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With over1,000 insurancecompanies in the U.S. , figuring out how to get pay up by each company is a complex challenge for doctors and hospital .
Each policy may postulate slightly different selective information on aesculapian claim , even for the same procedure . Incorrectly filed claim can lead to refuse coverage , requiring manual resubmission and delayed payments .
According to Nick Perry , co - beginner and CEO ofCandid Health , most aesculapian claim denials lead from bequest billing system providers struggling to keep pace with the increasing complexities of modern healthcare .
After five year at Palantir , Perry co - found Candid Health in 2019 with the goal of simplifying medical charge by automating call submissions and eliminating manual oeuvre for charge teams .
Since then , the company has attracted a growing number of telehealth provider , includingAllara , Nourish , andTalkiatry , and has recently begun adding large physician groups as customers . In 2024 , Candid ’s tax income grow near 250 % .
Investors note the company ’s fast growth pace . On Wednesday , Candid annunciate that it raised a $ 52.5 million Series C lead by Oak HC / FT and existing investors . The rung comes six months after Candid ’s $ 29 million Series B , which was led by 8VC with the participation of returning backer First Round Capital , BoxGroup , and Y Combinator .
Perry built the fellowship by drawing on his Palantir experience , where he witnessed the power of information analytics firsthand . Medical charge is at last a information engineering job , he tell TechCrunch .
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“ Legacy systems flagstone trouble with claims , and send them back to provider to make the call , ” Perry said . But Candid Health lay claim that it has developed , and continually refines , a sophisticated rules railway locomotive that allows providers to submit accurate claims to policy companies on the first try .
So far , Candid has n’t leaned into generative AI , but some of the modish support will go toward implementing the up-to-the-minute machine learning techniques . For instance , AI can identify title types consistently denied by insurance underwriter , enable Candid ’s organisation to correct those claim before they are submit .
The ship’s company may finally also build up an AI - powered feature that can call insurance society about denied call . But the troupe ’s ultimate goal is to invalidate those calls altogether .
“ There should n’t have to be a denial sound call , ” Perry say . “ It ’s much better to just submit the claim right the first clip . ”
In addition to competing with legacy billing systems , many of which are build by electronic health record company like Epic and Athenahealth , Candid Health competes with startups Apero and Adonis , which is indorse by Point72 Ventures and General Catalyst .
