Summary:
AI startups are revolutionizing the health insurance payments landscape.
Startups like Alaffia Health and Anomaly are using machine learning to reduce claims denials.
Claimable helps patients create appeal letters for denied claims, enhancing patient advocacy.
Companies like Cohere Health and Humata Health are automating prior authorizations to improve care access.
Innovative solutions from Goodbill and Guardian AI are tackling billing errors and unpaid claims.
Overview
Health insurers are increasingly denying payments for patient care, leading to frustration among patients and healthcare providers. In response, a new wave of startups is emerging, utilizing AI technologies to streamline and enhance the claims process in health insurance.
1. Alaffia Health
Founded: 2020
Total raised: $17.6 million
What it does: Automates claims processing tasks to reduce costs and improve efficiency for health plans using generative AI tools.
2. Anomaly
Founded: 2020
Total raised: $30 million
What it does: Uses machine learning to analyze insurer policies and claims data, helping clinicians prevent claim denials.
3. Anterior
Founded: 2023
Total raised: $23 million
What it does: Provides tech to automate prior authorizations for covered medical care, enhancing efficiency in health insurer operations.
4. Claimable
Founded: 2023
Total raised: Undisclosed
What it does: Assists patients in drafting appeal letters for denied claims, analyzing data to create personalized letters for a fee.
5. Cofactor AI
Founded: 2023
Total raised: $4 million
What it does: Analyzes medical records and insurer policies to assist hospitals in appealing claim denials.
6. Cohere Health
Founded: 2019
Total raised: $106 million
What it does: Works with health plans to automate prior authorizations, reducing unnecessary denials and improving patient care.
7. Humata Health
Founded: 2023
Total raised: $25 million
What it does: Automates document collection for prior authorizations and identifies likely denials, enhancing operational efficiency for hospitals.
8. Goodbill
Founded: 2021
Total raised: $5.3 million
What it does: Helps patients and employers reduce medical costs by identifying billing errors through analysis of medical records and bills.
9. Guardian AI
Founded: 2024
Total raised: Undisclosed
What it does: Provides tools for hospitals to analyze reimbursement patterns and automate claim handling processes, focusing on unpaid claims.
10. Thoughtful AI
Founded: 2020
Total raised: $40 million
What it does: AI agents assist healthcare clinics with processing claims and managing insurance coverage checks, streamlining the financial operations.
Comments