Prior Authorization Platform Humata Health Closes $25M Investment
June 20 2024 - 8:30AM
Business Wire
Strategic Investors Accelerate Expansion of
AI-Driven Prior Authorization Solutions Ahead of CMS Mandate
Humata Health, the company creating frictionless prior
authorizations for payers and providers with AI and automation,
today announced that it closed a $25 million investment. The
funding was led by Blue Venture Fund (representing the majority of
BCBS plans) and LRVHealth (representing nearly 30 health systems
and payers) with participation from Optum Ventures, .406
Ventures, Highmark Ventures, and
VentureforGood. With this funding, the company will broaden the
scope of its proprietary generative AI technologies, expand its
customer base with the nation’s leading healthcare providers, and
begin partnering with payers and delegated entities to deliver
complementary solutions that help them streamline prior
authorizations.
More than 42,000 physicians at 225 hospitals across the country
rely on Humata Health’s end-to-end technology to automate the
manual, increasingly complicated process of prior authorizations,
which often serves as an important checkpoint to ensure prescribed
care is clinically appropriate. The Centers for Medicare and
Medicaid Services (CMS) passed a rule that will require insurers to
provide authorization decisions in 72 hours for urgent requests and
seven calendar days for standard requests – which will result in
increased demand for solutions from Humata.
Humata was founded in 2023 by industry veteran and serial
entrepreneur, Dr. Jeremy Friese. The company has built proprietary
AI to streamline prior authorization for providers and payers that
it has augmented with assets purchased through acquisition and
continues to expand upon for a comprehensive, end-to-end
offering.
“As a physician executive at Mayo Clinic, I learned both the
challenging complexities and importance of the prior authorization
process. That’s why I founded Verata Health and now Humata Health
to deliver a solution that combines the power of AI, automation and
connectivity between payers and providers to create a frictionless
process,” said Jeremy Friese, MD, Chairman and CEO of Humata
Health. "With a large and growing customer base of providers
already, this investment validates our vision of solving prior
authorization on both sides of the proverbial fax machine. Raising
this investment from strategic investors that represent some of the
nation’s largest and most innovative providers and payers is a
testament to our approach and rapidly accelerates our trajectory to
have a positive impact for patients and the healthcare system."
The Humata Health platform transforms the end-to-end experience
of prior authorizations for providers and payers. With its
proprietary database, the Humata Health AI engine employs machine
learning to offer informed recommendations for crucial clinical
documents that should be included to improve submission quality. As
a result, payers are required to do less work and providers see
improved first pass approvals. In addition, constant monitoring
post-approval detects and flags changes that may lead to downstream
denials and write-offs. Bi-directional integrations with the most
common electronic health records (EHRs) and clinical documentation
systems, and broad payer connectivity at state, regional and
national levels facilitate unparallelled automation across all
interactions for seamless processing.
"Highmark is excited to partner with Humata to continue their
work of transforming the prior authorization process,” said Carl
Daley, CFO of Highmark Health. “Their solutions help providers to
focus more on patient care rather than paperwork. We are excited to
see how their continued innovation will further improve the process
for our providers and health plan."
For more information about Humata Health and its AI technology,
visit https://www.humatahealth.com/
About Humata Health
Humata Health creates frictionless prior authorization for
providers and payers. With its proprietary artificial intelligence
(AI) and automation technology, Humata Health delivers quality
prior authorization submissions to help get patients the care they
deserve. Humata Health is a physician-led company backed by a
syndicate of strategic healthcare investors including Blue Venture
Fund, LRVHealth, Optum Ventures, .406 Ventures, and Highmark
Ventures. For more information, visit www.humatahealth.com.
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Media Contact: Geoff Lopes fama PR for Humata Health
LRVHealth@famapr.com