What You Should Know:
– Sohar Health, an AI-driven eligibility determination and Verification of Benefits (VoB) provider, has announced a partnership with Talkiatry to automate Talkiatry’s insurance verification process.
– Sohar Health’s Eligibility Automation technology is designed specifically for behavioral health providers. The collaboration has resulted in improved claim accuracy, reaching 95%.
Today’s Cumbersome Insurance Eligibility/Verification Challenges
Patients seeking mental health services frequently encounter obstacles such as unreliable provider directories and unexpected insurance denials, creating significant barriers to timely and effective treatment. Recognizing the critical need for a smoother process, providers aim to accurately verify health insurance coverage early in the patient journey, including determining copays and deductibles, to minimize surprise bills and improve overall satisfaction.
However, traditional insurance eligibility and verification methods are often time-consuming, manual, and susceptible to human error. Studies indicate that six in ten adults face challenges understanding their insurance coverage, leading to denied claims. This issue has driven healthcare organizations to spend an estimated $19.7 billion annually attempting to overturn these denials, creating frustration for both patients and providers.
Automating Insurance Eligibility Process
Talkiatry, committed to improving access to high-quality mental healthcare nationwide through virtual appointments, sought to enhance its technology-driven patient experience by partnering with Sohar Health. Sohar’s AI-powered Eligibility Automation technology, specifically designed for behavioral health providers, proved instrumental in achieving this goal.
Sohar’s API facilitated a significant increase in claim acceptance rates by automatically confirming coverage and accurately estimating patient cost-sharing responsibilities before care delivery. To streamline Talkiatry’s eligibility verification process, Sohar implemented two key products from its Eligibility Automation suite:
- Discovery: This product enables companies to determine a patient’s health insurance coverage without requiring them to disclose their provider upfront.
- Verification: This product verifies patient eligibility for services and details the nature of their benefits.
The successful integration involved a high-touch collaboration between Talkiatry’s engineering and product teams and Sohar’s Chief Technology Officer. This partnership resulted in the development of capabilities that allow Talkiatry to rapidly determine a patient’s health insurance coverage and accurately estimate copays without requiring individuals to initially share their carrier information.
“When people seek mental health support, knowing whether they are covered by insurance or not can be the difference between seeing a psychiatrist or giving up on finding treatment. We must make that process as simple as possible to ensure our loved ones quickly connect with the care they need,” said Ashish Mandavia, M.D., co-founder and CEO of Sohar Health. “Through our focus on partnering with future-forward, tech-enabled organizations like Talkiatry, and our easy-to-use, consumer-friendly APIs, we’re able to reduce insurance-related barriers so patients can concentrate on getting the care they deserve.”
