How AI Can Help You Appeal Health Insurance Denials
Health insurers are using AI to deny care. You can use it to fight back.
Tom Whitehead, who lives with Crohn's disease, was denied coverage for the expensive medication Remicade after switching insurers in 2025. The newer biosimilar drug didn't work for him, causing worsening symptoms, urgent bowel movements, and kidney stones. His doctor's office appealed the denial, but the insurance company upheld it.
Whitehead turned to AI for help. Claimable, an AI tool, drafted a letter explaining his experience with the biosimilar drug, detailing missed work days and citing federal statutes to argue that the insurer should cover this "medically necessary drug." Five days later, his Remicade was approved. Health insurers are increasingly relying on AI to evaluate claims for drugs and treatments, but patients are also using AI to fight denials.
Services like Claimable, Fight Health Insurance, Mediloop, and Billyze help people understand their medical bills and challenge improper denials. Despite a survey finding that 21% of Americans experienced a denial in the past year and only half appealed it, many feel helpless when faced with medical bills and denials. AI tools can offer guidance, but each has a different approach.
Claimable costs $40 per appeal, while Fight Health Insurance is free and Billyze costs $79 per bill report. Mediloop charges $129 for bill negotiation and offers an annual household plan. These tools use AI to help patients argue against insurers' denials by analyzing regulatory language and other publicly available data to build effective appeal letters.
Written by urgent.news from Time's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
