Kaigo Health

Kaigo Health: AI Revenue Watchdog for SNFs

Kaigo Health is an AI revenue watchdog designed specifically for Skilled Nursing Facilities (SNFs). The platform monitors financial data to identify money leaking from buildings through denials, underpayments, pharmacy errors, and hidden vendor waste. By analyzing remittances, contracts, invoices, claims, and operating data, Kaigo provides business offices with a dollar-ranked list of found money and one-click recovery actions without requiring a new workflow.

Key Features

• Automated Financial Analysis: Reads remittances, contracts, invoices, GL lines, census, claims, and operating data to catch financial leaks.
• Bi-Weekly Recovery Lists: Delivers a dollar-ranked list of found money and recovery packets every other week for the office to approve.
• Revenue Capture: Identifies and helps appeal MA denials, underpayments, missed billing, and missed reimbursements.
• Cost Recovery: Flags pharmacy billing errors, medications billed after discharge, duplicate vendors, hidden fees, and zombie subscriptions.
• Spend Optimization: Tracks PPD (Per Patient Day) drift, vendor waste, spend leaks, and line-item outliers.

Use Cases

• Identifying False Pharmacy Charges: Catching medications, such as HIV meds, that are incorrectly billed to the facility instead of insurance.
• Eliminating Dead Subscriptions: Stopping recurring payments to vendors that are no longer being used by the facility.
• Routing Costs to Health Plans: Ensuring expenses like rent stipends and transportation are covered by health plans rather than paid out of pocket by the building.
• Detecting Margin Erosion and Anomalies: Normalizing numbers per resident day to spot slipping PDPM days, or investigating sudden spikes in food PPD costs to uncover issues like staff theft.

Getting Started

Website: https://www.kaigohealth.ai

Kaigo Health acts as an additional finance team member that never sleeps, helping SNF operators capture missed revenue, recover erroneous outgoing payments, and optimize spending. By turning complex financial data into simple, actionable recovery lists, the platform enables facilities to protect their margins efficiently.