Navigate the healthcare industry
Healthcare Brew covers pharmaceutical developments, health startups, the latest tech, and how it impacts hospitals and providers to keep administrators and providers informed.
A new startup is staking a claim in the making a claim business.
About 17% of adults reported they had at least one claim for treatment recommended by doctors denied in the past year, according to a 2024 survey from the Commonwealth Fund, and less than half those denials were challenged. Among the reasons patients didn’t challenge the denials, according to the research, is because they didn’t know who to contact, didn’t have the time, or didn’t know they had a right to challenge denial.
Further, six in 10 adults said their care was delayed due to insurance denials, but two in five adults who ended up challenging their denial ultimately got the cost cut or covered by their health plan.
That’s why Warris Bokhari founded Claimable, an online platform that helps patients appeal denials for care to treat 70 autoimmune conditions like Crohn’s disease and ulcerative colitis. The company launched on October 2 and is available to consumers nationwide.
Bokhari—who has previously worked at Amazon, Anthem, GE, and Apple—is looking to give patients “a real shot” to get their healthcare covered by their insurer after they’re denied, he told Healthcare Brew.
How it works. When patients want to use Claimable to appeal an insurance denial, they fill out a form online with information about their condition and health plan. The company then reviews that data, and using artificial intelligence, scrapes together information on the health plan as well as state and federal laws to create an appeal letter.
Claimable then submits the letter on behalf of the patient to their insurance. The service starts at $39.95 plus shipping, per Claimable’s website.
Claimable works with all insurance companies, according to a release, including Medicare and Medicaid, UnitedHealthcare, Anthem, Aetna, Cigna, and Blue Cross Blue Shield.
New offering. On November 25, the health tech company unveiled an additional free tool for families and patients diagnosed with pediatric acute-onset neuropsychiatric syndrome (PANS/PANDAS), a condition that is associated with a sudden onset of obsessive-compulsive symptoms or eating disorders in children.
The company created this offering after 13-year-old Gianna Coulter from Idaho was denied intravenous immunoglobulin treatment by Cigna. After several failed attempts to appeal, she was left unable to speak, eat, or walk without her medication.
After seeing Coulter’s father post about the issue online, Bokhari posted about it on X (formerly Twitter) and used Claimable to help her family file an appeal—and won.
The company plans to eventually expand to include denials related to treatments for more conditions including certain cancers and multiple sclerosis, Bokhari said, with the goal to work with 100 conditions by “early 2025,” according to the release.
“We’ve taken the pain out of sending a very well-formulated appeal that represents the true experience of the patient back to the insurer so the patient’s not ignored,” he said.
Other sites including FightHealthInsurance.com and Crosby Health are also helping patients fight health insurance denials.