The exponential growth of costs in healthcare remains a hotly debated and ever-evolving problem around the world. Over $4.1 trillion is spent on healthcare every year in the US alone, with administrative spending accounting for approximately one-quarter of the total amount. CoverSelf, a cloud platform for healthcare claims and payment integrity, is today announcing a $4.8m seed funding round to help reduce claims inaccuracies and reduce admin waste. The funding round was led by BEENEXT and 3one4 Capital.
One of the long-standing critical challenges that the US healthcare claims and payment integrity has faced is the lack of an open system that allows untethered collaboration between and among payers, vendors, and providers, without data and workflow silos and “black box” constraints. The CoverSelf platform empowers all stakeholders in the healthcare payment integrity and revenue cycle ecosystems with faster, easier, and more accurate processes, as well as faster innovation and releases. This plugs revenue leakages and eventually reduces healthcare costs by a substantial margin.
Rajasekhar Maddireddy, Founder of CoverSelf. said:
“The current claims integrity systems are very complex, and the deployed technologies are antiquated. Significant software innovation is needed to address the broken system that is currently creating out-of-control healthcare costs and waste. The cobbled-together software solutions result in scattered data and the inability to make real-time business decisions. Administrative complexity costs billions annually, an open and collaborative platform can significantly reduce the repetitive administrative costs.”
Founded in 2021, CoverSelf is a one-of-a-kind democratized, open and transparent healthcare platform, built by a team of highly experienced healthcare technology and payment integrity visionaries. CoverSelf has created a collaborative and comprehensive SaaS platform for all stakeholders, purpose-built for healthcare claims and payment integrity, providing a solid foundation for innovation while removing administrative waste and duplication of efforts. The company’s mission is to enable healthcare claims to be paid accurately, quickly, and conclusively. The platform enables a generational architectural shift that adapts to the dynamic nature of healthcare and empowers users without technical and external dependencies as the industry evolves.
“We have spent over two decades working hands-on in the claims accuracy and payment integrity sector and we believe that when everyone has the data, payment and reimbursement guidelines, and updated data sets they need to process clean claims on the first pass. However the payment models are becoming more complicated and the pace of change is increasing, creating additional challenges for stakeholders, who in turn are finding it more difficult than ever to understand the increasing complexity. Our efforts are driven towards leveraging our extensive experience to reduce complexity and administrative costs by building a unified healthcare dedicated platform” said Raghavendra Pawar, Founder of CoverSelf.
CoverSelf will use this funding round building out their platform and scaling the company operations as well as growing the sales, product and technology teams.
“Administrative spends are a major driver of overall healthcare costs. CoverSelf’s payment integrity solution is designed to be easy to implement and maintain, both under-appreciated features given the dynamic nature of healthcare. Raj and Raghav have leveraged years of experience to provide fresh perspective to the problem, and we are excited to be a part of their mission to simplify healthcare claims processing,” said Sonal Saldanha, VP, Investments 3one4 Capital.
Dirk Van Quaquebeke, Managing Partner at BEENEXT, added: “We are very excited to partner with team CoverSelf targeting the U$4.1 trillion US healthcare industry. Estimated cost of waste in the US healthcare system is approximately 25% of total health care spending. Claims and payments integrity, i.e., incorrect billing or fraud, alone accounts for over US$100bn of the problem. Now, anyone ever having worked in the US healthcare system, understands its massive complexity. We believe team CoverSelf has assembled a uniquely qualified team to abstract this away and improve healthcare outcomes at reduced prices for patients in the US.”