Hyphen and partners first in Massachusetts to unlock claims-based billing for HRSNs, formally bringing social care into the healthcare payment ecosystem

HARTFORD, Conn., June 17, 2025 — Hyphen, the digital platform company focused on building a connected healthcare ecosystem, today announced that non-traditional care providers using its new Social Care Claims solution were the first in Massachusetts to receive timely insurance reimbursement for services that address health-related social needs (HRSNs). By simplifying and automating claims processing, Hyphen is helping social care providers get reimbursed more easily for essential services — such as food, housing, and transportation support — laying the groundwork for a more sustainable and scalable social care system that ensures these services remain accessible to the people and communities who need them most.

Community-based organizations and social care networks have long played a critical role in addressing HRSNs, but they’ve traditionally relied on grants, invoice payments, and inconsistent funding streams to operate. Recent regulatory changes have opened the door for many of these organizations to shift to claims-based billing, a more stable and sustainable reimbursement model. However, most lack the technology and resources to effectively submit claims to insurers.

Hyphen’s Social Care Claims solution addresses this gap by automating the submission of clean, compliant claims. This reduces manual work, minimizes errors, and speeds up payment. The solution can be implemented in less than a month and supports billing across all payer types, making claims‑based reimbursement both practical and scalable for social care organizations of any size.

“Our partners are leading the way in making social care sustainable,” said Suzanne Wogelius, who leads product for Hyphen. “By removing administrative hurdles and making timely reimbursement possible, we’re making revenue more predictable and reliable so they can stay focused on caring for their communities. At the same time, we’re advancing Hyphen’s mission to connect the entire care ecosystem and make seamless, high-quality care a reality for everyone.”

Hyphen’s architecture supports end-to-end claims processing for HRSNs, including data ingestion, transformation to the standard 837P format, validation, routing to payers, ingestion of 835 remittance payment data to support payment reconciliation efforts, and historical claims tracking and trend analysis.

Under the MassHealth 1115 Waiver, 12 organizations in Massachusetts — including federally qualified health center ACO Community Care Cooperative (C3), food security organization Project Bread, and housing, home rehabilitation and nutrition service organization Revitalize CDC — have collectively submitted approximately 12,000 claims since going live in January, unlocking more than $1.4 million in payments for services that are now a covered benefit. Hyphen has achieved a first pass claims rate of nearly 100% since April 2025, demonstrating commitment to operational excellence and ensuring faster, more efficient reimbursement for its clients.

“In January, Massachusetts made programs addressing food insecurity a supplemental covered Medicaid benefit. While this allows our nonprofit Project Bread to submit claims, it also required us to stand up new infrastructure for claims processing with our various ACO partners, claims payment reconciliation, and patient trend analysis. Hyphen has been a critical partner in enabling us to steward the benefit program and reduce barriers to accessing healthy food in Massachusetts,” said Jennifer Obadia, Senior Director of Health Care Partnerships, Project Bread.

About Hyphen

Hyphen is a healthcare technology company that makes it easy for health plans, providers, and community organizations to share data and work together to deliver connected-care. The composable Hyphen platform is payer agnostic and uses real-time FHIR-based integration to enable access to critical information when and where it’s needed most — so all healthcare stakeholders can align care coordination efforts around the patient. Hyphen was built with deep experience in value-based care, a focus on health equity, and a steadfast commitment to ensuring value flows in ways that benefit the whole healthcare system. Learn more at hyphencare.com.

Media Contact: PressInquiries@Hyphencare.com