Counterforce Health
Counterforce Health is an American health-technology startup founded in early 2025 in Durham, North Carolina that develops artificial intelligence software to assist patients and clinics in appealing health-insurance claim denials.
History
Counterforce Health was co-founded by Neal K. Shah, Gavry Eshet, Riyaa Jadhav and Maggie Xu in January 2025. The idea for the company arose from Shah’s experience contesting insurance denials during his wife’s cancer treatment, which he described as “[...] people” due to the added stress. A beta version of the company’s AI-driven appeal letter service was tested in the same year at Wilmington Health’s rheumatology clinic. According to WECT, the tool reduced the time needed to prepare appeals and achieved a higher success rate than typical manual processes.
In May 2025, Counterforce Health received first place and a US$5,000 award at The Launch Place’s tenth IdeaFest pitch competition. Media coverage reported that within months of launch, thousands of patients and several clinics had used the service. GrepBeat noted that the approval rate for appeals submitted through the platform exceeded industry averages. According to ABC11, the tool has achieved an estimated 70% claim reversal rate and has been deployed in rural North Carolina through a mobile outreach unit. NBC News highlighted accounts from individual users who said the tool led to faster resolutions of denied claims.
Business model and approach
Counterforce Health operates a web-based platform that uses artificial intelligence to help patients and clinics contest denied health-insurance claims. The system processes denial letters, insurance policies, and relevant medical records, comparing them with medical literature, policy terms, and appeal regulations to generate a customized appeal letter. Its AI models draw on billing code databases, external review decisions, and legal case filings.
The company also develops “Maxwell,” a voice-controlled agent designed to contact insurers for appeal status updates.
The platform is provided free to patients and caregivers, with operational costs covered by CareYaya’s impact fund through grants and donations. The company has indicated that subscription fees for clinics may be introduced for advanced features.
Media outlets have described the product as part of a broader movement toward using artificial intelligence to reduce administrative barriers in health care, aligning with wider adoption of generative artificial intelligence tools in professional settings.
See also
- Health insurance in the United States
- Artificial intelligence in healthcare
- Insurtech
- Patient advocacy