligence (AI) to deny claims, leaving patients without coverage for necessary care. However, entrepreneurs are now developing tools that use AI to help patients appeal denials.
UnitedHealthcare has been criticized for its high rate of claim denials, with some cases using AI to deny patients care. The company’s CEO, Brian Thompson, was fatally shot last week, but the issue of AI-driven denials has been a topic of concern for years.
Entrepreneurs like Holden Karau and Warris Bokhari are now creating tools that use AI to help patients appeal denials. FightHealthInsurance.com is one such tool, which uses AI to analyze patient information and offer pre-written appeals.
Karau, a San Francisco-based software engineer, created the tool after experiencing difficulties in getting insurance coverage for her own medical needs. “I want to increase appeals because I think there are too many denials, and it’s essential that we level the AI playing field,” she said.
Bokhari, co-founder of Claimable, a startup that uses AI tools to fight denials, believes that regulatory changes are needed to address the issue. “We’re not going to fix health insurance with AI, but I think we can make it more accessible with AI,” he said.
Claimable has filed hundreds of claims and achieved a success rate of over 85%. The company’s goal is to add more than 100 conditions in 2025, expanding its services beyond rheumatology patients.
The issue of AI-driven denials highlights the need for greater transparency and accountability in the healthcare system. As the use of AI in insurance continues to grow, it’s essential that patients have access to tools like FightHealthInsurance.com to appeal denials and ensure they receive necessary care.
Source: https://www.forbes.com/sites/amyfeldman/2024/12/11/these-entrepreneurs-are-using-ai-to-fight-health-insurance-claims-denials