Getting approval for a new doctor to see patients and billing insurance often takes months – time that providers and patients don’t have.
On Wednesday, a New York-based startup raised $19 million to help resolve this issue. Health assuredwhich uses AI agents to automate provider credentialing and insurance enrollment, closed its Series A round, bringing its fundraising total to $25 million. The tour was led by Insight Partnerswith the continued participation of Capital of the first round And Related companies.
Co-founders Rahul Shivkumar and Varun Krishnamurthy launched Assured in early 2024, but the idea dates back to their previous company, Dawn Healtha virtual platform for the treatment of sleep disorders.
In hiring therapists, nurses and doctors in multiple states, the founders repeatedly ran into the same bottleneck: the tedious process of verifying providers’ licenses and getting them approved to bill insurance. It’s a slow, state-by-state, payer-by-payer job, with some payers requiring email requests and weeks of waiting for a response, and others using online portals that must be filled out and followed up by phone every few weeks, Shivkumar said.
Built and insured AI agents that do the work directly. The startup works with large group practices and health systems, offering three main services: credentialing new hires by checking their licenses and backgrounds against primary sources, registering providers with payers so they can get paid, and monitoring state licenses to ensure they don’t expire, Shivkumar said.
“It’s about making it easier to do some of these administrative workflows and making sure that your organization actually gets paid for the work that it’s doing,” he said.
The company’s platform is now used by more than 100 healthcare providers, including Houston Methodist And Health app.
Much of Assured’s product roadmap comes directly from customer feedback, Shivkumar said. In the first quarter of next year, the startup plans to launch a new product focused on privileging, the labor-intensive process hospitals use to check a new doctor’s credentials and confirm that they are qualified to perform procedures such as surgery.
For Shivkumar, Assured’s competitors generally fall into two camps. At the health system level, the company competes with BPO companies that hire staff, often overseas, to manually manage accreditation and registration. Among software companies, Shivkumar cited companies like Verifiable And Credentials pane as competitors, although he argued that their products still require humans to do the underlying work while the software just follows along.
“We’re building agents that can actually manage end-to-end workflows. Humans are primarily there to handle exception cases,” he noted.
The new funding, he said, will go toward product development and engineering research, as well as expanding the company’s commercialization team.
Photo: Weiquan Lin, Getty Images