Sohar Health

Sohar Health is a cutting-edge insurance verification and Revenue Cycle Management (RCM) automation platform designed specifically for healthcare providers. Founded by a physician and an engineer, Sohar Health leverages the power of AI and a robust API to tackle the complexities of front-end RCM processes. The platform is engineered to deliver unparalleled accuracy and speed, helping providers to maximize revenue, convert more patients, and significantly decrease claim denial rates. By automating what are traditionally manual and error-prone tasks, Sohar Health enhances operational efficiency and improves the overall patient intake experience.

The core mission of Sohar Health is to empower providers by offering a transparent, simple, and highly effective solution to navigate the intricate world of insurance claims. The platform is trusted by leading healthcare providers who have seen tangible results, including an 8:1 ROI within the first year, a 12% increase in patient conversion, and a significant reduction in administrative overhead.

How to use Sohar Health

Sohar Health is designed for seamless integration into existing healthcare systems and patient intake workflows. The primary method of use is through its developer-friendly API.

1. Integration: Developers integrate the Sohar Health API into the provider's patient registration or EMR/EHR system. The integration process is straightforward, allowing for quick implementation.
2. Automated Verification: When a new patient is being onboarded, the system automatically sends the patient's basic information (like name, date of birth, and state) to the Sohar Health API.
3. Real-Time Data Retrieval: The API instantly processes the request. In a median time of 6 seconds, it returns comprehensive data, including the patient's active insurance coverage (even if the patient didn't provide it), eligibility status, details of benefits, and in-network or out-of-network status.
4. Workflow Automation: The provider's system uses this accurate, real-time data to inform next steps. This could involve automatically confirming appointments for eligible patients, providing accurate cost estimates upfront, or flagging potential coverage issues for administrative review.
5. Rule Customization: Operations and RCM teams can use the Sohar Health portal to configure custom, no-code rules to handle complex payer contracts, carve-outs, and other specific scenarios, further automating decision-making without engineering support.

Core Features of Sohar Health

• Insurance Discovery: Automatically identifies a patient's active health insurance coverage using minimal demographic information (name, DoB, state), eliminating the need for patients to provide their insurance details upfront.
• Real-Time Eligibility & VoB: Conducts instant eligibility and Verification of Benefits (VoB) checks across a vast network of national and regional payers. Over 90% of verifications are completed in under 30 seconds.
• Network Status Verification: Instantly confirms if a provider is in-network or out-of-network for a patient's specific plan, helping to prevent surprise bills and manage patient expectations. This feature includes a customizable rules engine to handle complex plan nuances.
• Claim Denial Reduction: Proactively prevents claim denials by verifying and correcting member details in real-time, identifying benefit-related carve-outs, and ensuring network status accuracy before services are rendered.
• Cost Estimation: Provides the capability to offer patients a transparent, 'review order' experience with exact cost information as a final step in the intake process.
• Developer-Friendly API: A simple, robust API that allows for easy integration into any existing health tech stack.
• No-Code Rules Engine: Empowers non-technical RCM and operations teams to build and manage complex logic and automation rules directly within the Sohar portal.

Use Cases for Sohar Health

Sohar Health is ideal for various healthcare settings looking to optimize their front-end operations:

• Telehealth Platforms: Automate the entire patient intake and insurance verification process to handle high volumes of patients efficiently, as demonstrated by clients like Talkiatry.
• Specialty Clinics (e.g., Mental Health): Manage complex payer networks and carve-outs common in behavioral health, ensuring accurate eligibility checks and preventing downstream billing issues.
• Hospitals and Health Systems: Streamline front-desk and patient access workflows, reduce administrative time spent on phone calls and portal logins, and decrease costly claim denials.
• Digital Health Startups: Build a scalable and efficient patient onboarding experience from the ground up by integrating Sohar's powerful verification API.

Advantages of Sohar Health

• Unmatched Accuracy: Delivers over 96% accuracy in verifications, going beyond a simple 'valid response' to provide truly correct information.
• Exceptional Speed: Reduces verification time from hours to seconds, dramatically accelerating the patient intake process.
• Increased Revenue: Directly boosts the bottom line by increasing patient conversion rates and significantly reducing claim denials.
• Enhanced Operational Efficiency: Frees up administrative staff from manual, repetitive tasks, allowing them to focus on higher-value patient care activities.
• Improved Patient Experience: Creates a smoother, faster, and more transparent onboarding process for patients, reducing drop-offs and preventing surprise medical bills.
• Scalability and Flexibility: The combination of a powerful API and a no-code rules engine allows the solution to scale and adapt to the unique needs of any healthcare provider.

Pricing and Plans

Sohar Health operates on a custom pricing model tailored to the specific needs and scale of each healthcare provider. Pricing information is not publicly listed. To get a personalized quote and understand how the platform can benefit your organization, you are encouraged to book a demo with the Sohar Health team through their website.