What You Should Know:
– Sohar Health, a provider specializing in AI-driven eligibility determination and Verification of Benefits (VoB), announced the launch of Discovery.
– The patient intake solution leverages AI to redefine how healthcare providers verify insurance, using minimal patient data to quickly determine coverage status and plan details. The launch aims to significantly reduce verification delays, improve patient access to care, and enhance revenue cycle efficiency for providers.
Tackling Administrative Waste and Patient Frustration in Insurance Verification
The traditional process of verifying patient insurance coverage is a known pain point in the U.S. healthcare system, contributing significantly to the estimated $228-$280 billion spent annually on wasteful administrative costs within the $3.6 trillion industry. Manual verification methods—requiring staff to call insurers, navigate various payer portals, or await fax responses—are often slow and inefficient.
This friction impacts patients directly; studies show 58% of insured U.S. adults experienced insurance-related problems in the past year, with half of those unable to resolve the issues, sometimes leading to skipped care and health declines. Verification delays can cause significant patient frustration and contribute to high appointment abandonment rates.
Rapid, Automated Verification with Minimal Patient Data
Sohar Health’s Discovery platform is designed to eliminate these bottlenecks by automating the insurance verification component of patient intake. Utilizing just four basic data points – the patient’s first name, last name, date of birth, and state – Discovery’s AI engine can ascertain if the patient has active health insurance and identify their specific plan. This automated check delivers results in approximately 8 seconds, drastically faster than manual methods that can take hours or even days. Notably, the process works even if the patient does not have their insurance card or information readily available.
Boosting Accuracy, Patient Access, and Provider Efficiency
Beyond speed, Discovery offers enhanced accuracy, achieving a success rate of up to 60% in identifying coverage – a significant improvement over the reported industry benchmark of 20%. Sohar Health indicates even higher accuracy for major commercial payers, including Cigna, Aetna, and UnitedHealthcare. By enabling real-time eligibility checks, Discovery helps healthcare organizations establish a more consumer-friendly digital “front door.” This smoother intake experience reduces patient friction and has been shown to improve patient conversion rates by up to 12%. The automation benefits providers across various specialties—from primary and specialty care to urgent care, behavioral health, and telehealth—by reducing administrative burdens, freeing up staff resources, and improving overall revenue cycle efficiency.
“In a world where people no longer carry physical credit cards, let alone their health insurance card, Sohar removes the friction from accessing care. Just as fintech has transformed payments, we are transforming patient intake with real-time insurance verification,” said Ashish Mandavia, M.D., co-founder and CEO of Sohar Health. “As digital-first healthcare becomes the norm, patients expect a seamless, retail-like experience when booking appointments. With Discovery, we empower providers with instant, accurate, and automated eligibility checks, ultimately enhancing patient trust and streamlining care pathways.”
