Holden Karau, a remarkable figure in the tech world, has an intriguing story. She has worked at nearly every FAANG company during the day and dedicated her free time to building a free tool. This tool is designed to address a significant issue - health insurance denials.

Personal Motivation and Journey

Holden Karau's personal experiences with health insurance denials in the US were the driving force behind her creation of Fight Health Insurance. As an open-source engineer in California, she witnessed the challenges and suffering caused by denied claims. These experiences led her to set out on a mission to automate as much of the appeals process as possible.After dealing with her own frustrations in the US healthcare system while seeking trans healthcare and recovering from a motorcycle crash, Karau was determined to make a difference. She said, "I'm not going to put up with this anymore. It's time to fight back." This determination pushed her to turn a simple proof of concept into a consumer product that others could use.Another significant event that pushed her over the edge was navigating her dog's pet insurance. This experience made her realize the need for a more accessible and user-friendly tool. As a result, she decided to make Fight Health Insurance a free service, accessible to the average person.

How Fight Health Insurance Works

Fight Health Insurance is a free AI-powered platform that uses machine learning to streamline the insurance appeal process. It identifies and confirms details using machine learning and pulls data from PubMed with a fine-tuned large language model. The company uses an in-house AI tuned from a base model from Mistral AI to ensure accuracy and efficiency.To ensure patients' privacy, the system helps anonymize information by removing names and addresses. Users can generate an appeal by inserting basic information, uploading a claim denial letter, and, if relevant, their plan documents. Once the appeal is generated, users can review and edit it before mailing it off or having the company fax it for $5. This additional service was added after receiving emails from users expressing the need for a convenient way to submit their appeals.

Impact and Future Plans

With insurers increasingly using AI to sift through claims, Fight Health Insurance offers a way to "level the AI playing field." Karau believes that while doctors should make decisions about medications and diagnoses, there is an opportunity for more AI tools to assist in the grunt work of dealing with insurance. AI could be useful in following up with patients after appointments, reminding them about surgeries or submitting out-of-network provider forms.Currently, the company has two full-time staff and a few part-time contractors. Karau plans to monetize the platform by building a professional version for hospital systems and medical vendors who are also feeling the pain from health insurance denials. She emphasizes the importance of keeping the consumer version free, as patients already pay a significant amount.Since launching the side project in August, over 1,000 people have used the platform to help generate an appeal, and some have shared success stories. Karau is excited to see the impact her tool is having and looks forward to continuing to help people fight against health insurance denials.In conclusion, Holden Karau's story is a testament to the power of innovation and determination. Through her work on Fight Health Insurance, she is making a significant difference in the lives of many.