Waystar Team Celebrates IPO on Nasdaq
2024 Nasdaq, Inc. / Vanja Savic
medical payment company Waystar announced Monday a new generative artificial intelligence tool that will help hospitals quickly tackle one of their most expensive and tedious responsibilities: combating insurance denials.
According to one report, hospitals and health systems spend about $20 billion a year to reverse denied claims. March report From group purchasing organization Premier.
“If we can develop software that makes people's lives better during the stressful moments of their medical care, then we're doing something good,” Waystar CEO Matt Hawkins told CNBC. I think it means that there is.”
Waystar's new solution, called AltitudeCreate, uses generative AI to automatically draft appellate complaints. The company said this feature could help providers reduce costs and avoid the headache of combing through complex contracts and records to manually compile documents.
Hawkins led Waystar to an initial public offering in June, raising about $1 billion. The company processed more than $1.2 trillion in total claims in 2023, impacting approximately 50% of U.S. patients.
Claim denials have become a hot-button issue across the United States following major incidents. deadly gunfire UnitedHealthcare CEO Brian Thompson said in December. Americans flooded social media with posts about their frustration and anger with the insurance industry, often sharing stories about their own negative experiences.
When a patient receives medical care in the United States, a notoriously complex billing process begins. Healthcare providers, such as hospitals, health systems, and outpatient clinics, submit bills, called claims, to insurance companies. The insurance company approves or denies the claim based on whether it meets the insurance company's reimbursement criteria.
If a claim is denied, patients often end up paying out-of-pocket costs. Waystar says more than 450 million claims are denied each year, and the denial rate is rising.
An insurance company can ask the insurance company to re-evaluate a claim denial by filing a dispute letter, but this letter is time-consuming and expensive to prepare and does not guarantee a different outcome. there is no.
Hawkins said AltitudeCreate has been in development at Waystar for the past six to eight months, although there has been a lot of discussion recently regarding claim denials. The company focused on AI Partnership with Google Cloud Automating bill denials was one of 12 use cases the companies planned to explore.
Waystar has also offered a denial and appeals management software module for several years, Hawkins added.
AltitudeCreate is one of the tools available within Waystar's broader suite of AI products called AltitudeAI, which the company also announced on Monday. AltitudeCreate was rolled out at no additional cost to organizations already using Waystar's denial and appeals management software module earlier this month, the company said.
Waystar plans to make this feature more widely available in the future.
“Faced with this administrative waste in the healthcare industry, where provider organizations are understaffed and don't even have the time to follow up when a claim is denied, we're implementing software to help automate it. Experience That's what I did,” Hawkins said.
