Revenue cycle management specialist Waystar has acquired Digitize.AI, whose ability to automate prior authorization will help the cloud-based RCM company ease the payment process for its clients.
WHY IT MATTERS
Digitize.AI’s artificial intelligence-powered prior authorization platform, called Lia, deploys real-time analytics and machine learning to automatically check for new cases and securely submit them directly to payers. It can also continually monitor payers for responses. Once authorization is received, the platform automatically submits to the provider’s electronic health record system.
The company also offers a similar product, called Mia, designed for health plans. The aim of these platforms is to reduce the time and expense incurred by delays incurred by legacy prior authorization solutions, officials say.
Lia’s HIPAA-compliant system provides real-time performance dashboard for executives and teams, as well as customizable workflows. The cloud-based tool can adapt to changing payer rules, runs 24/7 behind the scenes and can integrate directly with EHR and payer systems.
THE LARGER TREND
Waystar integrates with a number of practice management, hospital information and EHR systems, and allows users to verify eligibility and co payments, enter patient information and expedite the patient check-in process by accessing relevant plan information.
Its platform, which features a customizable interface, is also designed to help increase POS collections by delivering up-to-date copayment and deductible information, and assists in tracking claims.
It can also identify incorrect and under-coded claims, helping protect and uncover revenue with a combination of machine learning and predictive analytics technology.
In June, Waystar bought healthcare financial assistance predictive analytics specialist PARO, which followed last September’s acquisition of Connance, a provider of workflow driven by predictive analytics solutions.
PARO’s presumptive charity solution helps non-profit health systems process identify patients that would qualify for charity under a provider’s Financial Assistance Policy, using thousands of sources of socioeconomic data instead of credit scores as an evaluation metric.
Connance specializes in patient propensity-to-pay algorithms, social determinant predictive algorithms and vendor management and organization software.
ON THE RECORD
“Providers today are overwhelmed with manual processes related to addressing prior authorization, and it’s one of our clients’ biggest challenges,” Waystar CEO Matt Hawkins said in a statement, noting Digitize.AI’s method of automating prior authorizations offers better results than other platforms.
“We believe Digitize.AI has an enormous potential to change the industry, and we were looking for a partner who had a shared view of the ability of technology to improve healthcare,” Justin Adams, CEO, Digitize.AI, said in a statement.