How AI Reversed Sarah’s $18,000 Denial and Saved Her Treatment Timeline
Sarah T., a vibrant 58-year-old art gallery manager, was facing a recurrence of ovarian cancer. Her oncologist recommended a specialized chemotherapy regimen combined with a newly approved targeted therapy drug. This drug offered a significant survival advantage for her specific genetic markers.
The financial blow landed hard: the insurer denied the targeted therapy, labeling the combination as "investigational", even though both components were individually approved. The cost $18,000 per cycle, meant Sarah's treatment was stalled.
Feeling hopeless, Sarah’s husband uploaded the detailed denial letter, the doctor's prescription, and her genetic test results to the Counterforce Health platform.
How Counterforce Health Stepped In:
- High-Speed Analysis: The platform's AI instantly identified the insurance company's loophole: they were denying the combination based on outdated guidelines.
- Evidence Assembly: Counterforce Health rapidly compiled a dossier that included three critical pieces of evidence: the drug's recent FDA approval date, Phase III trial data showing the synergy of the combination, and direct quotes from the ASCO (American Society of Clinical Oncology) guidelines supporting the regimen.
- The Result: The system generated a comprehensive, clinically airtight appeal letter in under an hour. When submitted, the overwhelming, cited evidence convinced the insurer to issue a full reversal of the denial within 72 hours.
Sarah started her life-saving treatment on the exact date her oncologist planned, avoiding a critical delay and the catastrophic $18,000 cost. "Counterforce gave us a voice backed by science," Sarah noted. "It removed the financial barrier so I could focus entirely on getting well."