Tech Worker Builds Free AI-Powered Tool For Fighting US Health Insurance Denials

The online news site San Francisco Standard profiles an open-source platform 'that takes advantage of large language models to help users generate health insurance appeals with AI...

'A Fight Health Insurance user can scan their insurance denial, and the system will craft several appeal letters to choose from and modify.'

With the slogan 'Make your health insurance company cry too,' [San Francisco tech worker Holden Karau's site] makes filing appeals faster and easier. A recent study found that Affordable Care Act patients appeal only about 0.1% of rejected claims, and she hopes her platform will encourage more people to fight back...

The 'dirty secret' of the insurance industry is that most denials can be successfully appealed, according to Dr. Harley Schultz, a patient advocate in the Bay Area. 'Very few people know about the process, and even fewer take advantage of it, because it's rather cumbersome, arcane, and confusing, by design,' he said. 'But if you fight hard enough and long enough, most denials get overturned....'

While some doctors have turned to artificial intelligence themselves to fight claims, Karau's service puts the power in the hands of patients, who likely have more time and motivation to dedicate to their claims. 'In an ideal world, we would have a different system, but we don't live in an ideal world, so what I'm shooting for here is incremental progress and making the world suck a little less,' she said.


Karau estimates she's spent about $10,000 building the platform, according to the article, which adds that 'it's free for users, though she might eventually charge for added services like faxing appeals.'

Thanks to Slashdot reader mirro_dude for sharing the news.

Read more of this story at Slashdot.