This company specializes in maximizing out-of-network revenue recovery for healthcare providers through the Independent Dispute Resolution (IDR) process. They leverage a proprietary database of over two million resolved dispute outcomes to provide data-backed pricing benchmarks for claim submissions. By using this specific data, Clearest Health enables practices to achieve significantly higher recovery rates compared to filing disputes without comparable payment information.
Funding
$2.8M 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.
TPFounders
Product
Problem
The complexity of healthcare billing leads to unpredictable costs for patients and administrative burdens for employers and third-party administrators (TPAs). Lack of transparency in provider pricing hinders informed decision-making and cost control, while compliance with federal transparency regulations adds further challenges.
Solution
Mano Health provides a healthcare platform that centralizes provider pricing data and integrates with claims management systems to offer real-time cost estimates and dynamic copay plans. The platform enables users to filter by plan and sort by price, providing clarity and predictability in healthcare expenses. By leveraging AI-driven claims guidance and plan analytics, Mano Health optimizes claims processing, ensures compliance with federal regulations, and empowers employers, TPAs, and members to access predictable costs and high-quality care. The platform aims to align incentives through data-driven insights, lowering healthcare expenses while improving provider payment efficiency.
Target Audience
Mano Health primarily serves employers seeking to provide attractive health benefits, TPAs aiming to reduce administrative complexity, consultants looking to offer innovative health plan solutions, and members desiring better care at lower costs.
Features
- Real-time cost estimates for healthcare services based on provider pricing data.
- Dynamic copay plans offering a single, predictable price for all services.
- AI-driven claims guidance to optimize the claims process.
- Plan analytics with customizable dashboards, automated email subscriptions, and PDF generation.
- Care navigation tools allowing users to filter by plan and sort by price.
- Integration with existing Claims Management Systems.
- Compliance guarantees with federal ACA and TiC regulations.