Breaking Down Barriers: Innovative Ceo Tackles Alarming Rise In Healthcare Insurance Claim Denials

The CEO behind Claimable, Warris Bokhari, is on a mission to tackle the daunting issue of insurance claim denials in the US healthcare system. As a former ICU doctor and two-time transplant recipient himself, Bokhari has seen firsthand the devastating impact of denied claims on patients’ lives.

Denial rates have been increasing for over a decade, with 17% of in-network claims by HealthCare.gov insurers being denied in 2021 alone, according to KFF’s latest report. This alarming trend has created “fearfulness” around getting sick and seeking medical help, as patients feel the weight of uncertainty about their coverage.

Bokhari’s own experience with living with two disabled parents in the UK, where they never went bankrupt due to medical expenses, informs his approach. He believes that in the US, the insurance industry can be a major obstacle to accessing necessary treatments, leading people to abandon seeking care altogether.

Claimable’s AI-driven platform boasts an impressive 85% success rate in overturning claim denials, with patients starting by describing their experience of living with a condition and what it would mean to get denied treatment. The platform then uses AI to analyze millions of data points from clinical research, appeal precedents, policy details, and the individual’s medical history to generate a customized appeal within minutes.

The company aims to make access to justice more affordable and accessible, with most appeals costing just $39.95, plus shipping. Bokhari emphasizes that patients “have a right to be heard,” and Claimable helps legitimize those patients’ stories.

Regulators and industry leaders have taken notice of the company’s success, recognizing that denial cases are often “very private tragedies” happening every day in American life. Claimable has closed its seed round and joined Nvidia’s startup program, backed by Walkabout VC and Humanrace Capital.

The company continues to push the boundaries of AI-driven innovation in healthcare with a team of around 11 employees. Bokhari advocates for a more constructive approach: appealing for justice and support. By harnessing the power of AI, Claimable is revolutionizing the way insurance claims are handled, one patient at a time.