Claim Health provides an AI revenue platform specifically designed for post-acute care revenue operations. This platform automates workflows from referral intake through cash resolution, including eligibility verification, prior authorizations, and billing. The system aims to reduce administrative burden, prevent upstream revenue risk, and provide leaders with real-time visibility into performance.
Funding
Funding not disclosed
Founders
Product
Problem
Healthcare agencies face challenges with revenue cycle management due to prior authorization issues, claim denials, and unbilled services. These inefficiencies lead to lost revenue and hinder operational efficiency.
Solution
Claim Health offers an AI-powered platform designed to optimize revenue cycle management for healthcare agencies. The system integrates with existing EMR, clearinghouse, and payer portal systems, ensuring continuous data synchronization to prevent claim loss. It analyzes workflows and claims to identify missed revenue opportunities, such as denials, delays, and underpayments, flagging them for prompt recovery. Additionally, the platform automates the generation of appeal letters and prior authorization requests, leveraging clinical documentation or utilizing voice AI to manage payer hold times. This comprehensive approach aims to reduce billing chaos and improve financial clarity for agencies.
Target Audience
The primary customers are healthcare agencies seeking to optimize their revenue cycle management and improve financial performance.
Features
- AI-driven analysis of claims to identify denials, delays, and underpayments.
- Automated generation of appeal letters and prior authorization requests.
- Voice AI capability to manage payer hold times for authorizations.
- 24/7 data synchronization with EMR, clearinghouse, and payer portals.
- Real-time financial dashboards with industry benchmarking.
- HIPAA-compliant system with configurable rules engines based on payer mix and specialties.
- Identification of unbilled visits and revenue recovery opportunities.