🍃 Ply Health: Get providers in network faster

tl;dr

Providers need to get in network with insurance companies, but the process is time-consuming and an administrative headache. We ingest provider information and use 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.

⭐ Our Solution

We provide standardized questionnaires to collect all required provider information and documents. Our 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, we’re automating each part of the enrollment process. We 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, our customers’ two most important KPIs.

Our product is currently optimized for behavioral health providers. We are working quickly to expand into other specialties.

📈 Results with Ply

We are currently working with practices such as Finni Health, Legion Health, Anna Autism Care, Shasta Health, and Birches Health.

For our customers, we’re getting in network 2x - 3x faster compared to alternative solutions, helping them earn additional hundreds of thousands of dollars in billing revenue.

🧑‍💻 The team

We’ve been friends for over 15 years but don't actually have pictures together because we’re both camera shy

Sam started her career in finance (M&A IB, then large cap PE) before realizing that she was meant to be a startup operator. She discovered the pain point of contracting and credentialing first hand when she was running BizOps at Finni Health.

David is a pre-med turned software engineer with a specialty in building scalable backend systems at Meta and Snap.

🙏 The ask

If you’re a behavioral health practice or are friends with one, we’d love to chat! Please reach out at hello@plyhealth.com or book a demo on our website.

If you’re at a behavioral health insurance payer, or are friends with one, we’d love to chat about potential partnerships. Please reach out at hello@plyhealth.com.

If nothing else, we’d appreciate sharing our launch and following us on LinkedIn!