Sift Healthcare has formed a strategic partnership with Hartford HealthCare to use AI and analytics to reduce reimbursement risks. The partnership merges clinical, coding, authorization, and payment data. This helps improve coding accuracy, enhance documentation, and align authorization workflows before claims are sent out. Instead of only managing past denials, this project targets areas like preservice authorization, concurrent level-of-care decisions, and clinical documentation. These are where payment risks often start.
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“Reimbursement pressure is increasingly shaped upstream, long before a claim is submitted,” said Cynthia Pugliese, Hartford HealthCare’s Senior Vice President of Revenue Cycle Services. Barry Stein, MD, HHC’s Chief Innovation Officer, noted, “This partnership enables us to apply advanced AI in a disciplined, workflow-driven way, helping our clinical and operational teams identify practical opportunities to improve how care is documented, authorized, and reimbursed.” Justin Nicols, Founder and CEO of Sift Healthcare, added, “Payers are applying increasingly sophisticated analytics to reimbursement decisions, and health systems need equally sophisticated tools to understand and respond to that shift.”
