Certify, a provider data intelligence company, has secured $40 million in Series B funding, bringing its total funding to date to $69 million, the company announced on Thursday.
The New York City-based company serves health plans and digital health companies and is working to streamline access to provider data, whether that’s for provider directories or medical claims. Its AI platform combines provider data from sources like state boards, certifying bodies and national clearinghouses, as well as self-reported data from providers. Its services for health plans and digital health companies include provider credentialing, licensing, monitoring and roster management.
“Provider data is the invisible backbone of healthcare — and right now, it’s broken,” said Anshul Rathi, founder and CEO of Certify, in an email. “Providers are asked to fill out the same 40-page application over and over again across disconnected systems. And health plans have their own siloed databases. What should be a shared foundation has become the root cause of billions in wasted spend, reduced access to care — due to inaccurate directories, for example — and delays in payments to providers.”
The $40 million round was led by Transformation Capital, and included support from General Catalyst, Upfront Ventures and SemperVirens.
“Certify’s health plan market penetration and powerful network effects set it apart in the healthcare data infrastructure space,” said Scott Rosen, partner at Transformation Capital, in a statement. “Their team is modernizing provider data administration by rearchitecting the foundational layer that healthcare runs on. The opportunity ahead — to unify, simplify, and scale provider operations across the industry — is massive.”
With the funding, the company will invest in product, engineering and its go-to-market engine, Rathi said.
The company now has 17 health plan customers, including Oscar, Carelon, University of Utah Health Plans, SelectHealth, Alignment Health and Centene.
Certify’s financing comes at a time when the health system spends nearly $3 billion a year to manually update provider directories, and about 43% of physicians deal with at least one symptom of burnout. In addition, starting July 1, new NCQA credentialing standards will take effect, requiring health plans to verify credentials more quickly and monitor license expirations on a monthly basis. The healthcare industry will have to operate with more current and accurate provider data, Rathi noted.
“Certify’s vision is to create a single source of truth for provider data – one that’s frictionless, accessible via one API, and only requires providers to update their information in one place rather than dozens of systems,” Rathi said. “This will remove the need for every payor, health plan, or health system to individually license and credential providers, resulting in an industry-wide reduction in administrative costs, and better experiences for providers and patients.”
Picture: Feodora Chiosea, Getty Images
