Daffodil Health Launches to Uber-Automate Healthcare Pricing and Bring Down Admin Spend
May 16 2024 - 12:11PM
Business Wire
The company closed a $4.6 million seed
investment led by Maverick Ventures to build AI-powered healthcare
pricing and admin platform
Daffodil Health, provider of healthcare pricing and
administration AI-powered solutions, today announced it raised $4.6
million in a seed funding round led by Maverick Ventures, with
participation from Epic Ventures.
The funding announcement comes at a time when more than $1T is
spent on healthcare admin, much of it wasted and with limited to no
benefit to patients. Technologies like AI and large language models
make it possible to uber-automate healthcare processes and make
middlemen redundant.
The company was started by a group of healthcare and technology
experts with over 100 years of combined healthcare and software
experience at companies such as MultiPlan, Google, and McKinsey.
They believe that change in how healthcare navigates pricing and
billing isn’t just possible, but a dire necessity.
“It is not lost on us that truly reducing healthcare admin spend
is difficult. We are also cognizant that numerous well-funded
companies and entrepreneurs have had limited success to date in
this realm,” said Navin Nagiah, CEO of Daffodil Health. “We also
fervently believe that what we are doing, needs to be done. Our
first application, a SaaS-based and AI-enabled OON/RBP repricer is
an important first step in our mission.”
The first problem the company has targeted is the complete
automation and AI enablement of out-of-network (OON) and Reference
Based Pricing (RBP) processes for payors and Third Party
Administrators (TPAs). Daffodil is specifically focused on the
automation and AI enablement of how to reprice, benchmark and
defend a claim that is outside of a plan’s network.
Daffodil’s SaaS-based, AI-powered solution allows for:
- Real-time repricing of claims based on the payor or TPA’s
preferred pricing methodology
- Easy configuration of complex pricing rules
- Automatic benchmarking of the repriced claims and
- Generation of detailed and defensible pricing rationale powered
by AI/LLM models
The company is delivering the above as a cloud-native SaaS
solution that is super easy to use and will result in both improved
productivity and dramatically lower costs. With early and deep
collaboration with digitally forward-looking and innovative payors
and TPAs, the application is expected to go live with multiple
implementations in the next few months.
“The intricate challenges of out-of-network repricing demand
innovative solutions that marry simplicity with efficiency,” said
Andrew Boyd, executive vice president and general manager,
healthcare solutions at Personify Health, a provider of health plan
administration and cost containment solutions. “There is an
opportunity for an end-to-end AI driven approach to streamline
these processes and achieve remarkable cost savings and enhanced
operational efficiency for TPAs and payors.”
"The out-of-network billing dilemma has hit a fever pitch in
recent years. From payors to TPAs and employers, it's perceived as
an oligopoly with no winners," said Prateesh Maheshwari, Managing
Director at Maverick Ventures. "Daffodil is boldly addressing this
issue through cutting-edge AI, transforming claims adjudication and
slashing administrative costs. With new price transparency laws
shaking up the game, it's prime time to revolutionize claims
processing and communication with AI."
For more information, please visit: www.daffodilhealth.co
About Daffodil Health
Daffodil was founded by a group of passionate healthcare and
technology experts with the lofty mission of using technology, data
and AI to automate healthcare pricing processes and reduce
administrative spend. The company’s first application, an
AI/LLM-enabled SaaS Repricer, was launched in 2024. The application
is focused on automating the out-of-network (OON) and Reference
Based Pricing (RBP) repricing processes end-to-end.
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