Boston startup uses AI to untangle health insurance problems
Boston Globe 3/21/23
As anyone who has had a billing dispute with their medical insurer quickly learns, the health care industry is mired in a tangle of databases and computer systems that don’t always talk to each other.
Boston startup CodaMetrix is aiming to untangle the mess with artificial intelligence. While doctors’ offices and hospitals employ teams of people to get approvals and reimbursements from insurance companies, CodaMetrix’s AI software is designed to speed up the process and cut down on the many frustrating denials.
At the heart of the reimbursement system, caregivers must select from tens of thousands of separate insurance procedure codes in order to receive reimbursements. CodaMetrix, founded in 2019, trained its software by reviewing thousands of examples of medical notes and the correct billing codes.
