Daffodil provides a SaaS claim repricing application that empowers Payors and TPAs to manage Out of Network and Reference Based Pricing processes internally. The platform uses AI/LLM technology to generate pricing rationale, configure complex pricing rules, and automate provider negotiation responses. This allows clients to reduce reliance on third-party middlemen and achieve predictable, lower costs for claim adjudication.
Funding
$4.6M 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 pricing in the U.S. is often complex, opaque, and reliant on archaic systems, leading to inefficiencies and inflated costs. Payors often depend on middlemen who charge a percentage of savings, which can be an expensive and non-transparent approach. Existing systems struggle to provide clear pricing rationale and efficient rule configuration, hindering cost management and negotiation with providers.
Solution
Daffodil provides a SaaS-based claim repricing application that empowers payors and third-party administrators (TPAs) to automate out-of-network and reference-based pricing processes in-house. The platform leverages AI and large language models (LLMs) to generate pricing rationale, configure employer and code-specific pricing rules, and proactively generate employer and provider reports. By offering a transparent and predictable pricing model, Daffodil enables users to gain complete visibility and control over the repricing process, reducing reliance on costly intermediaries and improving cost savings. The system supports multimodal claim input formats and facilitates effective provider negotiation responses.
Target Audience
Daffodil primarily targets healthcare payors and third-party administrators (TPAs) seeking to automate and optimize their out-of-network claim repricing processes while reducing costs.
Features
- AI/LLM-powered engine for automated pricing rationale generation and provider negotiation responses.
- Configurable pricing rules by employer and code, enabling customized pricing strategies.
- Employer reports to articulate value and demonstrate cost savings.
- SaaS-based application for easy deployment and integration.
- Multimodal input support for various claim formats.
- Transparent and predictable SaaS pricing model, avoiding percentage-of-savings fees.