CNBC – 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 insurance denials.
Hospitals and health systems spend nearly $20 billion a year trying to overturn denied claims, according to a March report from the group purchasing organization Premier.
“We think if we can develop software that makes people’s lives better in an otherwise stressful moment of time when they’re getting health care, then we’re doing something good,” Waystar CEO Matt Hawkins told CNBC.
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 headache of digging through complex contracts and records to put the letters together manually.
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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 U.S.
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 industry, often sharing stories about their own negative experiences.
When a patient receives medical care in the U.S., it kicks off a notoriously complex billing process.
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Providers like hospitals, health systems or ambulatory care facilities submit an invoice called a claim to an insurance company, and the insurer will approve or deny the claim …