AI Healthcare Provider Credentialing Software
Sophia Clark, Founder
Veronica and Sophia here, we’re building Harbera. Harbera is AI software that helps healthcare organizations keep their providers - physicians, dentists, nurse practitioners - in-network with insurers and compliant.
Without credentials doctors can’t treat patients
Credentialing is the bureaucratic process of verifying a providers’ qualifications and contracting them with insurance plans. The 900+ insurance companies across the U.S. have different and ever-changing credentialing requirements, and providers need to be re-credentialed regularly.
Keeping providers credentialed is critical. If a provider falls out-of-network, it can take months to get credentialed again. Health systems are often unaware that a provider has fallen out-of-network until claims start getting denied, leading to disrupted patient care and billions in lost revenue.
Monitoring credentialing is hard and gets harder at scale
There’s a lot that administrators need to keep track of: updates to insurance plan requirements (often mailed), license and certification expirations, malpractice sanctions, re-credentialing timelines, and more. Today, many back-office teams at hospitals and clinic groups use spreadsheets, filing cabinets, or even repurpose tools like Salesforce to track credentialing.
Here’s why monitoring is challenging for organizations:
- A telehealth company that accepts 10 insurance plans and works with 100 therapists across 30 states needs to track up to 30,000 statuses.
- A dental group working with 200 dentists needs to track 8,000 statuses. (Dentists are enrolled in over 40 insurance plans on average.)
What we’re doing
We are making credentialing easy. Our software integrates with a healthcare organization’s existing systems to continuously monitor and proactively re-credential providers across states and insurance plans. We keep administrators in the loop so providers never fall out-of-network. We make onboarding new providers seamless with real-time document validation. We analyze credentialing trends to identify revenue growth opportunities and optimize staffing.
About us
We’re best friends from college. We studied and taught Computer Science together at Harvard. Veronica was a software engineer at Stripe, and Sophia was a software engineer at House Rx, a specialty pharmacy software startup serving clinics across the country.
Ask
Do you know health leaders that work in multi-state or multi-practice healthcare organizations, like dental support organizations (DSOs), telehealth companies, hospitals, or clinic groups? We’d love to meet them!
Email founders@harbera.com to get in touch 🦡🧡
