Transforming Health Insurance Appeals with AI-Powered Solutions

About

Theoretically, insurance makes healthcare affordable; in reality, patients are often denied care that has been recommended by their physician. These denials are vague and confusing, and 47% of patients who did not appeal their denial did not receive care. The appeal process is overwhelming: the language is confusing, the process is opaque, and the system works against patients.

Claimable leverages AI technology to make the appeal process simpler and more effective. In collaboration with Claimable, we focused on defining their brand language and designing the initial user experience of their product. The aim was to better understand the wants, needs, and desires of potential customers, and to assist the Claimable team in communicating the product's value to potential investors.

Challenge

Navigating the complex maze of health insurance appeals

The health insurance appeal process is extraordinarily confusing to understand, which made creating prodoct flows tedious.

Business Value

Simplifying insurance appeals with direct-to-consumer solutions

Claimable offers a direct-to-consumer model that provides a simple way for patients to describe their denial experience in simple language, and receive a comprehensive denial appeal letter.

User Value

Patients can receive the care they need and deserve

Claimable simplifies and automates the complexities of health insurance appeals and removes the burden of proof from the patient, ensuring timely and comprehensive support to patients deserving of care.

Building Claimable's Brand Identity and User Experience

The team worked with Claimable to develop their brand identity, including the company's voice, look and feel, and how these elements come together in the product. We created a detailed brand strategy that included basic principles and a brand personality framework.

We focused on defining unique brand traits, using language that connects and motivates, developing different voices for various situations, and identifying key messages for the target audience. We also outlined the overall communication style and provided examples to ensure consistency.

Building a strong visual identity

Claimable's visual identity involved logo creation, defining colors, typography, and illustration style. We then extended the brand across the product and marketing touchpoints.

Designing the MVP: a user-centric approach

Our work on Claimable's MVP focused on developing a seamless, AI-powered platform to help users secure the care they deserve. The platform analyzes clinical research, policy details, appeals data, and personal medical stories to generate customized appeals in minutes. Users upload a denial letter, answer simple questions, receive an expert appeal, and a guide to submitting.

Key elements of the product

Simple and fast entry of the patient-experience information necessary produce a claim appeal letter. Clear indication of progress, along with periodic moments of encouragement, to help a patient see positive advancement towards their goal. A fair payment process, making it clear what a patient is purchasing and why it's valuable.

Finding success in getting patients the healthcare they deserve

Since launching, Claimable has achieved an 80% case success rate, saving patients nearly $1M, and have won TAI’s 2024 Prometheus Award.

Let's talk!

I'm currently looking for a full-time role and am open to freelance opportunities. Send me a message if you'd like to work together!

Or email me at swava.pearl@gmail.com.