Huraypositive is expanding its cloud SaaS-based medical claims review business in Japan. Its system has been adopted by approximately 850 institutions, significantly reducing processing time at a monthly cost of approximately ¥70,000–¥80,000. The company is targeting expansion driven by the FY2026 medical fee revision.
As the risk of delays and reductions caused by returned and adjusted claims rises during the review of medical claims submitted by Japanese medical institutions by the 10th of each month, Huraypositive provides the cloud-based SaaS product “レセプトチェッカー LS Plus,” which automates claims review. It verifies diagnoses, billing and applicable treatments using approximately 4,000 detailed review rules and approximately 24,000 applicability rules, and supports both outpatient and inpatient care.
The company says that migrating existing paper-based or installed billing-support systems to the cloud can reduce processing time for Japanese medical institutions from approximately 6–8 hours to approximately 15 minutes. The implementation cost is approximately ¥70,000–¥80,000 per month, and approximately 850 institutions currently use the service.
The business was not built from scratch. It was cloud-enabled through the acquisition of Japanese company DX Care. Its competitive advantage is thought to include the ability to apply updates centrally on the server after implementation. The FY2026 medical fee revision is viewed as a turning point that could significantly reshape the market, and the company aims to expand its competitive advantage through cloud migration.
Over the long term, the company aims to provide AI-based healthcare management intelligence using claims review data. It plans to release, in stages, functions such as detecting missed billings, forecasting adjustments and returned claims, and benchmarking among clinics, while pursuing a data utilization strategy centered on the Japanese market.