TL;DR: Splendor automates insurance workflows (benefits verification, prior auth monitoring, credentialing) for healthcare companies, eliminating the headaches of portal access, EDI, and AI phone calls.

https://youtu.be/Z0Y0GCHBHlA

The Problem:

Insurance verification, credentialing, and prior auth monitoring are tedious time/labor sinks, especially for specialty clinics and the tech stacks serving them.

With insurance verification, standard EDI 270/271 transactions work fine for basic stuff like primary care copays, but completely fall apart for specialized services like psychological testing or dental procedures. This forces companies to:

(a) hire armies of staff to manually check payer portals and make phone calls just to figure out patient benefits, or

(b) spend eng time building brittle scrapers that need to be constantly monitored and maintained.

For platforms onboarding multiple providers, this problem compounds exponentially.

Credentialing is equally brutal—every provider onboard requires navigating labyrinthine initial contracting and re-credentialing processes with zero effective automation available. Digital health companies want to be able to say “we accept most insurances,” but the logistics required to support that are grueling.

Prior auth monitoring means constant portal surveillance or phone tag with payers to track approval status. At scale, this becomes less and less tenable.

Pain points:

• Staff bloat: Manual verification requires dedicated headcount that doesn't scale
• Specialty blindness: EDI transactions can miss specialty- or procedure-specific benefits entirely
• Credentialing bottlenecks: Provider onboarding stalls on manual paperwork processes
• Prior auth limbo: No visibility into approval status without constant checking
• Integration friction: Disparate verification methods don't plug into existing workflows

The Solution:

Splendor orchestrates a waterfall of verification sources (portal access, EDI, AI phone calls, and more) into a unified API that integrates directly into your existing backend or EMR.

No more hiring verification teams, selenium scripts, or credentialing delays. Just automated insurance workflows that actually work for specialty healthcare scenarios. We’ve already processed tens of thousands of patients across mental health, dental, and vision.

Our Ask:

If you’re in any of these categories or want to learn more, we’d love to talk to you!

• digital health platforms
• EMR/EHR companies or vertical/horizontal companies that integrate into these
• billing companies
• MSOs/DSOs/BPOs
• multi-provider specialty private practices (psychiatric groups, dentists, physical therapists, etc.)

👉 Get started: https://splendorhealth.com

📩 Contact: hello@trysplendor.com