With greater than 1000 insurance Companies in the USA, considering on how to earn by every company, is a challenge for doctors and hospitals.
Each insurance may require barely different information about medical claims, even in the case of the same procedure. Incorrectly submitted claims may lead to a refusal to insurance, requiring manual shift and delayed payments.
According to Nick Perry, co -founder and general director Sincere healthMost of the denying medical claims results from older suppliers of billing systems who try to sustain with the growing complexity of recent healthcare.
After five years in Palantir Perry, co -founder of Candid Health in 2019 in order to simplify medical invoicing by automating claims and eliminating manual work for settlement teams.
Since then, the company has attracted the growing variety of teeth supplier, including Allara, Nourish and Talkat, and recently began to add large groups of doctors as customers. In 2024, Candid’s revenues increased by almost 250%.
Investors have noticed a fast company growth rate. On Wednesday, Candid announced that he collected a C series price $ 52.5 million run by OAK HC/FT and existing investors. The round appears six months after the B Candida series price $ 29 million, which was led by 8 VC with the participation of returning sponsors of the first round, box group and combinator Y.
Perry built a company, based on his experience of Palantir, where he witnessed the first -hand data evaluation force. (*29*) references are ultimately a problem of information engineering, said TechCrunch.
“Legacy Systems mean claims problems and send them back to suppliers to fix the claim,” said Perry. However, Candid Health claims that it has developed and continuously negotiated, a sophisticated engine engine that enables suppliers to present accurate insurance claims.
Until now, Candid has not relied on generative artificial intelligence, but some of the latest funds will probably be allocated to the implementation of the latest machine learning techniques. For example, AI can discover the forms of claims consistently denied by insurers, enabling the Candid system to correct these claims before submitting them.
The company can ultimately build a function powered by artificial intelligence, which may call insurance firms regarding rejected claims. But the company’s ultimate goal is to completely avoid these connections.
“There should be no telephone conversation,” said Perry. “It is much better to submit a application for the first time.”
In addition to competing with older billing systems, many of which are built by electronic health records, resembling Epic and Athenahealth, Candid Health competes with startups of Apero and Adonis, which are supported by Point72 Ventures and General Catalyst.