Fuse
Pre-Seed
AI workflow automation for US healthcare providers covering insurance eligibility, claims, and revenue intelligence.
AI workflow automation for US healthcare providers covering insurance eligibility, claims, and revenue intelligence.
Fuse's platform automates insurance verification, patient cost estimates, claims submission, and revenue intelligence for US healthcare providers. The system checks payer portals, places direct payer calls, and cross-references adjudicated claims to verify benefits at the CPT level.
It scrubs and submits claims, then consolidates eligibility, claims, and payment data into a financial dashboard for cash, denials, contract performance, and aged accounts receivable.
US healthcare providers spend a significant share of revenue on financial administration, with eligibility errors and underpayments contributing to lost revenue. Recent advances in AI and machine learning make it feasible to automate payer portal checks, direct payer calls, and contract analysis at scale.
Regulatory pressure for price transparency, including CMS machine-readable files and the No Surprises Act, is creating demand for tools that turn complex payer data into actionable fee estimates and underpayment detection.
Fuse combines payer portal checks, direct payer calls, and adjudicated claims data in a single model to verify benefits at the CPT code level, a granularity that generic eligibility tools often miss. It integrates into existing EMRs as a billing user without requiring new software or clearinghouse connections, which shortens onboarding to hours rather than months.
The platform learns payer-specific denial and approval patterns over time, applying them across pre-visit verification, pre-submission scrubbing, and post-denial retry.
