medical-necessity
(3)
Ethermed
Ethermed is a Philadelphia-based health technology company that uses large language models and clinical reasoning to automate prior authorization - the paperwork-heavy approval process between healthcare providers and insurers. Its platform intercepts physician orders, gathers documentation, compares payer guidelines, fills forms and submits requests with an audit trail, cutting approval times from days to minutes. Founded in 2021 by Dan Friedman and Michal Such, the company raised an $8.5M Series A in April 2026, bringing total funding above $15M.
basys.ai
basys.ai is a Cambridge, Massachusetts healthcare technology company that builds enterprise-grade, domain-specific AI for health plans and payers. Founded in 2022 by Harvard health data science alumni Amber Nigam and Jie Sun, the company automates prior authorization, utilization management, and payment integrity, turning a process that can take days into decisions rendered in minutes - with plain-language rationales and hyperlinks to the exact policy criteria and clinical notes behind each decision. The platform is designed to encode a payer's own coverage policies so it can compare them against a patient's longitudinal record without requiring integration marathons or sensitive data handoffs.
Verse Medical
Verse Medical is a New York-based healthtech company building the software infrastructure for in-home healthcare, starting with durable medical equipment (DME) and supplies. Its platform helps hospitals, payors, and care teams order and coordinate equipment like catheters, wound dressings, and diabetes supplies - replacing a fax-and-phone-call process with real-time insurance verification, medical-record-level documentation checks, and centralized order tracking. Founded in 2018 by Dhaivat Pandya out of Y Combinator, Verse today works with many of the largest U.S. health systems and is backed by investors including SignalFire, Sapphire Ventures, General Catalyst, and Abstract Ventures.