Certify, a supplier knowledge intelligence firm, has secured $40 million in Sequence B funding, bringing its whole funding up to now to $69 million, the corporate introduced on Thursday.
The New York Metropolis-based firm serves well being plans and digital well being firms and is working to streamline entry to supplier knowledge, whether or not that’s for supplier directories or medical claims. Its AI platform combines supplier knowledge from sources like state boards, certifying our bodies and nationwide clearinghouses, in addition to self-reported knowledge from suppliers. Its companies for well being plans and digital well being firms embrace supplier credentialing, licensing, monitoring and roster administration.
“Supplier knowledge is the invisible spine of healthcare — and proper now, it’s damaged,” mentioned Anshul Rathi, founder and CEO of Certify, in an e mail. “Suppliers are requested to fill out the identical 40-page software over and over throughout disconnected programs. And well being plans have their very own siloed databases. What ought to be a shared basis has turn into the foundation explanation for billions in wasted spend, lowered entry to care — attributable to inaccurate directories, for instance — and delays in funds to suppliers.”
The $40 million spherical was led by Transformation Capital, and included help from Common Catalyst, Upfront Ventures and SemperVirens.
“Certify’s well being plan market penetration and highly effective community results set it aside within the healthcare knowledge infrastructure house,” mentioned Scott Rosen, associate at Transformation Capital, in a press release. “Their crew is modernizing supplier knowledge administration by rearchitecting the foundational layer that healthcare runs on. The chance forward — to unify, simplify, and scale supplier operations throughout the {industry} — is very large.”
With the funding, the corporate will put money into product, engineering and its go-to-market engine, Rathi mentioned.
The corporate now has 17 well being plan clients, together with Oscar, Carelon, College of Utah Well being Plans, SelectHealth, Alignment Well being and Centene.
Certify’s financing comes at a time when the well being system spends almost $3 billion a 12 months to manually replace supplier directories, and about 43% of physicians take care of at the very least one symptom of burnout. As well as, beginning July 1, new NCQA credentialing requirements will take impact, requiring well being plans to confirm credentials extra rapidly and monitor license expirations on a month-to-month foundation. The healthcare {industry} should function with extra present and correct supplier knowledge, Rathi famous.
“Certify’s imaginative and prescient is to create a single supply of fact for supplier knowledge – one which’s frictionless, accessible through one API, and solely requires suppliers to replace their info in a single place slightly than dozens of programs,” Rathi mentioned. “This can take away the necessity for each payor, well being plan, or well being system to individually license and credential suppliers, leading to an industry-wide discount in administrative prices, and higher experiences for suppliers and sufferers.”
Image: Feodora Chiosea, Getty Pictures
