Claim Health

Claim Health addresses a real pain point: post-acute care revenue cycles are notoriously fragmented, with referral data stuck in faxes and portals, eligibility checks done manually, and prior authorization tracking left to spreadsheets. The platform’s standout feature is Revenue Assurance, which proactively scans EMRs for documentation gaps, coverage risks, and data errors before claims go out—catching issues that would otherwise lead to denials. This upstream prevention is rare in healthcare RCM tools. The Smart Intake module centralizes referrals from fax, email, and portals, using AI to extract patient data and verify eligibility in real time, turning hours of manual entry into minutes. Authorization Autopilot automates the full lifecycle of prior authorizations, from submission to renewal, with alerts for exceptions. Billing Operations handles claims-to-cash with payment posting, denial handling, and prioritized follow-up. Platform Intelligence gives leadership a unified, real-time dashboard of revenue performance. However, the platform is limited to post-acute care (home health, hospice, SNF) and may not fit smaller agencies due to undisclosed pricing (requires demo). Integration depth with specific EMRs isn't detailed, and the tool relies on AI that may miss edge cases. It's a strong choice for mid-to-large agencies wanting to reduce administrative overhead and denial rates; for smaller teams, a simpler RCM tool might be more cost-effective. The recent seed funding suggests stability and future development.