New AI startups are transforming healthcare insurance by automating the appeals process for denied claims, generating letters and escalating cases faster and cheaper than manual efforts. Companies like Claimable use AI trained on insurance laws and medical data to produce appeal letters, achieving a 75% reversal rate on denials for conditions and treatments covered. This innovation helps patients who rarely appeal denials, often successfully, and is expanding into enterprise deals with drugmakers and hospitals to scale volume. The technology also supports litigation against wrongful denials, signaling a structural shift in how insurance claims are contested amid growing AI use on both sides of the process.
Aetna's latest survey shows U.S. healthcare providers' trust in payers increased to a score of 6.1 from 5.4, reflecting improved perceptions of payer reliability and communication. Providers highlight technology's role in reducing administrative task...
CVS Caremark announced a global settlement with the Federal Trade Commission (FTC) resolving all litigation related to rebate practices, pharmacy network contracting, and vertical integration. The agreement ends ongoing investigations and allows CVS ...
