# Use Your Health Insurance Claims History with AI

Connect a supported health plan through Flexpa and your AI assistant can query the claims your insurer returns. These records can show billed services, insurance payments, and your reported share of the cost. They do not necessarily include every visit or show what you have already paid to a provider.

How it works: Health plan -> Authorization -> Returned claims -> Your assistant. Claims availability depends on the plan and its processing. Reported patient responsibility is not proof of payment.

## What is in your claims history

Health plans covered by the CMS patient access rule must make available adjudicated claims, including provider payments and your cost-sharing, plus clinical data the plan holds.

- **Claims:** Explanation of benefit records for services reported by your plan, with provider details, service dates, and payment or cost-sharing information where available.
- **Pharmacy claims:** Prescriptions you filled through your plan.
- **Coverage:** Your plan, member ID, and coverage period, the details on your insurance card.
- **Clinical data your plan holds:** Such as conditions and lab results, when your plan keeps them.

## How far back it goes

For plans covered by the CMS patient access rule, the required history covers dates of service on or after January 1, 2016, or the start of enrollment with that payer, whichever is more recent. Records from an earlier insurer require a separate connection.

Flexpa's patient access documentation describes new payer data becoming available within 24 hours of processing. That is not a promise that your assistant will show a claim within 24 hours of a visit: the plan must process it first, and the connection's sync schedule also affects retrieval.

## Which health plans work

The CMS patient access rule covers Medicare Advantage organizations, Medicaid and CHIP fee-for-service programs, Medicaid managed care plans, CHIP managed care entities, and qualified health plan issuers on the federally facilitated exchanges. Original Medicare connects through Blue Button 2.0. Check Flexpa for support for your specific plan and plan type.

When you search for your plan in Flexpa, a plan marked Coming soon is not available yet. You can request it, and Flexpa uses those requests to decide what to add next.

## Connect your plan

### Steps

1. Add Flexpa to a supported AI assistant using the Health records for agents documentation linked below.
2. When Flexpa opens, search for your health plan as it appears on your insurance card.
3. Follow the plan's sign-in instructions. Some plans require a separate data-sharing account rather than your usual member portal login. New accounts may need time to activate.
4. Approve sharing with Flexpa, then ask your assistant about your claims.

## What you can ask

- Summarize my claims from the past year
- What patient responsibility does each claim report?
- Which doctors have I seen, and when?
- What prescriptions have I filled?
- Show me my insurance card

## Questions

**How can I get my claims history from my health insurance company and use it with AI?** Add Flexpa to a supported AI assistant, search for your plan in Flexpa Consent, and follow the plan's sign-in and authorization instructions. Some plans require a separate data-sharing account. Your assistant can then query claims returned by the connected plan.

**Can ChatGPT or Claude read my health insurance claims?** A supported Claude or ChatGPT account can use the Flexpa records connector to query claims, coverage, and pharmacy claims returned by an authorized health plan connection. Availability depends on what that plan returns.

**How far back does my claims history go?** For plans covered by the CMS patient access rule, the required history covers dates of service on or after January 1, 2016, or the start of your enrollment with that payer, whichever is more recent. This does not guarantee a record for every visit; your assistant sees the records the connected plan returns.

**Does it work with my employer health plan?** Flexpa supports some employer-plan connections, but support varies by insurer and plan type. Search for your plan in Flexpa Consent to check availability. If it shows Coming soon, you can request the connection, but it is not available yet.

**Can I stop sharing my claims?** Request revocation through privacy.flexpa.com and remove the Flexpa connector from your assistant. Flexpa's revocation process does not delete claims data already received by the assistant provider; manage those copies separately with that provider.

## More

- [Claims data and AI (docs)](https://www.flexpa.com/docs/additional-resources/claims-and-ai)
- [Connect your health records to Claude or ChatGPT](https://www.flexpa.com/connect-health-records-to-ai)
- [What is patient access?](https://www.flexpa.com/docs/consent/patient-access)
- [Endpoint Directory](https://www.flexpa.com/docs/network/directory)
- [CMS-9115-F patient access rule](https://www.cms.gov/files/document/cms-9115-f.pdf)
- [Explanation of benefit records (docs)](https://www.flexpa.com/docs/fhir/explanation-of-benefit)

Last updated 2026-11-11.