What You Should Know:
– Claimable, a healthcare technology innovator, is taking on the pervasive issue 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 generate and submit customized appeals in mere minutes.
Combating a Broken System
The U.S. healthcare system is plagued by an alarming rate of claim denials. Every year, a staggering 850 million out of 5 billion health claims are denied, leading to significant consequences for patients:
- Delayed care: 60% of patients experience delays in receiving necessary treatment.
- Worsened health: 47% report a decline in their health condition due to denied claims.
- Financial burden: Medical debt contributes to 66% of personal bankruptcies in the U.S.
Claimable aims to address this crisis by empowering patients to fight back against unjust 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 Pilot Program
Claimable’s pilot program demonstrated impressive results, exceeding industry standards by a significant margin:
- 80% appeal success rate: 1.6 times higher than the average.
- Resolution in under 10 days: 3 times faster than the average.
- Appeals submitted in minutes: Eliminating the lengthy delays associated with traditional appeals processes.
- Nearly $3 million recovered for patients: Demonstrating the platform’s potential to alleviate financial burdens.
Focusing on Critical Needs
Currently, Claimable supports appeals for 60 life-changing treatments, with a focus on commonly denied medications for autoimmune diseases and migraines. These conditions affect approximately 65 million Americans, with women disproportionately represented at 80-85%.
Claimable plans to rapidly expand its support to over 100 treatments by early 2025, including those for Multiple Sclerosis, Cardiac Diseases, Diabetes, Obesity, Asthma, and certain cancers.
A Personalized and Efficient Approach
Claimable’s platform offers a user-friendly, guided appeal builder with features such as:
- Smart document scanning: Simplifying the process of gathering necessary information.
- Dynamic health questionnaire: Tailoring the appeal to the patient’s specific circumstances.
- Instant evidence matching: Identifying 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, generating compelling, fact-based narratives for each appeal.
Nationwide Availability and Affordability
Claimable is available to patients across the U.S. and accepts denials from all insurance providers, including Medicare, Medicaid, and major private insurers. The platform prioritizes affordability, charging a fee of $39.95 per appeal plus shipping.
“At Claimable, we’re harnessing 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, ensuring every patient can reclaim control over their healthcare and get the treatment they’re owed.”