Ply Health recently launched!
"Enroll providers with payers. Fast."
They use AI to get behavioral health providers in network, so they can start billing twice as fast.
Founded by Samantha Wu and David Zhang
tl;dr
Providers need to get in network with insurance companies, but the process is time-consuming and an administrative headache. Ply Health ingests provider information and uses AI to automate submissions, saving providers months of waiting.
❌ The Problem
Being in network with a health insurer is critical for both patients and providers:
- For patients, seeing in network providers means dramatically lower healthcare costs. This informs which providers they choose and whether they can even afford to visit one.
- For providers, being in network means a bigger pool of potential patients. It also simplifies billing and reimbursement.
However, the process of getting a provider in network is highly manual and fragmented. There are approximately 1,400 payers in the US, each with their own enrollment process. Some of these processes involve painstakingly filling out 50+ page forms.
On top of burning hours of administrator time, delays are costly. A single incorrect field can push back cases by months. With providers billing $3,000/week, this costs healthcare practices tens of thousands of dollars per provider.
⭐ Ply Health's Solution
They provide standardized questionnaires to collect all required provider information and documents. Their customers are then able to request a new network enrollment in just a few clicks instead of spending hours navigating insurance websites to find the correct forms.
On the backend, they’re automating each part of the enrollment process. They also have an experienced ops team as humans-in-the-loop to make sure everything is processed correctly. This ensures that enrollments are completed quickly and accurately, their customers’ two most important KPIs.
Their product is currently optimized for behavioral health providers. The Ply Health team is working quickly to expand into other specialties.
📈 Results with Ply
They are currently working with practices such as Finni Health, Legion Health, Anna Autism Care, Shasta Health, and Birches Health.
For their customers, they’re getting in network 2x - 3x faster compared to alternative solutions, helping them earn additional hundreds of thousands of dollars in billing revenue.
