Claim Health

Claim Health takes a proactive, AI-first approach to revenue cycle management for post-acute care. Instead of reacting to denials after the fact, it continuously monitors coverage eligibility and authorization usage within your EMR, catching issues before they disrupt care or revenue. The platform automates the entire referral intake process—from fax, email, and portals—reading each packet against your clinical criteria and surfacing gaps before admission. This addresses the administrative burden that plagues home health and hospice agencies, where manual data entry and portal logins consume staff hours. The platform's strengths include its depth of automation: Coverage Assurance rechecks eligibility on every active patient, Smart Intake centralizes referrals with AI analysis, Authorization Autopilot handles prior auths from submission to renewal with usage tracking, and Billing Operations automates payment posting and denial follow-up. Platform Intelligence gives leadership a real-time view of revenue risk and bottlenecks. HIPAA compliance and SOC 2 certification, plus backing from Y Combinator and other investors, lend credibility. Weaknesses include lack of public pricing—you must request a demo—which may deter smaller agencies. Integration depth is not fully documented, so you'll need to verify compatibility with your existing EMR and billing systems. The platform is focused exclusively on post-acute care, so it's not suitable for hospitals or acute care settings. While it automates many tasks, human oversight is still needed for edge-case referrals or denials. Overall, it's a robust solution for mid-to-large agencies seeking to reduce manual work and protect revenue, but smaller providers might find better fit with more transparently priced alternatives.