Over 70% of patients referred to Claimable complete and submit an appeal, with more than 80% submitted same day
SAN FRANCISCO, April 23, 2026 (GLOBE NEWSWIRE) — Claimable today announced the debut of its enterprise patient access platform, purpose-built for pharmaceutical manufacturers, health systems, and access partners, including specialty pharmacies and patient support hubs.
The AI-powered platform extends patient access programs beyond prior authorization, automating the appeal layer that sits between a patient’s prescription and coverage for their needed therapy. By integrating directly into existing patient support programs and revenue cycle operations, Claimable addresses the growing denial problem without adding headcount or replacing existing systems.
Denials are now the leading cause of treatment delays and patient dropout in specialty care. Denial rates are rising 25% year over year as payers increasingly leverage AI to automate claim reviews. The support infrastructure most manufacturers and health systems rely on was built for a different era. Call centers, manual workflows, overstretched clinical staff, disconnected case management: none of it was designed to keep pace with AI-powered denials. As a result, 99% of denials are never challenged, and 46% of patients abandon treatment after a denial, leaving medically necessary therapies out of reach for millions.
Claimable covers more than 85 commonly restricted treatments spanning asthma, obesity, diabetes, autoimmune disorders, and rare pediatric diseases. The enterprise platform is already live across 10 programs supporting treatments used by over one million patients nationwide, where initial denial rates can reach 70%.
“Insurers have figured out how to use AI to deny care at scale, while everyone else is left trying to fight back one appeal at a time,” said Warris Bokhari, MD, CEO and Co-Founder of Claimable. “The asymmetry is stark — denials are automated, but appeals are not, and that breakdown puts lives at stake. Patients are left to make impossible choices: delay treatment, pay out of pocket for medications that can cost more than $1,000 per month — or walk away from care altogether. We built Claimable to restore that balance of power, using AI so appeals move as fast as denials do, at the scale the problem demands.”
Most denied patients receive no appeal support at all, and those who do wait days or weeks for a provider to prepare and file. By contrast, Claimable scales appeal support to every denied patient, cutting the time between denial and treatment initiation. More than 70% of patients referred to Claimable complete and submit an appeal, with more than 80% submitted the same day.
Across established conditions, Claimable has achieved success rates exceeding 80%, with denials overturned in under 10 days on average. To date, the platform has recovered more than $30 million in previously denied care, reducing treatment delays, improving patient retention, and saving access and clinical teams hours of administrative work per appeal.
The process begins with flexible intake, allowing patients to enter through direct links, support team referrals, or API-based integrations with existing workflows. A guided, self-service experience allows most patients to build a personalized appeal in under 30 minutes.
Claimable’s AI appeal engine generates a case-specific appeal by combining three layers of evidence: the patient’s personal health narrative, a curated library of clinical studies and guidelines, and laws and health plan policies. Each appeal is matched to the exact treatment, condition, insurer, and denial reason, producing millions of bespoke strategy combinations.
The platform also provides enterprise teams with a set of operational tools to support patients throughout the appeals process:
- Enterprise operations console: centralized management layer supporting referral submission, document upload, real-time case tracking, and outcome visibility with role-based access controls.
- Program dashboard: aggregate, de-identified reporting to continuously optimize access strategies, including denial patterns and outcomes, conversion, and engagement analytics.
- Access content suite: branded landing pages, advocacy resources, training guides, call scripts, and email templates, all built to medical-legal review and compliance standards.
Security, governance, and safety oversight are native to the platform, including HIPAA-compliant hosting, SOC 2 Type II certification, consent management, audit trails, and AI-powered pharmacovigilance workflows that monitor patient-reported responses against FDA adverse event data.
Each enterprise deployment is assigned a named appeal specialist available to review escalated cases and adjust appeal approaches as payer behavior changes.
To learn more about how Claimable supports pharmaceutical manufacturers and health systems, visit getclaimable.com/for-pharma and getclaimable.com/for-health-systems.
ABOUT CLAIMABLE
Claimable is an intelligent patient access platform that closes the gap between the care patients are prescribed and the coverage they receive by challenging insurance denials at scale. Leveraging purpose-built AI and automation, the platform analyzes clinical research, policy details, appeals data, and patients’ unique medical histories to generate and submit customized appeals in minutes. Available nationwide, the platform supports denials from all insurance providers, including Medicare and Medicaid. Claimable has been recognized by Fierce Healthcare’s Fierce 15, Fast Company’s World Changing Ideas, and TIME100 Health for its leadership in patient access innovation. Backed by Quiet Capital, Next Level Ventures, Walkabout VC, Great Oaks, and others, the company continues to push the boundaries of AI innovation in healthcare. To learn more, visit www.getclaimable.com.
Contact:
Emily Fox
press@getclaimable.com
