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.
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?
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.
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.
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?
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.
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 ^
This is for Claimable:
We make it easy to appeal denied health claims
https://www.getclaimable.com
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?