Fight Health Insurance (FHI) is the name of an AI website with only one purpose: to help you appeal health insurance claim denials. “Make your health insurance company cry too,” is the site’s clever motto.
FHI is the result of an engineer who worked at IBM, Apple, and Google before landing at Netflix. Over the years, Holden Karau had to appeak several health insurance claim denials. Her appeals taught her a thing or two about dealing with health insurance companies.
In addition to familiarizing herself with writing letters and filling out appeal forms, she learned that appealing health insurance claim denials usually works. She won more than 90% of the 40 denials she appealed, and she realized she could deploy an AI chatbot that others could use to fight rejections.
A report from The San Francisco Standard points out two hidden rules of the health insurance industry.
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First, most denials can be successfully appealed. However, most people don’t appeal denied claims, with a study showing that Affordable Care Act patients only appeal about 0.1% of denials. Second, anybody, not just doctors, can file a claim with their insurer. You could do it yourself, just like Karau did.
She actually started helping friends with appeals and then wondered whether she could automate the process. The result is the Fight Health Insurance website. Karau spent a year developing the open-source AI platform before making it available to the general public in the US. The engineer spent about $10,000 to create the service.
Anyone looking to appeal health insurance claim denials can go to this link and enroll to use Karau’s AI for help.
The process involves scanning the insurance denial letter. The AI will then produce appeal letters that can be further edited by the user. The process doesn’t seem any different than asking ChatGPT or a similar chatbot to write a piece of text to you about a specific subject. However, Karau’s AI has been fine-tuned to generate health insurance denial appeals.
Dozens of people have reportedly used the service to generate appeals. Karau is using their feedback to improve the AI platform. Now that people are finding out about it, it’s likely even more patients will use this particular chatbot.
I’ll also point out that the service lets you delete your data once you’re done with generating your appeal.
The FHI website is available for free to anyone using it. A paid version of this health insurance AI chatbot might be available as an app for doctors’ offices in the future.
Finally, you should also know there’s no guarantee that health insurance denial appeals filed with the help of AI will be more successful than appeals you write yourself. But, from the looks of it, you have a great chance of winning your appeal if you file one. That’s the important step.
AI can speed things up for you, especially when dealing with multiple appeals. Just make sure you double-check the text the AI produces to ensure it contains all the relevant information before sending it to your insurer.
