I saw a segment of the evening news about using AI to fight insurance denials that I found interesting.
Here’s what ChatGPT had to say about with AI programs are best for this:
" 
Types of AI Tools Available
A. Appeals Drafting & Analysis AI
- Helps draft appeal letters and analyze denial reasons.
- Some also scan EOBs (explanation of benefits) and denial codes to match the correct arguments.
B. Claim Tracking AI
- Monitors claim status and flags denials automatically for rapid appeal.
- Can detect patterns of improper denials.
C. Legal AI Tools
- Used by attorneys to cite case law and insurance regulations automatically for stronger appeals.
Best AI Programs Currently Available
For Health Insurance Denials:
Resolve (getresolve.com)
- Uses AI + human advocates to appeal medical insurance denials.
- Handles out-of-network bills and denial appeals.
Health AI Services in Navina, AKASA, and Olive AI
- These are typically used by providers to fight payer denials automatically.
- If you are a medical office or hospital, these reduce denial rates and automate appeals.
Denial Management Modules in RPA Tools
- Tools like UiPath and Automation Anywhere can be trained with custom AI to appeal denials in bulk.
For Auto & Homeowners Insurance Denials:
DoNotPay (donotpay.com)
- Offers automated appeal letters for denied claims, small claims filing, and regulatory complaint letters.
Justly
- AI platform designed to handle insurance disputes and generate demand letters, though more oriented to auto claims and property damage disputes.
Legal AI:
If you are working with an attorney or handling complex, high-dollar denials:
- Harvey AI (for legal drafting and analysis).
- Casetext CoCounsel (now under Thomson Reuters, can help prepare legal briefs for denial litigation).
- Spellbook (for contract analysis if denial involves policy interpretation).
Considerations Before Using These Tools
Confirm your policy and denial reason precisely. AI is only effective if your inputs are accurate.
Know your appeal deadlines (often 30-180 days).
AI is a tool, not a guarantee; sometimes you may still need a human advocate or attorney, especially for repeated or complex denials.
Key Tip:
Start with DoNotPay if you are an individual consumer needing a simple letter,
or Resolve if it is a healthcare denial you want handled automatically.
For medical providers, consider Navina, AKASA, or Olive AI.
For law offices, Harvey AI or Casetext CoCounsel will streamline complex denial litigation."
Insurance companies have been accused of using AI to generate denials.
Well, quid pro quo’‘’‘’