Company Announces Accreditation from the National Committee for Quality Assurance
CertifyOS, the frictionless provider intelligence platform that delivers API-first credentialing, licensing, enrollment, and network monitoring to payors, providers, health systems and digital health companies, today announced the successful closing of a $14.5 million Series A funding round led by General Catalyst. The Company also announced it has received Accreditation from the National Committee for Quality Assurance (NCQA), a private, non-profit organization dedicated to improving health care quality.
CertifyOS plans to use the new capital to grow its commercial, product and engineering teams, enhance its existing insurance credentialing platform, and expand product offerings to include hospital credentialing, privileging, network accuracy, adequacy, and directory management.
“This funding reinforces market conviction around the importance of integrating provider data silos to make information accessible, transparent, and actionable,” said Anshul Rathi, CertifyOS CEO. “Our Series A funding will allow us to create the mid-level infrastructure that connects all of the disparate data sources currently housing primary provider data, eliminating the borders and friction to scaling networks that exist in healthcare today.”
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CertifyOS currently serves dozens of customers across the U.S., including VillageMD and Thirty Madison. The company’s data infrastructure provides an unmatched solution to provider data processing, cutting turnaround times from an industry standard of 28 days, to just under two minutes. By transforming the existing licensing and credentialing system, CertifyOS creates a massive cost savings to users—reducing administrative costs by an average of 40 percent.
“To bring transformative change, General Catalyst is committed to partnering with entrepreneurs and innovative health systems, plans and providers to tackle healthcare’s greatest pain points. The need to modernize medical licensing and credentialing is well understood – the challenge has been building a truly automated solution that reduces administrative burden on operational teams while being compliant,” said Chris Bischoff Managing Director at General Catalyst. “Anshul Rathi and the CertifyOS team demonstrate deep industry experience and understanding of the subject alongside a relentless drive to relieve the burden that healthcare organizations face in order to deliver quality care. In CertifyOS, we see an API-first fully automated solution with the potential to deliver a truly frictionless experience for payors, digital health companies and providers.”
Additional investors in the Series A round included early backers Upfront Ventures, Max Ventures, and Arkitekt Ventures, all of which also participated in the Company’s $4.55 million seed round. The company’s seed and Series A funding rounds have driven rapid growth throughout 2022 to date. CertifyOS has added more than 25 new customers to its roster and grown its team five-fold since the start of the year.
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“We’ve previously invested in several large virtual care delivery platforms, and managing licensing and credentialing is an administrative headache for everyone,” said Ryan Darnell, Managing Partner at Max Ventures. “The team at CertifyOS has a deep understanding of the problem—and needed solution—from their previous experience building similar technology within large scale digital health companies. We’ve had several portfolio companies become customers and each one of them has told us CertifyOS is the best solution on the market. The company’s growth since launch has been incredible and we’re excited to increase our investment in this round,” Darnell added.
NCQA accredits and certifies a wide range of health care organizations and manages the evolution of HEDIS®, the performance measurement tool used by more than 90 percent of the nation’s health plans. Accreditation for CertifyOS is an important validation for the company, which has operated using NCQA measurement standards since its inception. Now, CertifyOS will be able to retain additional insurance providers as customers, many of which require accreditation as a prerequisite.
“NCQA accreditation will open the floodgates to the insurance market for the company,” said Rathi. “From a credibility perspective, this is a critical stamp of approval from the leading healthcare quality organization—one that all stakeholders need in order to operate in this space. We are proud to see our processes validated at this important juncture for the company.”
Started by former Oscar Health employees, CertifyOS is led by a team with deep expertise in the provider licensing and credentialing processes. The CertifyOS platform was built based on keen insights from its leadership’s combined experiences of credentialing more than 40,000 providers. Full product automation across the platform creates systemic efficiencies, reducing an average month-long process to mere minutes. The platform is UI-agnostic, and can integrate with any third-party platform, enabling payors to seamlessly continue provider operations without changing technical architecture, systems, or procedures.