Healthcare technology company Hyphen is aiming to bring social-needs-related organizations into the payment ecosystem with its new platform.
The company is launching a new Social Care Claims processing tool that seeks to make it easier for services that address health-related social needs to secure reimbursement. The program is launching first in Massachusetts, which recently secured a Section 1115 waiver in its Medicaid program to allow such claims to be submitted.
Since going live in January, 12 organizations in the state have signed on with Hyphen and have submitted more than 12,000 claims, equaling more than $1.4 million in reimbursement.
Suzanne Wogelius, vice president of product management at Hyphen, told Fierce Healthcare that the team quickly determined it wanted to support these community organizations with the newfound flexibility.
Hyphen's central mission, she said, is to connect key entities through a flexible platform.
"We believe this is a foundational shift in how social care becomes reimbursable and really part of the healthcare ecosystem," Wogelius said.
The company's Social Care Claims processing platform is built as an end-to-end solution to support organizations that address the social determinants of health. It can intake key data and validate them, ensuring information is in the appropriate formats and routing it to insurers, according to an announcement.
Hyphen also connects these organizations to historical claims tracking and trend reports, per the announcement.
For instance, Wogelius said an organization using the platform can send its data over in an Excel spreadsheet and Hyphen can ensure that information is put in the proper format. That way, the service providers simply need to submit and file, and Hyphen does the rest, she said.
One of the early adopter organizations is Project Bread, which aims to address food insecurity in Massachusetts. Project Bread already had an existing relationship with Hyphen, so jumping into its new claims processing offering made sense, said Jennifer Obadia, Ph.D., senior director of healthcare partnerships at Project Bread, in an interview with Fierce.
She said the platform has enabled the team to generate its own reports and more effectively track data around claims, particularly for denials.
"Instead of having to go and generate a million different reports internally on our end, we just look at that dashboard," she said.