New Ai tool for Fighting Health Insurance Denials Bills Save Hospitals Billions, and Help Patients

Health-Care Payments Company Waystar On Monday Announced a new generative artificial intelligence tool that can help hospitals Quickly Tackle One of Their Most Costly and Tedious Responsibilities: Fighting Insuration Denials.

Hospitals and Health Systems Spend Nearly $ 20 Billion a Year Trying to Overturn Denied Claims, According to a March report from the group purchase Singh premier.

“We think if we can develop software .

Waystar’s New Solution, Called AltitudeCreate, Uses Generative ai to automatically draft appeal letters. The company said the feature could help providers drive down costs and spare them the head of digging through complex contracts and records to put the letters to the letter manually.

Hawkins Led Waystar Through Its initial public offering In June, where it raised Around $ 1 billion. The company handled more than $ 1.2 Trillion in Gross Claims Volume in 2023, Touching about 50% of PATIENTS in the US

Claim denials have become a hot-button issue across the nation following the deadly shooting of unitedhealthcare Ceo Brian Thompson in December. Americans Flooded Social Media With posts about their frustrations and resentment toward the Insurance IndustryOften sharing stories about their own negative experiences.

When a patient receives medicine care in the US, it kicks off a notorously complex billing process. Providers like hospitals, health systems or ambulatory care famins Any’s Criteria for Reimburesment.

If a claim is denied, patients are often responsable for covering the cost out of pocket. More than 450 Million Claims are denied Each Year, and Denial Rates are Rising, Waystar Said.

Providers can Ask Insurers to Reevaluate Claim Denials by Submitting An Apple Letter, but drafting these letters is a time-consumping and expensive process that doesn statetee a resulte

Hawkins said that while there’s been a lot of discusation Around Claims Denials Recently, AltitudeCreate has been in the works at waystar for the last six. The company announced an ai-focused Partnership with Google Cloud In May, and Automating Claims Denials was one of the 12 Use Cases The Companies Planned to explore.

Waystar has also had a denial and appeal management software module available for several years, hawkins added.

AltitudeCreate is one tool available within a broader suite of waystar’s ai offers called altitudeai, which the company also unveiled on Monday. AltitudeCreate rolled out to Organizations that are Alredy Using Waystar’s Denial and Appeal Management Software MODURE MODULES EARLIER This month at no additional cost, the company said.

Waystar plans to make the feature more broadly available in the future.

“In the face of all of this administ waste in health care where provider organizations are undersrsted and do’t have time to even follow up on a claim when it does get denied PS to automate that experience , “Hawkins said.