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How do you handle claim denial? RapidClaims Looks To Ai!

How do you handle claim denial? RapidClaims Looks To Ai!

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In an innovative move to streamline healthcare revenue cycle management, RapidClaims has emerged from stealth mode with a promising solution to tackle the escalating issue of claim denials in the US healthcare sector. The startup announced a successful $3.1 million funding round, focusing on addressing the $265 billion in claims annually denied due to coding errors and delayed submissions. This funding round, pivotal in advancing healthcare automation, was led by Together Fund, a notable $250 million global SaaS fund.

Claim denials, a significant challenge for healthcare organizations, largely attributed to coding inaccuracies and submission delays. Statistics show that coding errors alone are responsible for over 40% of claim denials, while untimely submissions account for another 35%. RapidClaims aims to address these inefficiencies through its innovative medical coding automation module.

The seed funding round saw participation from various investors including Better Capital, Neon Fund, Peercheque, and DeVC, alongside notable angels and advisors from the US healthcare industry. Among these, distinguished figures like Oscar Benavidez of Mass General, Ankit Jain of Infinitus, and Sachin Jain of Scan Health, bringing a wealth of industry experience to the table.

RapidClaims, under the leadership of CEO Dushyant Mishra, CPTO Jot Sarup Sahni, and CDO Abhinay Vyas, could transform the healthcare revenue management space.

The company’s emergence aligns with two key trends identified in 2022: the rise in claim denial rates across the US and the proven efficacy of large language models (LLMs) in addressing these challenges.

The startup’s solution aims to simplify the increasingly complex world of medical coding, a field that has seen its complexity skyrocket in recent years. For instance, the number of diagnosis codes, such as ICD codes, has expanded dramatically, from 19,000 codes in ICD 9 to nearly 120,000 in ICD 11. Staying abreast of the myriad guidelines, including NCCI edits, NCD/LCD guidelines, and Medicare policies. Moreover, became more challenging, necessitating innovative solutions like that offered by RapidClaims.

In conclusion, by leveraging AI and automation, RapidClaims not only aims to reduce the frequency of claim denials but also enhance overall efficiency in healthcare revenue management. This approach is expected to be a game-changer in the industry. As a result, offering a much-needed solution to a longstanding and costly problem. Lastly, with its fresh funding and strong leadership, RapidClaims is set to make a significant impact in the healthcare sector.

How do you handle claim denial? RapidClaims Looks To Ai!