What You Should Know:

你应该知道的：

–

–

Sohar Health

索哈尔健康

, an AI-driven eligibility determination and Verification of Benefits (VoB) provider, has announced a

，一家由人工智能驱动的资格认定和福利验证（VoB）提供商，宣布了

partnership

伙伴关系

with

with

Talkiatry

Talkiatry

to automate Talkiatry’s insurance verification process.

自动化Talkiatry的保险验证流程。

– Sohar Health’s Eligibility Automation technology is designed specifically for behavioral health providers. The collaboration has resulted in improved claim accuracy, reaching 95%.

– Sohar Health的资格自动化技术专为行为健康供应商设计。此次合作使索赔准确性提高到了95%。

Today’s Cumbersome Insurance Eligibility/Verification Challenges

当前繁琐的保险资格/验证挑战

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..

寻求心理健康服务的患者经常遇到诸如不可靠的服务提供商目录和意外的保险拒赔等障碍，这些问题给及时有效的治疗造成了重大阻碍。认识到简化流程的迫切需求，医疗服务提供者旨在患者就诊初期就准确核实健康保险覆盖范围，包括确定共付额和免赔额，以减少意外账单并提高整体满意度。

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..

然而，传统的保险资格和验证方法往往耗时、人工操作且容易出现人为错误。研究表明，十分之六的成年人难以理解自己的保险覆盖范围，导致索赔被拒。这一问题使得医疗机构每年花费约 197 亿美元试图推翻这些拒赔决定，给患者和医疗服务提供者都带来了挫败感。

Automating Insurance Eligibility Process

自动化保险资格流程

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..

Talkiatry致力于通过虚拟预约改善全国范围内高质量心理健康护理的可及性，为提升其技术驱动的患者体验，与Sohar Health展开了合作。Sohar的专为行为健康供应商设计的AI驱动的资格自动化技术，在实现这一目标中发挥了关键作用。

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:.

Sohar的API通过在护理提供之前自动确认覆盖范围并准确估算患者的费用分摊责任，显著提高了索赔接受率。为了简化Talkiatry的资格验证流程，Sohar实施了其资格自动化套件中的两个关键产品：

Discovery:

发现：

This product enables companies to determine a patient’s health insurance coverage without requiring them to disclose their provider upfront.

该产品使公司能够在不要求患者事先透露其保险提供商的情况下，确定其健康保险覆盖范围。

Verification:

验证：

This product verifies patient eligibility for services and details the nature of their benefits.

该产品验证患者的服务资格，并详细说明其福利的性质。

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..

成功的整合涉及 Talkiatry 的工程和产品团队与 Sohar 的首席技术官之间的高度协作。这种合作关系促成了能力的开发，使 Talkiatry 能够快速确定患者的健康保险覆盖范围，并准确估算共付额，而无需个人最初共享其保险公司的信息。

“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 .

“当人们寻求心理健康支持时，知道是否被保险覆盖可能是看精神科医生或放弃治疗的区别。我们必须使这一过程尽可能简单，以确保我们所爱的人迅速获得他们所需的护理，”

Ashish Mandavia, M.D.

阿希什·曼达维亚，医学博士

, 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.”

索哈尔健康公司的联合创始人兼首席执行官。“通过我们与像Talkiatry这样面向未来、技术驱动的组织合作，并借助我们易于使用、对消费者友好的API，我们能够减少与保险相关的障碍，让患者专注于获得他们应得的护理。”