Health insurtech CoverSelf extended seed round to $8.2 mn

Healthcare insurtech platform CoverSelf has announced $3.4 mn in additional investment in the business – extending its seed funding round to $8.2 mn.

New investment in CoverSelf was funded by existing investors BEENEXT and 3One4 Capital, with additional funding coming from new investor Z21 Ventures

3One4 Capital is a venture capital firm based in Bangalore, India. BEENEXT is a venture capital firm based in Singapore, which was founded in 2015.

CoverSelf is an insurtech for healthcare claims and payment integrity, based in San Francisco. Founded to democratise the healthcare claims and payment integrity industry, CoverSelf has developed a solution aimed at empowering integrity teams in health insurance companies to resolve health claims with hospitals and other medical practices in a transparent way.

Rajasekhar Maddireddy and Raghavendra Pawar, Co-founders of CoverSelf
Rajasekhar Maddireddy and Raghavendra Pawar, Co-founders of CoverSelf

With over $4.1 trn spent on healthcare in the US alone, CoverSelf aims to reduce costs, particularly on the administrative side, which account for one-quarter of all healthcare costs in the US.

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

Rajasekhar Maddireddy, Co-founder of CoverSelf

“Our modern cloud-native platform and comprehensive content support both pre-pay and post-pay, offering complete customization with in-depth exclusion management.”

“Implementing a Shift Left approach, we continuously enable transitioning to prepay while ideating in postpay, preventing write-offs for low-dollar claims, with CoverSelf’s unified platform. Supports analytics or content configuration in 5 programming languages – we ensure no gaps in configuration capabilities and timely releases”, sayd Maddireddy.
Empowering PI teams, our patent-pending English-like language, CREOL, allows easy configuration. Generate CREOLs with GenAI for even lesser or zero technical dependency. Simultaneously explains rationale, references, and policies – all versioned. Complete documentation and query support for various stakeholders.

Health insurtech CoverSelf extended seed round to $8.2 mn

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.

CoverSelf’s vision is to democratise the healthcare claims and payment integrity industry with a fully open and transparent solution built with a spirit of collaboration

Dirk Van Quaquebeke, Managing Partner of BEENEXT

“As payers start using CoverSelf, they will progressively need fewer external payment integrity vendors,” said Sonal Saldanha, Vice President at 3one4 Capital. “Ultimately, CoverSelf aims to be the dominant payment integrity platform for insurance companies.”

Deploying its services at two new partners in recent months, CoverSelf has helped its clients process 25 times more claims in the same time window than was done previously.

One platform, one configuration, one team – our solution offers multiple points of integration and intervention for all pre and post-pay payment integrity, effectively reducing waste

Raghavendra Pawar, Co-founder of CoverSelf

“CoverSelf empowers subject matter experts (SMEs) with a modern UX/UI that’s super easy to work with and aids them by eliminating technical dependencies, maximising efficiency and fostering rapid innovation. Speed to release has shifted from weeks to mere hours, thanks to our collaborative approach and operational efficiency.”

“This propels our mission to shift from the current outsourcing model to insourcing, transforming payment integrity with an open and transparent platform, empowering payers to own their intellectual property, improving, provider experience, and increasing provider experience”, sayd Rajasekhar Maddireddy.

Founded in 2021, CoverSelf’s Payment Integrity Platform engages modern technologies to address payment leakage & claims inaccuracies while remaining transparent & accessible to Payers. The platform empowers payers to prevent and adapt to the ever-evolving claims & payment inaccuracies. We also help you reduce complexity and administrative costs with our unified healthcare dedicated platform.

It is purpose-built, utilizing multiple approaches to reduce administrative waste while identifying new savings opportunities. It empowers teams to configure their own policies, and logic in simple English or using simple policy-specific templates overcoming the fear of losing IP.

Peter Sonner   by Peter Sonner