Fairway Health
AI Co-Pilot for Health Insurers to Authorize Treatment Faster
Fairway Health is an AI-assistant for health insurers to quickly process patient treatment authorizations. We use LLMs to analyze long (70+ page), messy medical records and determine if a patient is eligible for a treatment.
Active Founders
Moses Im, Founder
CEO of Fairway Health. Moses was previously an MD candidate at Thomas Jefferson Medical School where he also was a clinical researcher in patient outcomes of surgical vs transcatheter aortic valve replacement. Before medical school, he also did molecular biology research at Princeton University in HIF-1α as a possible therapeutic target for Parkinson's Disease and the role of HIF-1α in early-stage development of aviary lungs. Moses has a bachelor’s degree in molecular biology from Princeton.
Joseph Chen, Founder
CPO of Fairway Health. Joseph has dedicated several years building at the intersection of health, ML, and software. He has research experience at Deepmind, Columbia, and Synbio Technologies in areas such as fabricating a neurosurgical tracking sensor and predicting antibody heavy and light chain pairing within an NGS sequencing library. He was also a software engineer at Pillpack where he built a service that checks if users' prescriptions are safe to take in the context of their health profile.
Grace W, Founder
CTO of Fairway Health. Grace previously worked at Asana and AWS on authentication/authorization and IoT device data monitoring respectively. Before that, she worked at MDClone, developing packages to enable the analysis of hundreds of thousands of datapoints for attributes such as patient remission. She also previously did research in ML in computer vision (detecting diseases from retinal OCT scans) and natural language processing (efficiently optimizing pre-trained language models like GPT).
Company Launches
TL;DR
Fairway Health is an AI assistant for health insurers to quickly process patient treatment authorizations. We use LLMs to analyze long (70+ page), messy medical records and determine if a patient is eligible for a treatment.
What is Prior Authorization?
Prior Authorization is a process where physicians must obtain approval from a patient’s health insurance plan before a specific treatment or medication is delivered. This process can take an average of 2-14 days, with some cases taking upwards of 15-31 days. This prevents patients from receiving necessary treatments in a timely manner. The entire healthcare industry is also projected to spend $36 billion each year in administrative costs for this process.
This process for health insurance is still manual and inefficient:
- Patient documents sent to health insurance are a mess and can be a 70-100+ page fax.
- Health insurance companies have to allocate more headcount to try and manually check these documents against their medical necessity criteria, costing them millions each year.
How it works:
We speed up the medical eligibility determination for health insurers. We ingest patient documents + criteria from health insurance plans and use LLMs to output an approval/denial decision with justification based on an evaluation of each sub-criteria. We also highlight the context within the medical document that informed the decision to allow for easy review.
Our ask:
Are you in health insurance or do you know anyone in health insurance? Ping us at moses@fairwayhealth.co. We would love to get connected and hear if we can help speed up your medical necessity determination process.