JEWISH SENTINEL

JEWISH WORLD • DECEMBER 20-26, 2024 5 By YULIAKARRA O r Peles, CEO of Nym Health, describes the U.S. healthcare system as a “sort of Wild West scenario.” “It’s by far the most complicated healthcare system in the world,” he says. Not only does the country “lack universal healthcare, but it is also the most expensive healthcare system in the world, with annual national health expenditures stand- ing at $14 trillion; around $1 trillion of that money goes to waste due to mismanagement.” Israel-founded Nym, which em- ploys 80 workers at offices in Tel Aviv and New York, offers an AI-powered platform that the com- pany claims can help the U.S. healthcare system deal with bureau- cracy overload.   The company’s groundbreaking technology has automated the reve- nue cycle management (RCM) cod- ing process for healthcare facilities. RCM utilizes medical billing software to track patient care from registration and appointments to the final payment of a balance. When healthcare clinics bill in- surance companies, they transform Trimming The Fat Israeli tech firm helps cut U.S. health-insurance red tape INNOVATION the patient’s medical file, including diagnosis, procedures, and medical services, into alphanumeric codes. Until now, this process has been manually performed by medical re- cord technicians, of whom there are nearly 200,000 in the U.S., due to the sheer volume of claims filed with insurance companies.  “There are around 100,000 exist- ing codes and around 3 billion claims being filed annually; it’s an enormous burden on the system,” notes Peles, who has been with Nym since 2022. “We’ve created a solution that reads a medical file, understands it from a clinical perspective, and then automatically turns it into codes - without the touch of a human.” Nym’s unique product, which has been on the market since 2021, is already used in over 20 healthcare settings. Peles says that while other start- ups have tried to develop similar solutions, “No one has been able to reach this level of accuracy before.” The Nym platform connects to the healthcare system at a specific clinic where it is installed, accesses the relevant files, and “creates a medical ontology.”  “The platform also knows how to perform ‘sanity testing’ to verify Nym’s AI-powered platform automatically translates notes from patient charts into diagnostic and billing charge codes. that the medical story of a patient checks out - for instance, he was walking, fell, and a cast was ap- plied to treat a broken bone.” Peles explains that if the platform identifies medical scenarios that don’t make sense, it sends them back to the staff to be double-checked and does not automatically proceed with the coding process until the discrepancy is resolved.  continued on page 28