AI Billing

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Candid Health Transcript
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5/5
13 min readReviewed on: 11/15/2023
Reviewer
Title: Director of Implementation
Organization Type: Virtual-First Provider
Specialty: Metabolic Health
Summary
  • Product Usage: Candid is mainly used for post-visit claims adjudication, including claim submission, payment posting, denial management, accounts receivable, and reporting.

  • Strengths: The product offers a clear user interface, sufficient denial management functionality, responsive customer service and is more cost-effective compared to competitors.

  • Weaknesses: The product lacks the ability to bulk edit claims and some configuration options are not available to end users but must be done by their engineering team.

  • Overall Judgment: Despite minor areas for improvement, the product is a valuable, cost-effective solution to revenue cycle management, with excellent customer service and a straightforward user interface.

Other Products Considered

Candid Health Transcript
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4/5
13 min readReviewed on: 11/09/2023
Reviewer
Title: Finance Lead
Organization Type: Virtual-First Provider
Specialty: Behavioral Health
Summary
  • Product Usage: The product is used for back-end revenue cycle processes, from claim submission to payer and patient payment reconciliation.

  • Strengths: The product is flexible, accepts APIs, and works with a variety of claim formats.

  • Weaknesses: The product is a startup, meaning they are still building and developing certain features that established products already have.

  • Overall Judgment: The reviewer deemed their choice of Candid Health to be the right one as it provides flexibility and partnership that other mature products might not offer.

Adonis Transcript
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4.5/5
16 min readReviewed on: 10/31/2023
Reviewer
Title: Cofounder
Organization Type: Virtual-First Provider
Summary
  • Product Usage: The team mainly uses the Adonis for claims processing, with Adonis taking full control of the RCM process.

  • Strengths: Adonis RCM services require minimal involvement from the users team, making them appear like an extension of the users team; the alignment of incentives was also praised.

  • Weaknesses: The absence of a medical coder for accurate representation of the users care and flow with the right CPT codes was noted as a weakness; the late availability to the dashboard was also seen as a negative.

  • Overall Judgment: The reviewer has been happy with Adonis, relishing the minimal involvement their team needs to have and praising the customer service and the strong connection the company tries to establish with its customers.

Enter Health Transcript
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4/5
13 min readReviewed on: 10/05/2023
Reviewer
Title: Revenue Cycle Coordinator
Organization Type: Specialty Practice
Specialty: Pulmonology
Summary
  • Product Usage: Enter functions as the claims submission provider, handling insurance responses, verifying eligibility, and informing us of any claims denials.

  • Strengths: Enter offers transparency, allowing the reviewer to see actions taken on a claim, are specific in what needs to be done to resolve a given claim, and are responsive to operational feedback.

  • Weaknesses: Enter sometimes does not respond to messages quickly enough, and they sometimes fail to keep track of changes, resulting in redundancy in communication.

  • Overall Judgment: Despite some communication issues, Enter provides a very good service offering transparency, support, and guidance. The reviewer feels their decision was correct.

Other Products Considered

Candid Health Transcript
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4.5/5
22 min readReviewed on: 09/18/2023
Reviewer
Title: Engineering Lead
Organization Type: Virtual-First Provider
Specialty: Metabolic Health
Summary
  • Product Usage: Candid Health is used to submit claims, handle EFT/ERA and EDI enrollments, perform preliminary checks on claims, and manage the claims process through an integrated workflow.

  • Strengths: Candid Healths key strengths include a highly responsive team, a tech-focused approach, and a flexible rules engine.

  • Weaknesses: Ambiguity in service scope was a challenge initially which led to some confusion about responsibilities, the CSV export feature has been less reliable, and larger-scale operations may want to bring certain services in-house to handle higher complexity.

  • Overall Judgment: Candid Health comes highly recommended for its high-quality sales process, support, and account management, with particularly positive remarks on its ability to improve workflows and its desire to grow with customer base.

Candid Health Transcript
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5/5
24 min readReviewed on: 07/27/2023
Reviewer
Title: Head of Product
Organization Type: Virtual-First Provider
Specialty: Metabolic Health
Summary
  • Product Usage: The product has been used for about a year and a half for revenue cycle management and it is adapted for scaling up operations, including new features like remote patient monitoring-based billing.

  • Strengths: Its expertise, understanding of venture-backed companies, scalability, and tech focus made it stand out from the competition; it also provides proactive services and handles issues effectively, even offering support for troubleshooting.

  • Weaknesses: The product had minor issues which were promptly addressed with transparency; there were also some gaps in functionality which, though identified and prioritized by the company, led to delays in delivery.

  • Overall Judgment: The reviewer has had a positive experience with the product and its performance, communication, and support from the vendors, considering it to be one of the best vendors in delivering value from their product.

Other Products Considered

Apero Transcript
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5/5
12 min readReviewed on: 07/06/2023
Reviewer
Title: Operations
Organization Type: Diagnostic Center
Summary
  • Product Usage: Apero was primarily used to power all backend aspects of our Revenue Cycle Management (RCM) process, from claim submission to reporting.

  • Strengths: Apero excels in offering granular tracking and reporting on each individual claim throughout the RCM lifecycle.

  • Weaknesses: While offering a robust solution, Apero could further improve its product by adding higher-level summary features or more visually appealing information displays.

  • Overall Judgment: The company was satisfied with Apero due to its tech-forward approach, responsive customer service, and strategic partnership attitude.

Other Products Considered

Enter Health Transcript
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4/5
22 min readReviewed on: 06/27/2023
Reviewer
Title: Head of Product
Organization Type: Long-term Care Facility
Summary
  • Product Usage: Enter Health was used for revenue cycle management (RCM) services focused on CMS-1450 institutional billing for Medicare and Medicaid in a value-based setting.

  • Strengths: The strengths of Enter health include their advancement in AI and software efficiency, reasonable pricing model at smaller and larger scales, transparency in the data system, well-designed search function for outstanding or processed claims, automated functionalities, and excellent customer support.

  • Weaknesses: The products main weakness was its lack of knowledge and expertise in the users specialty and extensive difficulties in the integration process.

  • Overall Judgment: Enter Health is a robust platform with efficient and transparent processes, despite its shortcomings in handling specific specialties; better understanding of the different models between service-based and tech-based RCM could influence the decision to use it.