Kaigo Health

Skilled nursing facilities (SNFs) routinely lose money on pharmacy charges that should have been billed to insurance, vendor charges that don't match contracts, DME leakage, and recurring costs that no longer belong on their books. At the same time, they fail to capture money owed to them through ADRs, ECM opportunities, skill-in-place and care-level capture, authorizations, concurrent reviews, and Part B reimbursement. SNF staff, facing a tough financial climate and nursing shortages, often lack the time to pursue these referrals, authorizations, and appeals. The result is dollars leaking out of the building and revenue left uncaptured on the table.

Kaigo combines a human and AI workforce to act as an outsourced business office for SNFs. It starts by accessing data through exports and then full integration across invoices, P&L, census, payer and vendor contracts, and PCC, then cross-references every line item against every other line to investigate discrepancies. The team executes on findings by filling out referrals, chasing authorizations, submitting appeals, and disputing charges, then delivers a simple report of missing dollars and recommended actions every other week. Kaigo prepares the analysis and drafts only; the facility's prescribers, billers, and staff review, decide, and submit, with recovered money returned directly to the building.