PRINCETON, NEW JERSEY — Sheer Health won an expedited insurance appeal for patient Mathew Evins, enabling him to undergo back surgery in mid-October in Princeton, New Jersey, after his insurer had twice denied coverage. Sheer Health reviewed Evins's insurance policy and authorization requests, submitted the expedited appeal, and worked with his doctor to understand the authorization issue.

Evins had lived with chronic back pain for eight years. By 2024, he had difficulty walking and had exhausted non-invasive treatments before his doctors agreed he needed surgery. The insurance company told his surgeon, "Your patient needs another six weeks of physical therapy." Evins complied with the requirement, but after the additional six weeks, his insurance company denied coverage again.

Over seven months without surgery, Evins's condition deteriorated. "This damage could become worse and/or permanent if the surgery isn't done as soon as possible," Evins said.

Jeff Witten and Ben Howard co-founded Sheer Health. The service allows patients to take a picture of their medical bill and upload it. "Our goal is for people to never have to deal with their health insurance again," Howard said. "We'll handle everything." Sheer Health fights every insurance battle on behalf of its clients for either a $40 monthly fee or a percentage of recovered money.

After Sheer Health resolved the authorization issue, Evins had his back surgery. "I'm doing great," he said, adding that after his surgery he was able to walk down the street, which he could not do before. "It's people's lives that these insurance companies hold in the balance. Take that seriously. You're not their medical practitioner," he said.

Katherine Hempstead, senior policy officer at the Robert Wood Johnson Foundation in Princeton, said that using Sheer Health amounts to buying insurance for insurance itself. "I think it's sad that we need that. It's treating a symptom, you know, which is often a good business idea, but it doesn't make me feel like, 'Okay, that's all we needed,'" she said. Hempstead added, "It's not the case that the providers are the angels and the insurance companies are the devils."

Twenty-seven million Americans do not have health insurance, and 73% of Americans say healthcare delays and denials are a major problem. AHIP, a national trade organization, said in a statement that health plans, providers, and drugmakers share a responsibility to make high-quality care affordable and easier to navigate.