Sift Healthcare: Introducing AI into Healthcare Payments

CEO Justin Nicols was working on mobile payment application designed for small businesses when he uncovered the need for an innovation in healthcare billing. He observed the staggering number of manhours devoted to the processing and collection of medical bills, and noted dollars wasted because of disparate data systems and human capital intensive workflows . With a background in data-driven eCommerce, he knew predictive analytics would revolutionize the process. His company, Sift Healthcare, designed to enable healthcare providers to optimize payments and processes, launched in November 2017. The company, which was founded in Milwaukee and still headquartered here, has since processed 29 million claims and $12 billion in patient receivables. As impressive as those numbers are, Sift is only getting started.

Winner of the 2019 Wisconsin Innovation Award in Health IT-Software, the company uses data science and AI to determine the most effective workflows for insurance claims, and the best-fit payment plan and contact approach for individual patients. These machine learning integrations may help hospitals recover from the financial setbacks caused by the COVID-19 pandemic. Despite the introduction of a vaccine, hospitals continue to feel the impact of the virus. Surges in demand for care of COVID-19 patients caused hospital expenses to soar, along with significant lost revenue from  the cancellation of most elective procedures. According to Kaufman Hall, a consulting firm specializing in financial and performance measures in the healthcare industry, September 2021 data shows that hospital operating margins are still 2.9% below the same time frame in 2019. The introduction of AI into the revenue cycle should reduce the cost to collect and add to the bottom line of hospitals and health systems.

Vice President of Marketing and Accounts Bethany Grabher, joined the team in April 2019, shared that the growth-focused company has raised an impressive $7 million in capital and will be looking at further fundraising in the first half of 2022.

In past interviews, Nicols has expressed pride in the fact that much of Sift Healthcare’s early funding came from Wisconsin, including Winnebago Seed Fund and Rock River Capital Partners. When asked why the Wisconsin connections are important to Nicols, Grabher said:

“Justin was born and raised in Milwaukee and has really strong ties to the community. He went to UW-Milwaukee and is very committed to (the city). There has never been a discussion about Sift going elsewhere. There’s always been a commitment to being here, in Milwaukee. It’s harder for us to get data science talent and fundraising is different than on the coasts. But we are drawing a lot of great talent from local universities, and we have found innovative and supportive local investors.”

Grabher, with her extensive experience working for startup companies, was asked to share some advice to those looking to create a marketing plan for a new startup business. She offered the following:

“I think the most important thing is to be flexible. I’ve worked at a couple of different startups and the product, the customer and the intentions evolve all the time. So you have to be thinking almost two steps ahead (about) where this can go. How do we tell the story today that is going to work for where we are going to be six months from now? Or two years from now? How do we stay relevant and stay ahead of the curve, and make it palatable for both investors and potential clients? So, I feel like you have about 10 different stories going through one thought line.”

To follow Sift Healthcare’s progress as it begins its Series A funding round, and learn more about its innovations in healthcare billing, connect with the company via Twitter or LinkedIn.

Sift Healthcare: Introducing AI into Healthcare Payments

CEO Justin Nicols was working on mobile payment application designed for small businesses when he uncovered the need for an innovation in healthcare billing. He observed the staggering number of manhours devoted to the processing and collection of medical bills, and noted dollars wasted because of disparate data systems and human capital intensive workflows . With a background in data-driven eCommerce, he knew predictive analytics would revolutionize the process. His company, Sift Healthcare, designed to enable healthcare providers to optimize payments and processes, launched in November 2017. The company, which was founded in Milwaukee and still headquartered here, has since processed 29 million claims and $12 billion in patient receivables. As impressive as those numbers are, Sift is only getting started.

Winner of the 2019 Wisconsin Innovation Award in Health IT-Software, the company uses data science and AI to determine the most effective workflows for insurance claims, and the best-fit payment plan and contact approach for individual patients. These machine learning integrations may help hospitals recover from the financial setbacks caused by the COVID-19 pandemic. Despite the introduction of a vaccine, hospitals continue to feel the impact of the virus. Surges in demand for care of COVID-19 patients caused hospital expenses to soar, along with significant lost revenue from  the cancellation of most elective procedures. According to Kaufman Hall, a consulting firm specializing in financial and performance measures in the healthcare industry, September 2021 data shows that hospital operating margins are still 2.9% below the same time frame in 2019. The introduction of AI into the revenue cycle should reduce the cost to collect and add to the bottom line of hospitals and health systems.

Vice President of Marketing and Accounts Bethany Grabher, joined the team in April 2019, shared that the growth-focused company has raised an impressive $7 million in capital and will be looking at further fundraising in the first half of 2022.

In past interviews, Nicols has expressed pride in the fact that much of Sift Healthcare’s early funding came from Wisconsin, including Winnebago Seed Fund and Rock River Capital Partners. When asked why the Wisconsin connections are important to Nicols, Grabher said:

“Justin was born and raised in Milwaukee and has really strong ties to the community. He went to UW-Milwaukee and is very committed to (the city). There has never been a discussion about Sift going elsewhere. There’s always been a commitment to being here, in Milwaukee. It’s harder for us to get data science talent and fundraising is different than on the coasts. But we are drawing a lot of great talent from local universities, and we have found innovative and supportive local investors.”

Grabher, with her extensive experience working for startup companies, was asked to share some advice to those looking to create a marketing plan for a new startup business. She offered the following:

“I think the most important thing is to be flexible. I’ve worked at a couple of different startups and the product, the customer and the intentions evolve all the time. So you have to be thinking almost two steps ahead (about) where this can go. How do we tell the story today that is going to work for where we are going to be six months from now? Or two years from now? How do we stay relevant and stay ahead of the curve, and make it palatable for both investors and potential clients? So, I feel like you have about 10 different stories going through one thought line.”

To follow Sift Healthcare’s progress as it begins its Series A funding round, and learn more about its innovations in healthcare billing, connect with the company via Twitter or LinkedIn.