Health Harbor

Health Harbor: Revolutionizing Healthcare Interactions with AI

What if you could eliminate the endless phone calls with insurance companies, freeing up your staff to focus on more critical tasks? Health Harbor offers an AI-driven solution to automate interactions with health insurance payors, handling everything from benefits verification to claim follow-ups.

What is Health Harbor?

Health Harbor is an AI-powered platform designed to streamline communication between healthcare providers and insurance companies. It automates routine tasks such as:

• Benefit Verifications: Checks coverage for specific procedure codes and places of service.
• Prior Authorizations: Submits prior authorization requests and follows up on their status.
• Claim Follow-Up: Tracks the status of claims (not found, pending, paid, or denied) and investigates denials.

How does Health Harbor work?

Health Harbor offers two primary automation options:

• AI Agent: The AI agent autonomously handles calls with live insurance representatives for benefits verification, prior authorization, and claims status updates.
• AI Copilot: The AI copilot navigates Interactive Voice Response (IVR) systems and waits on hold before transferring the call to your staff, saving them valuable time.

The AI agent follows these steps:

1. Submission: The healthcare provider submits a benefits verification request via the web portal or API.
2. First Call: The AI navigates the insurance company's IVR, waits on hold, and speaks with a representative.
3. Validation: The data obtained from the call is normalized and compared with historical results to identify inconsistencies. If discrepancies exist, another call is initiated.
4. Results: Once the results are validated, the healthcare provider is notified via webhook or can view the results on the web portal.

Why Choose Health Harbor?

• Affordability: More cost-effective than outsourcing to traditional call centers. The platform is designed to reduce operational costs associated with manual insurance verification processes.
• Accuracy: The fully automated system boasts a 90% accuracy rate.
• Scalability: Capable of handling thousands of calls daily.

Who is Health Harbor for?

Health Harbor is designed for any healthcare provider or organization that interacts with insurance companies, including:

• Medical practices
• Behavioral health providers
• Pharmacies
• Chronic care management facilities
• Pulmonary rehabilitation centers

It is particularly useful for organizations that deal with a high volume of insurance-related inquiries and need to optimize their administrative processes. Examples of customer feedback highlight Health Harbor's impact:

• A director of clinical operations at Kivo Health stated, "The speed and accuracy of the results enable our patients to make informed decisions."
• The co-founder & CEO of Flair Health, a chronic care management facility, reported, "Health Harbor’s seamless eligibility verifications enable us to focus on patient care."

Key Benefits of Using Health Harbor

• Reduced Administrative Burden: Automate routine tasks, freeing up staff to focus on patient care and other complex issues.
• Improved Efficiency: Obtain results faster and more accurately compared to manual processes.
• Cost Savings: Reduce operational costs associated with insurance verification and follow-up.
• Better Patient Outcomes: Enable patients to make informed decisions about their care by providing accurate and timely insurance information.

What Payors Does Health Harbor Support?

Health Harbor currently supports major insurers covering approximately 50% of US plans, with coverage expanding monthly. This ensures that a significant portion of insurance-related tasks can be automated. The platform's ability to work with any payor, any specialty, and any type of call makes it a versatile solution for the healthcare industry.

Verifying and Ensuring Accuracy:

To maintain transparency and accuracy, Health Harbor provides multiple verification data-points, including:

• Representative's name
• Reference number
• Call end time
• Transcript
• Call recordings

Completion times are typically within one day, with a two-business-day SLA. Urgent requests submitted by noon ET can receive results on the same day.

In conclusion, Health Harbor offers a compelling AI-driven solution to automate and streamline interactions with health insurance companies. By automating benefits verification, prior authorization, and claim follow-up processes, Health Harbor enables healthcare providers to reduce administrative burdens, improve efficiency, and ultimately focus on providing better patient care. The result is a more efficient, cost-effective, and patient-centered approach to healthcare administration.