What Counterforce Health does

Counterforce Health is a Delaware-incorporated, privately held company founded in 2023 that operates an AI-powered platform for appealing denied health insurance claims. Its core product ingests denial letters, insurance plan details, and supporting documents, then generates customized appeal letters citing peer-reviewed medical journals, clinical guidelines, federal and state regulations, and specific plan terms. A secondary product, Maxwell Voice AI (in beta), provides conversational voice-based guidance through the appeals process. The company supplements its core platform with the "Appeals on Wheels" mobile clinic program for rural outreach, a Small Clinic Grants program for under-resourced clinics, and a free 1:1 Case Management service for complex cases.

The platform is delivered as a free, self-service web application with no charge to individual patients, removing financial barriers and positioning the company as a product-led growth play. Operations are funded entirely through innovation grants from the National Institutes of Health (NIH) and the University of Pennsylvania; the company explicitly states it will never accept funding from insurance companies. The Terms of Service reserve the right to introduce future fees for certain features, but no paid tier is currently operational, so the company is effectively pre-revenue from a commercial standpoint.

Counterforce reports 10,000+ appeals completed on the platform and a 75% approval rate — approximately 2x the national average — serving individual patients, physicians and provider practices, patient advocates, and rural/small clinics. Marketing is heavily skewed toward earned media (NBC, CBS, ABC, Fox, Axios, Good News Network, NIH press) and organic search through a content-heavy blog with state- and medication-specific appeal guides. The advisory bench includes clinical, legal, public health, and insurance-side expertise from Duke Palliative Care, Cornell Tech, UNC Gillings, UC Berkeley, SCAN Health, and a former Blue Cross Blue Shield CEO.

Name

Counterforce Health

Legal name

Counterforce Health, Inc.

Website

https://counterforcehealth.org

Company type

Private

Founded year

2023

Operating status

Operating

Headcount range

11–50 employees

Short description

Counterforce Health provides a free AI-powered platform that helps patients, physicians, and advocates appeal denied health insurance claims, achieving a 75% approval rate. Funded by NIH and University of Pennsylvania grants, it also offers a beta voice AI assistant (Maxwell).

Ownership category

akta.pro rank

Product category

Healthcare AI Software / Insurance Appeals Automation

NAICS

Other Individual and Family Services (624190)

SIC

Services-Prepackaged Software (7372)

akta.pro primary industry

Adherence, Reminders & Engagement Automation (Medication/Follow-up) (HLACAEAJ)

akta.pro secondary industries

Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment) (HLACABAK), Responsible AI, Security & Privacy Platforms (Safety, Guardrails, PII) (HDAEANAG)

Keywords

• Health insurance appeals
• AI appeal generation
• Denial management software
• Patient advocacy tools
• Healthcare appeals platform

Headquarters

HQ city

Spring Lake

HQ country

United States

HQ region

North America

Markets served

GTM type

B2C

Offering type

Software

Cost components

Technology or R&D, Personnel, Operations, Marketing or Sales, Infrastructure

Revenue model

1. Free Individual Service (Current): Service is currently completely free for individual patients, funded entirely through innovation grants from NIH and research universities. Company explicitly states they will never accept money from insurance companies.
2. Potential Future Paid Features: Terms of Service state that Counterforce Health reserves the right to introduce fees for certain features in the future. No paid features currently operational.

Pricing tiers

Go-to-market motion3 records

Distribution channels3 records

Marketing channels4 records

Core offering

Counterforce Health provides a free, AI-powered web platform that analyzes health insurance denial letters, insurance plan details, and supporting documents, then generates customized, evidence-based appeal letters citing peer-reviewed medical journals, clinical guidelines, and federal/state regulations. The platform is paired with a conversational voice AI assistant (Maxwell, in beta), a mobile-clinic outreach program (Appeals on Wheels), free 1:1 case management for complex cases, and grant-funded adoption support for small clinics, all delivered free to individual patients.

Product overview

Counterforce Health offers a unified AI-powered platform for fighting health insurance claim denials, combining an appeal letter generation engine with a voice AI assistant. The core product analyzes denial letters and generates customized appeal letters citing peer-reviewed medical evidence and legal standards. Supporting initiatives include mobile outreach (Appeals on Wheels), grant programs for clinics, and free 1:1 case management for complex cases. The company also maintains an educational blog covering specialty drug coverage requirements across major insurers. All individual patient services are provided completely free through NIH and university grant funding.

