Healthtech · Digital Care · 200–1000 · North America #b025_12

Context

We provide virtual addiction treatment with medication and recovery coaching, increasingly through health plan contracts nationwide.

Industry

Healthtech · Digital Care

Size

200–1000 employees

Region

North America

Tools budget

$5K–20K per month

Needs

Claims & prior authorization. As health plan contracts grow, denials and slow reimbursements are hurting cash flow and need systematic fixing.

Today: revenue cycle director overseeing billing and coding teams with engineering automation of payer claims · Urgency: now

Staffing & scheduling. Keeping prescribers licensed in the right states and scheduled by region is a constant manual chore.

Today: licensing specialist and regional provider recruiting to cover state-by-state clinician credentialing · Urgency: now

Who decides

cfo finance · team trial

Expects from suppliers

Experience with behavioral health and substance use billing rules; Licensure and credential tracking across states; Reporting on denials by payer

Not a fit

Billing vendors unfamiliar with controlled-substance telehealth; Credentialing tools without multi-state support

Stack

EHR system in place, CRM in place

Buying triggers

scaling transaction volume, regulatory change