Y Combinator LAUNCH VIDEO

Hi I'm Angel I'm Ahmad we're co founders of Avelis Health I've had three knee surgeries and I've had to fight down over a quarter million dollars of inflated charges from the hospital today we're gonna show you how that works Today we're gonna show you how that works this is Aliyah Aliyah just had a baby and she's worried about the bill she's gonna get from the hospital the hospital has two options they can either bill her with code O80 which means they're gonna get paid $12,000 or they can use code O72.1 which means they're gonna get paid $16,000 so here you might be asking how do they know what code to write thousands of pages of documents that detail exactly what code to use under exactly what circumstances so the hospital being the savvy businessman they are decide to use code O72.1 cause it's an extra $4,000 Fortunately Aliyah's company has great healthcare insurance Divided Health Insurance Aliyah - 20% Insurance - 80% Divided healthcare and under her policy she has to pay 20% of the total amount so after divided healthcare processes her claim they're gonna send her something that looks like this and this can get confusing so I want you to stay with me here the hospital tried to charge you $72,000 we're gonna allow them to charge you $16,000 and remember that comes because the hospital use code O72.1 we'll pay 80% you have to pay 20% so that means that because divided allowed the hospital to charge $16,000 Aliyah has to pay $3,200 just to have a baby so you might be asking isn't it in Divided Healthcare's interest to make sure that this is the right code because if it turns out that the code was O80 they would have saved $4,000 that brings me to my next point that depends who pays Self-Insured (Employer pays) vs Fully Insured (Insurance pays) that brings me to my next point that depends who pays see the majority of large companies are self insured and that means that when their employees go to the hospital they pay the claims instead of the insurance company but they still hire the insurance company to do all the work for them so that means that no matter what price this comes in at Divided Healthcare makes the same amount of money so they're not gonna be super incentivized to spend extra resources to make sure that those codes are correct so that's where Avelis Health comes in Avelis Machine Learning Large Language Models we work with self insured companies to audit their medical claims and to prevent things like this from happening we use machine learning and large language models to read the medical record to check the coding against clinical guidelines and to figure out if code O72.1 was supported because if it's not we'll get the claim reprocessed to O80 that will save $4,000 $800 of that will go back to Aliyah and $3,200 will go back to her employer we've already audited millions of dollars of claims and we've found significant overpayments so if you're an employer and you're self insured you're overpaying for healthcare head to avelishealth.com