Get the care your child deserves
Challenge denials with confidence
Claimable's AI-powered appeal platform is your ally in overturning unjust IVIG denials for PANS and PANDAS. Backed by a physician-led team, we’re here to help your child access the care they need, faster, and without financial stress.
The Claimable difference
Our AI-powered appeal builder combines smart document scanning, a dynamic health questionnaire, and instant evidence matching to create professional appeals in minutes tailored to your unique health story.
Why now?
An estimated 1 in 200 children in the U.S. suffers from PANS/PANDAS, but countless families face senseless barriers to care. IVIG is the recommended treatment for many children, yet insurers routinely deny it.
Claimable helped overturn its first IVIG denial in just 96 hours—reimbursing the family's out-of-pocket costs and giving the child her life back. Now, we're bringing this life-changing support to more families across the U.S.
How Claimable works
What’s in your winning appeal?
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My 10-year-old son, has lived with PANS for the past 12-24 months, a condition likely triggered by a strep infection. The ripple effects of this disorder, compounded by a diagnosis of psoriatic arthritis, have devastated every aspect of his life.
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The academic, social, and psychosocial fallout of PANS has been catastrophic, forcing him to quit his beloved baseball team and he grew more isolated as he lost connections to friends, teammates, and familiar routines.
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Your formulary restriction ignores the scientific consensus and clinical guidelines supporting IVIG for PANS with moderate-to severe or treatment-refractory presentations.
The PANS Research Consortium (PRC) guidelines and peer-reviewed literature affirm that, particularly for patients with persistent, disabling, and refractory PANS, IVIG is the preferred immunomodulatory therapy, offering hope when all else fails (see citation).
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Your “not on formulary” denial disregards the requirement that health plans consider medical necessity and clinical appropriateness, even when a drug is not listed on the formulary.
Under the Affordable Care Act (ACA), health plans providing essential health benefits must allow for exceptions and access to off-formulary medication when no suitable covered alternative exists. In this case, no drug on your formulary has worked to restore his health, and your denial is causing ongoing, severe harm.
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