CertifyOS

Somewhere right now, a patient is told their doctor is in-network. They are wrong. A claim is denied, a phone tree is dialed, an apology is issued. Multiply that by a country.

The reason is almost always the same: provider data. The sprawling, constantly expiring record of every clinician's license, sanction history, specialty, location, and plan participation. It lives in spreadsheets, fax machines, and the heads of overworked credentialing staff. CertifyOS decided that record should live in an API instead.

Today CertifyOS sits underneath health plans, health systems, and digital health companies as a quiet layer of plumbing. It verifies credentials, manages licenses, runs enrollment, and watches for sanctions in real time. The pitch is unfashionably simple: one API, one provider ID, and data you can actually trust. The company tracks more than 1,600 data points on a single provider and manages over 15 million medical licenses - more than most clinicians know exists about themselves.

Hospitals adopted electronic records. Payors built sleek member apps. And underneath all of it, the question of "is this provider real, licensed, and allowed to practice here" was still answered by people emailing licensing boards one at a time.

Credentialing a single provider could take months. Directories went stale the moment they were published. Every payor, every health system, and every digital health startup rebuilt the same verification process from scratch - badly, and at enormous cost. The industry had a strange habit of treating its most load-bearing dataset as someone else's afterthought.

The cost of all this fragmentation is not abstract. It shows up as administrative overhead, as provider burnout from filling out the same forms forever, and as patients who simply cannot find care that their insurance will actually cover.

Anshul Rathi did not discover provider data chaos from the outside. He lived in it. As one of Oscar Health's first employees, he spent roughly six years building the insurer's provider network function - which is a polite way of saying he spent six years wrestling the exact problem CertifyOS now sells against.

His bet, placed in 2020, was contrarian in its modesty. Most healthtech founders promise to reinvent care. Rathi promised to reinvent the database that care depends on. He assembled a team of former health plan operators with decades of combined experience in provider data systems - people who had felt the pain and were done patching around it.

The wager was that provider data was not a feature to be bolted onto a credentialing tool, but infrastructure that the entire industry could share. Build it once, build it right, and sell the layer rather than the interface.

CertifyOS is deliberately UI-agnostic. It sells the data layer through an API and lets customers build whatever interface they want on top. Underneath, it pulls continuously from thousands of primary sources - licensing boards, sanctions registries, and the rest - so the source of truth updates itself instead of waiting for a quarterly cleanup.

Skeptics are right to ask whether "infrastructure" is just a word startups use to sound load-bearing. CertifyOS has a few answers. It is NCQA-accredited, which is the kind of credential that opens doors at payors. It has 75+ partners. And it has investors who fund things that compound: Transformation Capital, General Catalyst, Upfront Ventures, and SemperVirens.

The money tells a clean story. A $14.5M Series A in 2022 to expand beyond credentialing. A $40M Series B in 2025 to build the rest of the layer. Roughly $69M in total, against a company that says it tripled its growth year over year heading into the raise.

Good infrastructure disappears. Nobody thanks the water main. CertifyOS's stated mission is to change how healthcare manages provider data by cutting costs, streamlining access, and lifting administrative burden off the people who deliver care.

The company is fully remote and globally distributed, run by operators who measure success less in screenshots and more in whether a credentialing team can stop emailing licensing boards by hand. The values are unglamorous on purpose: collaboration, results, accountability, feedback, and be yourself.

Return to where we started: a patient, a denied claim, a doctor who was supposed to be in-network. In the world CertifyOS is building, the directory was already correct because the data underneath it updated itself in real time. The credentialing finished in days, not months. The sanction would have triggered an alert before it became a problem.

None of that is glamorous. It will never trend. But the difference between a healthcare system that works and one that quietly fails people is often just a database that tells the truth. CertifyOS made a bet that someone should finally build that database once, and well, for everyone.

The phone call still happens, for now. The whole point is to make it stop.