We’re excited to announce that we’re leading a $10mm Series A round at Alaffia, the leading AI-powered automation for health insurers to efficiently detect and stop waste, fraud, and abuse through medical claim reviews.

Overpayments to healthcare providers siphon over $250bn from the US healthcare system each year. These overpayments can be as simple as a billing mistake where a provider double-bills for the same procedure, or, they can be the result of bad actors trying to game the system, making healthcare more expensive for everyone.  The current claims review process has created many large public and PE-backed companies that rely on large, specialized teams to review a subset of claims.

With healthcare expenditures representing 17% of GDP today and projected to reach 37% by 2050, it’s now more crucial than ever that our resources are spent properly. 

Identifying inappropriate charges is extremely tough. To do so, a medical specialist needs to review the details of the patient’s medical record to make sure the care provided matches the care billed for. Reviewing exhaustive itemized bills and medical records (sometimes tens of thousands of pages long) requires significant manpower and is only feasible in the most expensive cases, leaving billions to fall through the cracks.

To learn more about how Alaffia is tackling this critical challenge, click here.

Read the full announcement in Fierce Healthcare or Axios.