New AI tool for fighting health insurance denials could save hospitals billions, and help patients
- Waystar launched AltitudeCreate, a new AI tool
- Purpose: Help hospitals fight insurance claim denials
- Key stat: Hospitals spend $20B annually fighting denied claims
Company Background
- Waystar is a health-care payments company
- Had IPO in June, raising $1B
- Processed $1.2T in claims in 2023
- Covers ~50% of US patients
Context & Timing
- Follows UnitedHealthcare CEO shooting in December
- Public outrage over insurance industry practices
- Project was in development for 6-8 months
- Part of Google Cloud partnership from May
The Problem
- 450M+ claims denied annually
- Denial rates increasing
- Current appeal process:
* Time-consuming
* Expensive
* No guaranteed success
- Patients often pay out-of-pocket for denied claims
The Solution: AltitudeCreate
- Uses generative AI to draft appeal letters
- Part of broader AltitudeAI suite
- Available to existing Waystar clients
- No additional cost for current users
- Planned broader rollout in future
Impact
- Could reduce administrative costs
- Helps understaffed providers
- Aims to improve healthcare billing efficiency
- Potential to save billions in administrative costs