New Company Fights Insurance Denials for $50 with 80% Success

Living in a country with a for-profit healthcare system brings with it extreme frustrations and confusion when it comes to dealing with health insurance companies. Every American undoubtedly has a horror story about navigating the labyrinth of prior authorizations, referrals, out-of-network providers, deductibles, and copays. Every American must become an expert in their own individual health insurance policies. Dealing with all the nuances and bureaucracy of the health insurance industry, especially when you need immediate healthcare or worse, an emergency, can be a daunting task.

However, one company has emerged in recent months to try to ease the burden of navigating the American healthcare system. Utilizing industry knowledge, modern technology, and existing regulations, Claimable helps patients overcome health insurance denials at an affordable cost.

Founded by a medical doctor, data scientists, and a medical product expert, Claimable uses the power of artificial intelligence and industry knowledge to help patients fight many health insurance denials. Co-founder Zach Veigulis states that in the U.S., there are roughly 850 million health insurance denials per year, representing approximately 17% of all claims made annually.

"Of those 850 million denials, less than 2 million appeal every year," Veigulis said to The Mirror U.S.. "To put it another way, 99.9% of denials are essentially unchallenged. And you know, the reason why is most people don't know they can appeal, and if they didn't know they could, they wouldn't know how."

Seeing this, Veigulis and his co-founders sought to fill a much-needed gap in the market, helping people who otherwise would not have known of their right to appeal their denial, fight back against insurance companies who fully expect their customers not to appeal their decisions.

"So you would come to Claimable either from a referral from, you know, let's say, a physician or a pharmacy, or even just finding us on your own, we would ask you questions about your specific denial," Veigulis said. "We would ask you questions that, really, anybody could answer who has that condition, who's suffering from that condition, about, you know, what they've tried and failed, what their symptoms are, and then also things about their life, their impact, right?"

"They're no longer able to work as they used to. They may be estranged from their family. They're, you know, anything that impacts them in that space takes about 25 to 30 minutes," he continued. Veigulis said the company then takes that information and cross-references it with a patient's specific insurance policy, utilizing AI to identify the most relevant medical evidence to support the patient's appeal.

"So scientific, peer-reviewed studies, cases also where the insurers have been beaten in the past for similar situations," Veigulis said. "We take that and we construct an appeal letter for you. This all takes, you know, from like, end to end, getting to finish somewhere around, you know, between 25 and 45 minutes, depending on how long your story is, and then we also, we send that to your insurer, but we also suggest other places for this to go as well."

Veigulis said that service is provided for just $50 on average, including shipping and handling for mailing all patient documentation and appeal letters to the insurance company. According to him, since its founding in October 2024. The company can now assist with about 70 different conditions, mainly related to denials involving preventively expensive medications and medical treatments that insurance companies often deny, claiming they are not medically necessary.

Veigulis says the company has achieved an approximately 80% success rate since launching last year in overturning denials. One of the patients who spoke with The Mirror U.S. for this story detailed her experiences with the company on getting a denial of a medication she had already been taking for six months.

Patty, who did not wish to give her last name or disclose what condition she was taking medication for, said that she was approved for the medication for six months beginning in January 2025. "The insurance, pretty much I knew was always going to deny it at first and request a prior authorization, which they did in January and which they approved upon receiving the prior authorization from my doctor's office," she said.

"They approved it for six months, and then, when it came time for the new prior authorization that was needed, they had my doctor's office submit it for another six months, and they denied it this time and said they were no longer covering this medication," Patty added. According to Patty, her quality of life had significantly improved by being on the medication, and she couldn't imagine going back to the life she had before beginning the medication.

"I was just working so hard, so hard, and just that alone, it was just I couldn't imagine having to do this journey without the benefit of this medication," Patty said. "So now I'm thinking, Oh God, I'm not going to get this, I'm not going to have this tool. I'm working my butt off with this walking program and dietary changes. Still, I know once I start taking this, it's going to reduce my success in my cardiovascular health significantly."

Feeling devastated, helpless, and overwhelmed by the appeal process, Patty was making little progress with her insurance company. On a whim, she decided to Google how to appeal an insurance claim, and Claimable came up.

"I was like, huh, and it was incredible. The interface was extremely user-friendly. I could not get over how incredibly simple it was to," Patty said. "I found it, I completed it, and it probably took me 20 or so minutes, and it gave me a comprehensive appeal letter."

She said that within 24 hours, her insurance company contacted her to let her know they had received her appeal. Then, a few days later, her medication was approved. She said her doctor's office couldn't believe how quickly the process took.

"I think it's remarkable. I think you are getting far more benefit. And I mean, I know it all sounds like a commercial, but like, I've paid far more for a hell of a lot less in my lifetime," Patty said. Veigulis said that the company is working to expand its coverage to more insurance networks, medications, and health conditions over the next year.

"We'd love to expand across, you know, all conditions, frankly. And you know, we have a vision that we can, you know, right now there's really kind of two options when you're faced with the denial, right? Many times, it's a matter of paying out of pocket or not receiving care." Veigulis said. "Yeah, and we want in every encounter, whether that be at the pharmacy window, whether that be in your provider's office, sitting on the exam table, whether that be you sitting on your couch, opening your mail, receiving the denial, wherever denials happen."

"We always want there to be a third option, and people to know that they can fight back," he added. Anyone interested in utilizing Claimable's services can visit their website to start their claim.