CareCredit - Women's Health April 2024

Machinify Introduces AI-Powered Apps for Managing Healthcare Claims

Machinify has introduced a suite of three artificial intelligence (AI) apps designed to address the entire healthcare claims lifecycle.

Together, the apps cover everything from prior authorization through final payments, the AI-powered, healthcare administration-focused company said in a Monday (March 4) press release.

“There is an enormous opportunity to leverage AI to change the economics of healthcare,” Prasanna Ganesan, founder and CEO of Machinify, said in the release. “Machinify is leading the way, bringing together purpose-built AI, enterprise-scale software and deep domain expertise into one connected offering.”

One of the new apps, Machinify Auth, automates the submission and processing of provider authorization requests, according to the release. It provides instant approval for most requests and shortens review times by 50% when clinician review is required.

Another app, Machinify Audit, identifies potential issues on incoming claims, analyzes the corresponding medical records against clinical and coding guidelines, and ensures accurate payment, the release said. This app reduces claims review time by 50% while also increasing the accuracy of the payer’s audit program.

The third new app, Machinify Pay, accurately prices claims and automates claim corrections by enforcing coding, contractual and payment processing, per the release. This app increases up-front accuracy, reduces manual rework and automates 40% of recoveries.

“Machinify gets rid of administrative inefficiencies that run rampant in the industry, costing payers and patients unnecessarily,” Dharmesh Thakker, general partner at Battery Ventures and the lead investor in Machinify, said in the release. “The healthcare industry has been slow to adopt new technology, but with the results Machinify’s customers have experienced and ease of implementation, payers can’t afford to wait.”

Generative AI holds the promise to help patients and providers more effectively manage the entire healthcare journey, PYMNTS reported last September.

AI use cases targeting administrative burden and operational efficiency come at a time when the industry has seen both labor shortage issues and physician and nurse burnout.

The technology also has the potential to transform the healthcare space by improving drug discovery, diagnostics, patient care and other functions, according to “Generative AI Can Elevate Health and Revolutionize Healthcare,” a PYMNTS Intelligence and AI-ID collaboration.