Overturn · In development
Send a photo of the denial letter. Overturn writes the appeal.
An AI agent for health-insurance appeals
What it does
- Status
- In development
- Built by
- The Emerald Foundry
- Area
- Automated decisions
- Output
- A filing-ready appeal, as a PDF
Most denied health-insurance claims are never appealed, and most that are appealed are overturned. The gap is not the merits. It is that the letter is hard to read, the deadline is buried, the regulation that decides the case is one the patient has never heard of, and the appeal has to be written in a form the insurer will accept.
Overturn does that work. A patient photographs the denial letter; the agent reads it, works out the real appeal deadline, asks the questions only the patient can answer, and drafts an appeal grounded in the regulation that governs the plan, delivered as a filing-ready PDF.
How a case moves
04 stepsRead the letter
The denial is photographed and read as a document: the plan, the service, the reason code, and the appeal rights the insurer is obliged to print and usually prints small.
Find the real deadline
Appeal windows depend on the kind of plan, the kind of denial, and the state. Overturn works out which rules apply and gives the patient the date that actually matters, not the one on the letter.
Ask what only the patient knows
The letter never contains the whole case. The agent asks the few questions that change the outcome, in plain language, and nothing it could have worked out on its own.
Draft the appeal, ready to file
A regulation-grounded appeal in the form the insurer must accept, as a PDF the patient can send the same day. The reasoning is shown, so a patient or their doctor can check it before it goes.
The rule it is built against
A right to contest a decision a machine made about you
Insurers increasingly deny claims with automated systems, and the person on the other end appeals, if at all, by hand. Overturn is the Foundry's reference build for the other side of that exchange: what a working right to human review looks like when the patient has an agent too.
The institution has advised on legislation requiring human appeal of automated decisions, including the Algorithmic Accountability Act and the Transparent Automated Governance Act. Building Overturn is how we find out what such a right costs to exercise, and what an insurer would have to disclose for it to mean anything.