AI Startup Has Helped Reverse Thousands of Denied Health Insurance Claims

Since he was 12, Bryan Kopsick has gotten an infusion of a drug called Remicade every eight weeks to control his Crohn’s disease, a painful bowel inflammation that can cause severe diarrhea. The medication lets Kopsick, now 30, caddy professionally on the PGA Tour and at other golf tournaments. This Jan. 1, however, his health insurance changed, and the new company, UnitedHealthcare, wanted him to try cheaper alternatives to Remicade, which costs tens of thousands of dollars a year. “My heart started beating fast,” Kopsick says. He didn’t want to mess with a treatment that had worked for more than half his life. The only time he’d missed a dose, he’d developed another inflammatory condition that caused painful cysts. Now, Remicade was controlling that too.

“You don’t know what you’re going to do,” Kopsick recalls of the moment of panic. “You know you’re going to be screwed.” A UnitedHealthcare rep was supportive but powerless to override the denial, he says. And sure enough, Kopsick developed new cysts in February, not long after missing his dose. It was then that he began speaking with Warris Bokhari, a British doctor and entrepreneur. Three years ago, Bokhari co-founded Claimable, a company that helps patients appeal their health insurance denials using artificial intelligence. He also works directly on appeal letters that his company hasn’t yet fully automated, what Bokhari calls “hand-to-hand combat” with insurers.