Development Health Secures $14.3 million to Simplify Prior Authorization
The company announced Wednesday that developing health, a welfare verification and prior authorization platform, has raised $14.3 million in Series A funds.
The San Francisco-based company’s platform can view coverage and prior authorization requirements for a wide range of drugs. It also creates AI-generated answers for prior authorization requests and allows providers to review them before submitting. Notify the provider immediately when the payer sends a prior authorization determination. Some of its clients include digital health companies RO, Lifemd and Sunrise.
“Today, the provider wasted a day digging out the right forms [for prior authorization]fill them manually, fax them back and forth, and then wait with the payer. Develop the plug directly into the EMR and prescription workflow, display coverage checks in real time, automatically fill and submit the correct prior verification package, automatically follow, and then push the results directly back to the provider's system. ”
Series A funding is led by Wing Venture Capital, which includes participation from Capital, J Ventures and South Park Commons. Overall, Development Health has raised $17.6 million.
One investor believes that developing health is meeting huge unmet needs.
“Developing health is addressing one of the most frustrating pain points in healthcare – providing patients with the medications they need without weeks of paperwork and endless sources,” said Sara Choi, a partner at Wing Venture Capital. “They built a system that allows Genai to work in one of the most critical and overlooked workflows in the industry. Developing health is designed to be an essential infrastructure for any provider dealing with the complexity of drug access.”
London said financing would help the company integrate with electronic health records and pharmacy welfare managers so that coverage checks and prior authorization become more effective. The startup also hopes to expand drug access to medical benefits, including labs and imaging.
In addition, funds will support the development of healthy health, “We need to bring these capabilities beyond digital health and into a more traditional provider environment,” Longden said.
The previous authorization process is often a point of debate between the payer and the provider. Payers say there is a need to ensure that care is appropriate and cost-effective, while providers think it creates harmful delays in care and adds administrative burden.
London said the work was “really personal” for London and co-founder Benjamin Easton. The two have previously worked for provider-oriented startups Canvas Medical and Rupa Health.
“Through our own families — and the time we spend in the healthcare system — we have seen how frustrating it is when the right treatment is delayed by paperwork,” Longden said. “At the end of the day, a prescription or an affordable prescription is not a prescription at all. These delays matter: This could be the difference between someone starting treatment tomorrow or waiting for weeks.”
Several other companies are also trying to remove the complexity of previous licensing, including Cohere Health and Rhyme.
Photo: NITO100, Getty Images
