1. America’s Silent Epidemic: Automated Claim Denials
Nearly 1 in 5 insured Americans will see at least one medical claim denied this year—often in milliseconds by black-box algorithms rather than physicians. (ABC11 Raleigh-Durham) When denials hit, most families never appeal, even though 75 % of appeals succeed. (Counterforce Health) The result is a stealth tax on cancer patients, parents of chronically ill children, and anyone unlucky enough to collide with a bot that says “no.”
2. Counterforce Health Flips the Script With Patient-First AI
The ABC 11 WTVD segment introduces Counterforce Health, a nonprofit born in Research Triangle Park that “uses the very same AI insurers deploy—only to help patients fight back.” (ABC11 Raleigh-Durham) Co-founders Neal K. Shah, Riyaa Jadhav and Gavry Eshet built the platform after watching automated denials add mortal stress to Shah’s wife’s cancer battle:
“I was spending four or five hours a day arguing while she was in the ICU. The stress alone is killing people.” — Neal K. Shah (ABC11 Raleigh-Durham)
Today, the free web app drafts legal-grade appeal letters in minutes, achieving a 70 % reversal rate across thousands of denials. (ABC11 Raleigh-Durham, Counterforce Health)
3. How the Tool Works
| Step | What You Do | What Counterforce AI Does |
|---|---|---|
| Upload Docs | Drag-and-drop your denial letter & plan booklet. | Parses every clause to locate policy violations. |
| Review Draft | Skim an automatically generated appeal letter. | Cites federal regs, CPT codes & evidence-based guidelines. |
| Send & Track | Print, e-fax, or portal-upload the appeal. | Notifies you when the insurer responds—usually within days. |
The system is trained on thousands of successful appeals and updated with new legal precedents weekly. (Counterforce Health)
4. Beyond the Screen: Appeals on Wheels
Denials hit hardest in internet-scarce counties, so Counterforce retrofitted a mobile clinic—“a box truck with satellite internet and AI inside”—to serve rural North Carolina. (ABC11 Raleigh-Durham, Counterforce Health) Patients walk in with a paper denial and leave with a printed, evidence-packed brief ready for certified mail.
5. Real-World Wins Highlighted by ABC News
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$18 k-per-month cancer drug — After three automated refusals, Counterforce’s appeal forced coverage, saving the family six figures a year. (ABC11 Raleigh-Durham)
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Rapid ICU approval — A same-day reversal prevented a critically ill patient’s transfer to a lower-acuity ward.
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Clinic productivity — A Johns Hopkins–trained navigator now “generates 15–20 appeals a day,” quadrupling her previous throughput. (https://www.wect.com)
6. Why This Matters Nationally
Regulators and journalists are sounding alarms about insurer use of AI to rubber-stamp rejections at scale. (The Guardian, Financial Times) Counterforce Health offers an immediate countermeasure while broader policy reforms grind through Congress and the courts.
7. Try It—It’s Free
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Visit CounterforceHealth.org
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Click “Start Free Appeal.”
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Let AI do the paperwork so you can focus on healing.
No credit card. No upsell. Just an evidence-based path to “Yes.”
8. Final Word
“Sometimes when enough people get loud, society wakes up,” Shah told ABC 11. (ABC11 Raleigh-Durham) With Counterforce Health, that collective voice is now amplified by algorithms every bit as sophisticated as the ones denying care.
Need help today? Upload your denial at Counterforce Health and join the growing counter-force turning AI into a tool for justice.