Smarter Health provides a digital infrastructure that facilitates structured data exchange among healthcare payors, providers, and specialists, enhancing the efficiency of patient care processes. The platform addresses the rising costs of healthcare by automating claims assessment, patient management, and care pathway monitoring, ultimately improving patient experience and operational transparency.
Funding
$6.2M 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.
EVFounders
Product
Problem
Healthcare providers, payors, and specialists often struggle with inefficient data exchange, leading to increased administrative costs and fragmented patient care. Manual processes and disparate systems hinder real-time claims assessment, patient management, and care pathway monitoring. This ultimately impacts patient experience and operational transparency.
Solution
Smarter Health provides a digital infrastructure that streamlines data exchange among healthcare stakeholders, automating key processes to enhance efficiency and reduce costs. The platform offers solutions for patient concierge services, digital pre-authorization, case management, and final bill/claims adjudication. By capturing data in a structured format and leveraging AI capabilities, Smarter Health enables real-time benchmarking, automated claims assessment, and proactive monitoring of care pathways. This allows for faster patient discharge, improved claims processing, and better insights into population health trends.
Target Audience
Smarter Health primarily targets healthcare payors, providers (hospitals and clinics), and specialists seeking to streamline operations, reduce costs, and improve patient care coordination.
Features
- Digital pre-authorization with embedded international diagnosis codes and localized procedure codes for real-time benchmarking.
- AI-powered claims assessment to automate approval/rejection recommendations.
- Real-time case management updates from providers/specialists on clinical progress and bill size.
- Automated exclusion and pre-existing conditions checks during claims adjudication.
- Patient channel management tools for appointment scheduling and patient registration.
- Queue and flow optimization system to minimize patient waiting times and improve capacity utilization.
- Admission digitization to consolidate hospital admissions and pre-authorization forms in a single interface.