Healthcare billing is complex and creates lots of friction because of competing interests between the patient (receiving the treatment), the provider (delivering the care) and the insurance company (paying for the patient’s service). By construct, medical billing is an endless loop of love and hate between all the participants, with providers accusing payers of abusive and dominant behaviors while payers accusing providers of fraudulent practices.
At KLAIM, we aim to make healthcare billing simple for payers and providers by uniquely combining technology and finance.
We streamline the claim submission and adjudication process using artificial intelligence and offer a dedicated network and payment solution that helps healthcare providers get paid instantly.
We started addressing the billing workflow from the provider side, especially smaller clinics. For our current clients, we offer a SaaS solution that enables them to submit and manage their claims in a very simple and easy way with automated data capture and expert guidance. In addition to this, we propose a claim factoring solution offering cash against medical claims to ease the cashflow burden faced by providers and weather any payment delays from insurance companies.
- Benefits for providers: Less admin, ability to get paid immediately to ease cash flows
- Benefits for payers: Providers are not complaining about the payment delays anymore
We aim now at working closely with insurance companies to build a powerful claim error detection and waste fraud and abuse system that we can deploy on the provider side to avoid having unverified and potential erroneous claims being submitted to the insurance companies limiting unnecessary administrative waste for all participants (in the US alone the Excess administrative burden related to claim submission is totaling a staggering figure of 250 billion annually).
Finally, because payments and reconciliations are painful for all the participants, we aim by working closely with financial institutions to expand our financial offering by building an easy way for both payers and providers to process payments, receive payments and reconcile them all within the same platform.