Overview
Counterforce Health is a claims technology platform for health insurance policyholders and healthcare providers, operating in the health insurance vertical. The company builds AI software that generates structured, evidence-backed appeal letters to contest health insurance claim denials, drawing on training data from successful appeals, healthcare code databases, external review databases, and insurance litigation records.
The platform accepts uploaded denial letters, medical records, and coverage policies, and produces appeal drafts in approximately two minutes. Letters include legal references, clinical evidence citations, and CPT codes. A companion voice AI agent (Maxwell) is in beta to automate insurer phone follow-up. On the B2B side, the company offers Revenue Cycle Management solutions for hospitals and health systems designed to increase provider productivity in generating and submitting insurance appeals. The service is free for individual patients; B2B revenue cross-subsidizes the consumer product.
Founded in January 2025 in Durham, North Carolina, Counterforce Health has processed over 10,000 appeals with a claimed 75% approval rate. The company has received grant funding from NIH, PennAITech, and the AgeTech Collaborative from AARP, and won first place at The Launch Place IdeaFest pitch competition. Media coverage includes NBC News, CBS, ABC, Fox News, and Axios.
Products & Services
Free Appeal Generator
AI-powered tool that generates legal-grade appeal letters for health insurance claim denials. Users upload a denial letter, medical records, and coverage policy; the system produces a detailed letter with legal references, clinical evidence citations, and CPT codes in approximately two minutes. Completely free for individual patients.
Key Features
- Generates structured three-page appeal letters with peer-reviewed citations
- Built on training data from successful appeals, external review databases, and insurance litigation records
- Claimed 0% hallucination rate with source citations from medical journals and clinical guidelines
Target Users: Individual patients and caregivers
Maxwell Voice AI
Conversational AI agent (beta) that calls insurance companies to follow up on pending appeals on behalf of patients. Automates navigation of insurer phone systems and follow-up on submitted appeals.
Key Features
- Automated outbound calls to insurer phone lines
- Tracks pending appeal status on behalf of patients
- Reduces manual follow-up burden for patients and providers
Target Users: Individual patients
RCM Solutions
Revenue Cycle Management solutions for healthcare providers, including hospitals, health systems, and clinics. Designed to increase provider productivity in generating and submitting insurance appeals.
Key Features
- Claimed 3-5x productivity increase for revenue cycle staff
- Automates bulk appeal generation and submission workflows
- Integrates with existing provider workflows
Target Users: Hospitals, health systems, revenue cycle management companies
Appeals on Wheels
Mobile clinic initiative using satellite internet to bring insurance appeal assistance to rural and underserved communities.
Key Features
- Physical outreach combined with the digital appeal tool
- Serves communities without reliable broadband access
Target Users: Rural and underserved patient populations
Free 1:1 Case Management
Expert human support for complex appeal cases that exceed what the automated system can handle independently.
Key Features
- Direct case support from trained staff
- Handles multi-step or escalated denial situations
Target Users: Individual patients with complex cases
At a Glance
- Founded
- 2025
- Headquarters
- Durham, North Carolina, USA
- Employees
- 1-10
- Funding
- Seed
Category & Focus
- Category
- Claims Technology
- Subcategories
- Appeal automation AI document generation Revenue cycle management
- Insurance Verticals
- Health
- Target Customers
- Consumers, Carriers, TPAs
Customers
- Three unnamed small clinics using the platform regularly for patient appeals (B2B)
- Large healthcare systems and hospital groups (target B2B segment)
- Individual patients (consumer segment -- 10,000+ appeals processed)
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Last updated: 2026-06-13