SaaS ideas your next customers are already looking for
100 SaaS startup ideas for the people who said they'd pay, from agency owners to dentists. Micro SaaS ideas, AI SaaS ideas and B2B SaaS ideas: find yours, build it, sign them up.
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Pain points in business: what people struggle with
Search the problems to solve, as people described them on Reddit and other platforms, in their own words.
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Prior Auth and Claim Denials
Clinicians and billing staff waste time on manual prior authorizations, wrongful denials, downcoding, and appeals across payers.
In their words
Automate the appeals just like they automate the denials.
Initially had our phone nurse doing the PAs but have now hired a company whose sole purpose is doing prior auths.
BCBS in IL and Texas have started automatically downcoding all 99214 and 99215 claims to 99213 and requiring appeals.
3 months of Simple Practice's credentialing partner submitting the wrong forms and forcing me to talk to AI when I knew from the beginning they must have been doing it wrong.
I've been dealing with a denied prior authorization for a CT scan all day.
prior authorization is the actual job and medicine is the side gig I squeeze in between the paperwork
Easy appeal but such a waste of our time.
Anyone else receiving UHC/UBH claim denials for 90834 (and of course 90837).
Are you wondering why your legit Delta Dental, MetLife, Humana, Ameritas, Principal, and United Concordia claims are getting rejected and denied?
the real challenge is that healthcare workflows make almost no sense
It took a year before I finally got some dingdong to actually look at the images I sent and they approved it.
I do prior auths, get denied, and the pharmacy blames me.
spends several hours per month dealing with this but she has saved us probably tens of thousands of dollars in mis-processed claims that the insurance companies can't even properly handle.
They were spending at least 1 hour every day on calls with the insurance companies for prior authorization instead of seeing patients.
Medical practices and billing staff
Where they talk
- r/CodingandBilling
- r/therapists
- r/medicine
- r/FamilyMedicine
- r/HealthcareAIAgents
- r/Dentistry
- r/adjusters
- r/nursing
Tools they use today
- Availity
- CoverMyMeds
- Epic
- Excel
- Athena
- Cerner
- Claude Cowork
- Doximity
Why those fall short
- no clinical contact, calls hung up, no callback, no feedback channel
- appeal process long, arduous, unclear; no specific denial sent
- insurers hide exception criteria and step-therapy requirements; no transparency
- denials recur, appeals need same info re-sent, no reimbursement for time
- appeals are slow, unclear and controlled by the insurer
Map of ideas
Drawing the map…