AI Steps In to Fight Health insurance Denials as Costs Soar
WASHINGTON – Facing a surge in healthcare costs and increasingly frequent insurance denials, a new artificial intelligence platform called counterforce Health is offering free appeal drafting services, aiming to level the playing field for patients who often can’t afford professional help. The move comes as average out-of-pocket healthcare spending reached $1,425 per person in 2022, according to a recent report from the Kaiser Family Foundation (KFF).
For many Americans, especially those with low or middle incomes, the added expense of hiring someone to write an appeal – typically ranging from $300 to $1,000 – is prohibitive. This effectively limits access to potentially life-saving treatments and medications. “Right now,appealing is really for the rich,or I would even say the ultra-rich,” says counterforce Health founder,Shah. “To solve this problem, [we had] to figure out a way to do it for free or dirt cheap because peopel don’t have $300 to spend on a patient advocate when they can’t afford the medicine they critically need. We thought AI would be the perfect use case as the ongoing cost per user is literally pennies.”
Counterforce Health works by collecting personal and health-related data – including insurance details, denial letters, and medical background - to generate a draft appeal letter. The company emphasizes data security, stating it does not sell user information, utilizes encryption, and adheres to confidentiality and legal compliance requirements. Users can access the service by visiting the Counterforce Health homepage and completing a brief questionnaire, followed by uploading their denial letter and insurance information. The AI then generates a fully drafted, editable appeal ready for submission.
Currently, Counterforce Health intends to remain free for individuals, offering a potential lifeline for those navigating the complex and often frustrating process of challenging insurance decisions. The platform’s emergence highlights a growing trend of leveraging AI to address affordability and access issues within the healthcare system.