Differentiator

Problem solved

Functional benefit

Brands

• Maxwell Voice AI: Voice AI that guides users through the appeal process and advises on rights in a natural, conversational way. Currently in beta.

Products and services

• AI-Powered Appeal Letter Generator Free, self-serve web platform that analyzes denial letters and insurance plan details to generate customized, evidence-based appeal letters for individual patients, providers, and patient advocates in approximately two minutes; backed by HIPAA-compliant infrastructure and trained on a proprietary dataset of successful appeals.
• Appeals on Wheels Truck-based mobile service with satellite internet that delivers in-person AI appeal assistance to patients in rural and underserved areas where access to care is already limited.
• Free 1:1 Case Management Free human case-management service where case managers help patients navigate complex, high-stakes insurance denial cases, providing expert strategy, evidence gathering, and appeal coordination beyond the self-serve platform.

Quantifiable outcome

• 75% of appeals get approved (vs. <1% national appeal rate)
• +6 more outcomes

Named customers6 records

Segments4 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability5 records

Feature4 records

Partnerships

Seven partnerships are on record, tiered advisory.

• Duke Palliative Care (Dr. David Casarett)advisoryOthersChief of Duke Palliative Care serves as advisor to the company, providing clinical and healthcare system expertise.
• Cornell Tech (LizAnn Eisen, JD)advisoryOthersProfessor at Cornell Tech serves as advisor, providing technology and legal expertise.
• UNC Gillings School of Public Health (Dr. Erin Kent, PhD)advisoryOthersProfessor at UNC Gillings School of Global Public Health serves as advisor, providing public health expertise.
• UC Berkeley School of Social Welfare (Dr. Angela Perone, PhD, JD)advisoryOthersProfessor at UC Berkeley serves as advisor, providing policy and social welfare expertise.
• SCAN Health (Dr. Linda Rosenstock, MD)advisoryOthersChairperson of SCAN Health serves as advisor, providing expertise in healthcare delivery for seniors.
• Cory Christensen, MBAadvisoryOthersFormer CEO of Plum Health serves as advisor, providing healthcare business and startup expertise.
• Bob Greczyn, MPHadvisoryOthersFormer CEO of Blue Cross Blue Shield serves as advisor, providing insider perspective on insurance company operations.

Scale indicators10 records

Broad incumbents

• AKASA: AI platform automating revenue cycle management for hospitals and health systems, including denials and appeals workflows from the provider finance side. Overlaps with Counterforce's provider value prop on cost-to-appeal and revenue recovery, but focuses on the broader RCM stack.

Direct peers

• Anterior: AI clinical co-pilot that automates prior authorization submissions and clinical documentation for payers and providers. Same insurance-approval problem space, with overlapping data sources (medical records, clinical guidelines) used to support authorization decisions.
• Solace Health: Marketplace connecting patients with independent healthcare advocates and navigators, many of whom focus on insurance disputes and denial appeals. Comparable D2C model targeting patients facing administrative healthcare friction, with adjacent AI tooling for navigators.
• Cohere Health: Provider- and payer-side AI platform for prior authorization and utilization management — directly addressing the same medical-necessity and denial workflows Counterforce contests, though typically on the payer-side review rather than patient-side appeal.
• CoverMyMeds: McKesson-owned platform that helps patients and providers complete prior authorization requests and access medication coverage. Directly adjacent to Counterforce's denial-appeal focus, particularly for prescription benefit denials, with a much larger installed provider base.
• Health Advocate (Maximus): Human-services advocacy and benefits-navigation business owned by Maximus, helping members resolve insurance claims and appeals. The legacy incumbent in patient-side appeals that Counterforce's AI positioning is building a faster, software-first alternative to.

Others

• Sesame: Direct-to-consumer healthcare marketplace offering transparent cash-pay visits and care navigation. Not a denial-appeal competitor, but operates in the same D2C consumer healthcare adjacency and shares the ethos of removing friction from insurance-mediated care access.

Emerging players

• Waymark: AI platform supporting community-based providers with prior authorization, documentation, and care delivery workflows. Emerges from a similar bet that AI can dismantle administrative burden in insurance-facing workflows, and serves many of the same under-resourced clinics.

Market position

Strengths5 records

Weaknesses5 records

Key risks6 records

Key highlights7 records

Customer concentration

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles13 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Counterforce Health