Fuse provides HIPAA-compliant automation for healthcare revenue cycle management, focusing on digital patient intake and billing processes. The platform verifies insurance eligibility at the CPT code level by checking payer portals and conducting direct payer calls. This automation reduces administrative time significantly while generating accurate, upfront patient cost estimates for improved transparency.
Funding
$500K 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 providers often struggle to analyze complex insurance contracts and claims data, leading to underpayments and missed revenue opportunities. Lack of transparency in negotiated rates and the administrative burden of manual analysis further exacerbate these challenges.
Solution
Fuse leverages large language models to extract and structure data from healthcare providers' insurance contracts, claims, and payer communications. The platform identifies underpayments, benchmarks negotiated rates against peer data, and uncovers opportunities for revenue growth. By automating benefits checks, verifying patient eligibility, and estimating patient fees using AI, Fuse reduces administrative overhead and denial rates. This data-driven approach enables providers to optimize contract negotiations, improve billing accuracy, and achieve greater price transparency.
Target Audience
Fuse primarily targets US healthcare providers, including integrative care facilities, behavioral health (telehealth) providers, and specialty care clinics, seeking to optimize revenue and reduce administrative costs.
Features
- AI-powered extraction of key data points from insurance contracts and claims
- Automated benefits verification through payer portals and AI-driven payer communication
- Benchmarking of negotiated rates against aggregated industry data
- Identification of underpayment trends and revenue recovery opportunities
- Patient fee estimation tools for improved price transparency
- Integration with existing billing systems and electronic health records (EHRs)
- Customizable reporting dashboards for tracking key performance indicators (KPIs)