Health AI Startup Has Helped Reverse Denied Health Insurance Claims | Hacker News Reader

Health AI Startup Has Helped Reverse Denied Health Insurance Claims

bloomberg.com

21 pointspir8life4me13 comments

Arms race framing misses it. Insurers have used algorithmic denial scoring for years (ProPublica/Cigna-EviCore, StatNews/UnitedHealth-NaviHealth). Denial works because appealing is expensive for patients and near-free for insurers. Claimable inverts that cost. End state isn't that insurers pay more. It's more like "insurers deny less aggressively up front."

Isn't this just going to become an arms race... one side's AI denies the claim and provides justification, the other side's AI drafts a rebuttal, and so on and so on.

This is for Claimable:

We make it easy to appeal denied health claims

https://www.getclaimable.com

It's amazing how so much of healthcare tech is designed to plug holes in a healthcare system that's very specific to the US.

Personally I'd be worried about growth if I were a founder: can this expand to other countries? What if the US moves to a public healthcare system one day?

On the other hand, healthcare administration headcount has grown over 1000% since 1970, and few things grow as fast. Feels like plenty of runway.

This ^

Health Tech Product Builder here - thinking about expansion outside of the United States is a champagne problem that they can solve later and also:

lol on public option. We are barely keeping the lights on at the FDA, CDC and VA. The administration is trying to defund every public service it can think of.

reversing denied health insurance claims only changes who pays for it (end of the day premiums will probably go up proportionatly), it does nothing to reduce the overall cost which is a much bigger problem.

I can imagine one person in this arrangement who cares quite a lot about who pays.

"oh this is a great idea!"

> visits claimable website

> my condition isn't on there

> I click "I cant find my denied care"

> Get a form to request a new treatment

> I have to pick the treatment from a pre-filled dropdown list

> it's not there

boneheaded design, how am I going to request a new treatment if i have to pick from your supported treatment list. Slop

These tech solutions for social/political problems are astonishingly wasteful.

Capitalism is so ridiculously inefficient

Compared to what, and measured by what?

In this case, socialized medical insurance, like all other developed countries have.

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