Battling health insurance denials might seem overwhelming, but one software engineer is determined to tip the balance.
Holden Karau, who built FightHealthInsurance.com, knows firsthand the hurdles of claim rejections, especially as a trans person navigating the American health care maze. She started the site after her own claims were denied, including treatments for injuries from when she was hit by a car.
With over a decade at top tech companies like Amazon, Google, Apple, and Netflix, Karau has plenty of experience handling data and creating machine learning tools. She once joked that she might be the rare person who loves paperwork, yet she saw how it could be weaponized against patients.
Karau’s frustration became a mission: use artificial intelligence to help everyday people appeal claim denials. FightHealthInsurance.com is a free platform where patients can upload denial letters and get clear, tailored appeal drafts—with AI doing most of the heavy lifting.
The tech world is buzzing about her site, but scrutiny of insurance company practices has also surged recently. News coverage shot up after a tragic incident involving a UnitedHealthcare executive, focusing public attention on insurers’ methods.
Automating Denials and the Growing AI Debate
There’s growing evidence that insurance companies are already using advanced algorithms to review—and often reject—claims. According to a Senate report, AI tools have driven denial rates higher among Medicare Advantage subscribers, with UnitedHealthcare doubling their denial rate for post-acute care between 2020 and 2022.
UnitedHealthcare reportedly adopted a prediction tool called nH Predict, which sifts through vast amounts of data to make coverage recommendations. Critics say these AI-powered systems make errors, and lawsuits claim that the models often override clinicians’ professional judgement, pushing managers to follow the algorithm over medical advice.
Appealing denied claims can feel like bringing a typewriter to a computer fight, Karau points out. Insurance giants have near-instant access to mountains of data and leverage technology most patients do not even understand.
FightHealthInsurance.com is designed to close that tech gap. Users just upload their denial, check the AI’s summary for accuracy, and can then add any supporting documents.
The website creates several draft appeals, and patients can pick, tweak, and finalize their response. Those without a printer or fax at home can even have the machine transmit the letter directly for a small fee.
Karau says she regularly hears from users who succeed in getting their care covered. She recalls a recent story: a motorcycle rider denied crucial back surgery finally got approval after using one of the site’s AI-drafted appeals.
A version for doctors is in the works, aiming to help providers fight for their patients too.
Karau believes these kinds of tech-driven efforts could profoundly shift the balance. For her, each successful appeal makes it just a bit harder for insurers to unjustly deny care, and that might be what sparks real change in the future, especially given how an AI tool helps individuals fight denied insurance claims. This connects with the ongoing conversation around AI chatbots and medical advice challenges in our health system.
