Ascertain provides AI agents designed to automate complex healthcare administrative workflows, including prior authorization, eligibility verification, and referral processing. The platform ingests unstructured data to automate form completion and reliably communicate results, significantly lowering administrative costs. By integrating seamlessly with existing systems, Ascertain empowers clinical staff to reduce repetitive tasks and focus more time on direct patient care.
Funding
$10M raised to dateRaised to date based on public sources. This may differ from the amount the company actually raised and is based only on what is publicly available on the internet.
Founders
Product
Problem
Healthcare case managers and administrative staff spend a significant portion of their time on manual, repetitive tasks such as prior authorizations, claims processing, and patient outreach. This administrative burden diverts focus from direct patient care and contributes to staffing shortages in critical roles.
Solution
Ascertain provides an AI-powered case management assistant designed to automate these administrative workflows for healthcare organizations. The platform integrates with payer portals to streamline prior authorization submissions and automates communication across various channels to provide real-time status updates. By leveraging AI to analyze clinical guidelines and payer policies, Ascertain reduces manual errors and ensures compliance. This automation allows case managers and clinical teams to reallocate their time towards complex patient care activities and strategic coordination.
Target Audience
Ascertain targets health systems, payers, and independent provider groups that employ case managers and administrative staff responsible for patient care coordination and administrative processing.
Features
- AI-driven automation for prior authorization submissions via payer portal integrations.
- Automated communication management across fax, email, and web portals for real-time status updates.
- Policy and guideline adherence engine that analyzes and applies clinical rules to reduce errors.
- Workflow automation for specific case management functions including disability/absence management, utilization management, and discharge planning.
- Natural Language Processing (NLP) capabilities for summarizing medical records and extracting key insights to accelerate decision-making.
- Agentic AI platform designed for integration into existing healthcare operational workflows.