CertifyOS Secures $14.5M for Frictionless Provider Intelligence

What You Should Know:

– New York City-based CertifyOS raises $14.5M in Series A funding led by General Catalyst and has received Accreditation from the National Committee for Quality Assurance (NCQA), a private, non-profit organization dedicated to improving healthcare quality.

– CertifyOS delivers API-first credentialing, licensing, and enrollment to payors, health systems and rapidly-scaling digital health companies.

Provider Intelligence Platform

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.

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.

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.

“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.”

NCQA Accreditation

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.

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