Claimable
AI-powered appeals platform overturns insurance denials at scale for pharma hubs, providers, and patients.
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Proprietary AI model with purpose-built database for 80%+ win rate
Key Differentiators
- Proprietary AI model with purpose-built database for 80%+ win rate
- scales without added headcount
- patient-led appeals leverage legal protections
- pharma-grade analytics/insights from appeals data
Overview
Claimable provides an AI-powered platform that generates and submits customized insurance denial appeals for patients, providers, pharma patient support teams, hubs, and specialty pharmacies. It analyzes clinical research, policies, precedents, and patient stories to create appeals challenging reasons like medical necessity, step therapy, and formulary exclusions, with ~80% success rate and resolutions often under 10 days. Services include patient self-service appeals ($39.95), provider referrals, enterprise platforms for health systems, and integrations/API for pharma hubs/specialty pharmacies to scale appeals, track outcomes, and gain denial analytics.
Services & Capabilities
- AI-generated customized appeals submission (fax/mail), denial tracking/dashboard, strategic denial analytics, provider/health system enterprise tools, pharma/hub/specialty pharmacy integrations/API, free appeals for specific conditions like PANS/PANDAS.
Competitive Position
- Proprietary AI model with purpose-built database for 80%+ win rate
- scales without added headcount
- patient-led appeals leverage legal protections
- pharma-grade analytics/insights from appeals data
Recent Developments
• Sep 2024: Platform launch • Oct 2024: AI appeals launch, 60+ treatments, 1.6x success rate • Feb 2025: WSJ feature on denials, patient wins vs UHC using Claimable • Mar 2025: HIMSS25 AI panel w/ CEO • 2026: Fierce 15 list
Client & Partner Ecosystem
None publicly named; integrates with pharma hubs, specialty pharmacies, manufacturer programs
Technology Platform
Appeals Hub (AI appeals platform)
Therapeutic Focus
Autoimmune/rheumatology, migraines, asthma, GLP-1s/obesity/diabetes, expanding to oncology, MS, cardiology
Target Customers
Patients, healthcare providers/health systems, pharmaceutical patient support/hub teams, specialty pharmacies
Sources
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