From TIME · Alana Semuels · · 2m
AI tools help patients fight insurance denials
As health insurers use AI to reject claims, patients are turning to AI services to appeal those denials and recover coverage for medications and procedures.
In brief
As health insurers use AI to reject claims, patients are turning to AI services to appeal those denials and recover coverage for medications and procedures. AI tools like Claimable and Fight Health Insurance help patients appeal insurance denials for medications and procedures, reversing rejections that patients…
Denied the drug that worked
Tom Whitehead switched insurers in 2025 and was denied coverage for Remicade, the expensive medication he received monthly for his Crohn's disease.
The biosimilar made things worse
The biosimilar did not work well for Whitehead.His symptoms worsened, he had urgent and unpredictable bowel movements, and he got kidney stones twice, ending up in the hospital.
He turned to AI for help
Whitehead found Warris Bokhari, founder of Claimable, an AI tool that helps people appeal insurance denials for medication and other treatments.
Five days to approval
Five days after Claimable sent the appeal letter, Whitehead's doctor's office called to say his Remicade had been approved. He now receives injections every five weeks or so and says he feels much healthier.
Most people don't appeal denials
A survey of more than four thousand five hundred U.S.working-age adults with private health insurance found that twenty-one percent reported a denial of coverage in the past year.Only about half of them appealed it.
Why people don't fight back
People often don't appeal denials because it can be intimidating to know what paperwork to file, and bills can pile up.
The cost of denials
About forty-three percent of people in the survey said a claim denial led them to incur medical debt.Half of those bills were one thousand dollars or more.Sara R.
“It's not insignificant sums of money when you end up with a denial of care.”
Four AI tools for patients
Claimable helps appeal coverage denials for about forty dollars per appeal.Fight Health Insurance is free.Billyze searches hospital bills for errors for seventy-nine dollars per report.
When AI became good enough
Using AI to help with medical bills only became realistic in the last few years.
“That's when the models got good enough that it was like, yeah, we can actually do this, let's make it available for people to use.”
The founders' bigger hope
Bokhari hopes his AI tool won't need to exist someday.If it becomes more expensive for insurers to deny care than to pay for it, they may approve more claims.
“We hope that this bends our system back towards reality, where denying patients at massive scale starts becoming a problem for the insurers because it's driving a cost line for them.”
The takeaway
AI tools like Claimable and Fight Health Insurance help patients appeal insurance denials for medications and procedures, reversing rejections that patients rarely challenge alone.
