July 12, 2024
Meet the startup using AI to slash healthcare's trillion-dollar administrative burden

We want to hear from you! Take our quick AI survey and share your insights on the current state of AI, how you’re implementing it, and what you expect to see in the future. Learn More

Anterior, a healthcare technology startup founded by clinicians, has raised $20 million in Series A funding to tackle inefficiencies in U.S. healthcare administration. The round was led by New Enterprise Associates (NEA), with participation from existing investors including Sequoia Capital.

Founded by Dr. Abdel Mahmoud, a physician with a computer science background, Anterior aims to use artificial intelligence to streamline prior authorization processes for health insurers. The company’s AI system acts as a “copilot” for nurses reviewing medical records, potentially increasing productivity from 10 cases per day to 20-30.

“Our mission is very broadly [to reduce] the trillion dollars spent on administrative processes, half of which is spent by payers, where we’ll be focusing most,” Mahmoud explained in an exclusive interview with VentureBeat.

From fax machines to AI: The tech behind Anterior’s healthcare revolution

Anterior’s technology combines narrow AI systems with large language models to handle unstructured medical data. “What we’ve really done is combined the decades of progress we’ve made in AI, with some of the juice that large language models bring around, bridging those unstructured environments,” Mahmoud told VentureBeat.

Countdown to VB Transform 2024

Join enterprise leaders in San Francisco from July 9 to 11 for our flagship AI event. Connect with peers, explore the opportunities and challenges of Generative AI, and learn how to integrate AI applications into your industry. Register Now

The company’s approach involves three key components: structuring unstructured medical records, converting complex clinical criteria into computer-executable logic, and applying clinical reasoning to make initial determinations that are then verified by human nurses.

While initially focused on prior authorizations, Anterior sees potential applications in other areas of healthcare administration, including care management, payment integrity, and claims adjudication. 

“Anywhere a business is hiring a doctor not to provide care, but to make business decisions… that’s a site that they’re paying for some sort of clinical reasoning work,” Mahmoud said.

Clinicians-turned-engineers: Anterior’s unique approach to building AI for healthcare

A unique aspect of Anterior is its integration of clinical expertise into its technical teams. According to Mahmoud, about half of the company’s staff are clinicians or have clinical backgrounds, including some who have transitioned into AI engineering roles.

The funding comes at a time when the healthcare industry is grappling with staffing shortages and mounting administrative costs. If successful, Anterior’s technology could significantly reduce the time and resources health insurers spend on administrative tasks, potentially leading to cost savings across the healthcare system.

However, the company will need to navigate complex regulatory environments and earn the trust of healthcare providers and insurers as it seeks to expand its reach. As AI plays an increasingly prominent role in healthcare decision-making, ensuring accuracy, safety, and transparency will be crucial for companies like Anterior.

With this new funding, Anterior is well-positioned to scale its operations and bring its AI-powered solutions to more health plans across the United States. As the healthcare industry continues to digitize and seek efficiencies, startups that can effectively blend clinical expertise with cutting-edge AI technology may find significant opportunities for growth.

Source link