What You Should Know:
– Sohar Health, an AI-driven provider of eligibility determination and Verification of Benefits (VoB) raises $3.8M in seed funding round led by Kindred Capital, with participation from Y Combinator, General Catalyst, Character, and prominent angel investors,
– The funding will accelerate Sohar’s mission to eliminate insurance barriers that delay care, burden providers, and leave patients in limbo.
The Problem: Inefficient Insurance Verification:
The healthcare system faces significant challenges in patient onboarding due to outdated systems and manual processes. These inefficiencies lead to:
- Patients encountering roadblocks in accessing care, such as delayed appointments and denials.
- A significant number of insured individuals (45%) receiving unexpected medical bills for care they thought was covered.
- Patients delaying treatment (6 in 10) after insurance denials.
- Substantial unpaid medical debt in the U.S. (estimated $140 billion).
- Revenue loss and wasted time for providers, with the average denial costing $118 to reprocess and nearly one in five claims being denied on the first submission.
- Worsening patient conditions and higher downstream costs due to delayed treatment.
- Frustration and distrust among patients, particularly vulnerable populations navigating chronic conditions or mental health concerns.
Sohar Health’s AI-Powered Solution
Sohar Health is addressing these issues by rebuilding healthcare’s “front door” with real-time, AI-powered eligibility and benefits verification. Instead of relying on manual workflows and outdated systems, providers using Sohar Health can instantly confirm coverage, reduce administrative overhead, and see more patients. For patients, this translates to fewer delays, fewer denials, and a faster, clearer path to care.
Key features of Sohar’s verification product include:
- Real-Time Eligibility Checks: Sohar’s AI achieves a median response time of 6 seconds, with 90% of eligibility verifications completed within 30 seconds, seamlessly integrating into providers’ patient intake workflows.
- High Accuracy: The platform boasts a 96% accuracy rate in benefits data, including copay and coinsurance information, minimizing claim denials and administrative errors.
- Bulk API Capabilities: Sohar’s solution allows up to 1,000 verification checks per API call, ensuring patients maintain coverage from appointment scheduling to consultation.
Sohar Health’s AI-powered solutions ensure that patients get connected with the in-network care they need while simultaneously increasing revenue capture for providers. The company’s technology is currently supporting leading behavioral health providers, primary care organizations, and telehealth platforms, effectively removing insurance verification as a barrier to care.
“At Sohar Health, we believe the future of healthcare is seamless, efficient, and patient-focused,” said Ashish Mandavia, M.D., co-founder and CEO of Sohar Health. “With this funding, we are developing a product suite to help healthcare organizations streamline insurance workflows, allowing providers to focus on patient care rather than paperwork. The launch of Verification further strengthens access to care by eliminating administrative friction and improving the patient experience.”
