We believe every dollar spent on healthcare matters because healthcare matters to everyone.

CEO
Malinka Walaliyadde
Founded
2019

Problem Tech Solves

The U.S. spent about $3.8 trillion on healthcare in 2019, or approximately $11,582 per person, according to the Centers for Medicare and Medicaid Services. A 2019 study published in JAMA estimates that administrative costs account for $266 billion of wasteful spending in healthcare annually. The complex and highly manual system of claim preparation and billing is a key driver of healthcare costs in the U.S. This complexity of healthcare reimbursement drives up hidden costs that affect what every consumer pays and erodes the trust people have in the healthcare system. It’s a massive, deeply embedded problem. AKASA enables providers to efficiently navigate financial and operational complexity of revenue cycle operations — a key driver of healthcare costs in the United States. There’s a lack of new technology in the field and nothing that is purpose-built specifically for the financial function of healthcare (revenue cycle management). Over the past two decades, financial leaders have been forced to cobble together a patchwork of solutions that often don’t integrate with one another and only automate a portion of revenue cycle processes. AKASA’s unique expert-in-the-loop approach, Unified Automation™, combines artificial intelligence with human judgment and revenue cycle expertise to deliver robust and resilient automation purpose-built for healthcare. Unified Automation eliminates the need for consultants, in-person implementations, multiple vendors, or hiring new staff to manage the automation process.

Tech Brief

AKASA has built the most sophisticated automation approach on the market for revenue cycle management called Unified Automation™. It provides hospitals and health systems with a single solution that uses the same artificial intelligence (AI) and machine learning (ML) technology employed by driverless cars to improve the efficiency, accuracy, and scalability of healthcare operations, starting with revenue cycle management (RCM). Complexity of revenue cycle operations has grown dramatically, driving up costs and eroding trust people have in our healthcare system. AKASA's Unified Automation™ is purpose-built to navigate those complexities efficiently, accurately and autonomously — reducing the cost of care for healthcare providers and infusing a bit of trust back into our healthcare system. Other general solutions, such as robotic process automation (RPA), may work for simple, discrete tasks, but often fail quickly in the highly complex, dynamic nature of healthcare. This leaves hospitals and health systems stuck with a trail of broken bots and blown budgets. In fact, a Forrester report indicated that for every $1 spent on RPA technology, an additional $3.41 is spent on RPA bot creation and maintenance. United Automation is a flexible AI-based solution that operates within a healthcare system’s existing electronic health record (EHR) and revenue cycle infrastructure, automating complex administrative tasks, reducing errors, and improving efficiencies. Our expert-in-the-loop technology works with AKASA’s team of in-house revenue cycle and operations experts to ensure that exceptions and edge cases are resolved - seamlessly blending human judgment and subject matter expertise with machine learning.

Tech Differentiators

AKASA is the only company using AI and the expert-in-the-loop approach, which allows hospitals and healthcare systems to truly automate complex, dynamic staff workflows. Our advanced, machine learning automation addresses complex workflows and continuously adapts. First-gen RCM technology focused on embedding within legacy systems to augment staff operations. This provided dashboards and visualized workflows, but didn’t perform work. Next came a focus on automation with technology like RPA. RPA works best on basic, linear workflows, but is limited when automating tasks in complex environments. These approaches rely heavily on consultants who retrofit old technology to a dynamic industry. Total cost of ownership is underestimated as RPA often doesn’t address ongoing maintenance, forcing leaders to hire engineers or consultants every time a bot breaks. When macros or bots automating any process break due to variable changes, the bot has to be reprogrammed or recoded. However, machine-learning automation is far more flexible. For example, our Unified Automation solution has been designed with exceptions and outliers in mind. If it encounters something new, the platform flags the claim to AKASA's team of revenue cycle experts who resolve the claim while the system learns from the actions they take. This seamlessly integrates human judgment and subject matter expertise into our solution. At AKASA, we’re one of the only companies who is publishing rigorous, peer-reviewed research validating our AI technology which supports the business side of healthcare. We've presented research at conferences like the International Conference on Machine Learning and Machine Learning for Healthcare Conference.

Validation

Case study: Methodist Health System, a multi-state health system including five hospitals and 33 clinics which has $970M in net patient revenue. For this customer, AKASA’s Unified Automation platform performed the work equivalent to 19+ FTEs who are working to perfect productivity. Research: Our most recent research was presented at the 2021 Machine Learning in Healthcare Conference, showcasing how AKASA’s machine learning model (Read, Attend, and Code) outperformed leading industry state-of-the-art models and human coders when autonomously coding medical notes. Other research presented at the conference included MIT, Stanford, Harvard and Google Brain. Testimonials: "We have been impressed with the AKASA team's expertise in revenue cycle operations. They were able to deploy Unified Automation™ quickly and we've seen the system adjust to process changes in real-time. We've also had significant improvements in our revenue cycle operations over the past several months as our business office staff has had a greater opportunity to work at the 'top of their license' by focusing on more difficult claims while automation handles claim status checks and other time consuming tasks that are necessary but are a less strategic use of our staff's time and talent." Jeff Francis, vice president and CFO of Methodist Health System. “AKASA has been an innovative partner, bringing deep expertise of clinical and operational workflows to our automation efforts. The alignment in focus for both teams and the efficiency of deployment has made this a highly effective collaboration for Sutter Health.” Scott Abram, VP of Revenue Cycle at Sutter Health

Why Us

AKASA is building the future of healthcare using AI. We need solutions that address the root causes of erroneous, surprise medical bills at-scale to protect patients. Unified Automation is designed to be a giant leap forward, modernizing the infrastructure of healthcare to reduce administrative costs often passed onto the patient.

❮ Return to FULL LIST OF FINALISTSView Next Company❯