RISA Labs

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RISA Labs is a healthtech startup specializing in AI-driven workflow automation for oncology care. Their flagship product, the Business Operating System as a Service (BOSS), is designed to streamline complex administrative processes, particularly focusing on reducing prior authorization delays that often hinder timely cancer treatment. By integrating advanced AI agents, large language models, and digital twins, BOSS decomposes intricate workflows into manageable micro-tasks, automating traditionally manual and time-consuming procedures. This innovation aims to enhance coordination among healthcare providers, expedite treatment decisions, and ultimately improve patient outcomes. Key Features and Functionality: - Prior Authorization Automation: BOSS automates the end-to-end prior authorization process for oncology drugs, addressing medical necessity, payer criteria, and submission across various platforms, including portals, APIs, and e-fax systems. - Eligibility and Benefit Verification: The system performs real-time verification of patient coverage, benefits, and financial responsibilities across multiple payers, with seamless integration into electronic health records (EHRs). - Claims Status Monitoring: BOSS offers automated tracking of claim statuses, continuously reconciling authorizations, payer responses, and payment events to ensure accurate and timely processing. - Denial Management: The platform systematically detects, classifies, and resolves claim denials by generating guideline-aligned appeals, reusing evidence, and maintaining closed-loop status updates. - Customizable Workflows: BOSS provides composable, rules-driven workflows tailored to each practice's standard operating procedures, payer mix, and operational constraints, ensuring flexibility and adaptability. Primary Value and User Solutions: RISA Labs' BOSS platform addresses critical challenges in oncology care by eliminating administrative bottlenecks that delay treatment initiation. By automating prior authorizations and other administrative tasks, BOSS reduces the time-to-treatment, minimizes scheduling disruptions, and alleviates treatment-related anxiety for patients. Healthcare institutions benefit from improved cash flow, reduced operational costs, and enhanced compliance with clinical guidelines and payer policies. The system's interoperability ensures seamless integration across diverse healthcare systems, enabling providers to focus more on patient care rather than administrative burdens.