| The moolah
New York-based startup Anterior raised $40 million to tackle one of healthcare's most widely loathed pain points: administrative clinical work inside health plans, especially prior authorization. The round brings the company's overall fundraising total to $64 million since its founding in 2023. Investors include Sequoia Capital, NEA, FPV and Kinnevik. The platform
Essentially, the startup focuses on the "last mile" that makes large language models usable for health plans, accounting for things like for accuracy, safety, integration and auditability. The platform also offers modular actions — such as reading faxes, interpreting medical records against guidelines and converting policy PDFs into decision logic — that health plans can combine to automate their staff's workflows at scale. "At the core, we have a clinical AI reasoning platform," CEO Abdul Mahmoud stated. Proof point
In Anterior's deployment with Geisinger Health Plan, its system is approving cancer care for patients in roughly 155 seconds — versus the weeks it previously took, Mahmoud said. "That means a cancer patient can get their care approved while they're still sitting in the consultation room," he declared. The competitive landscape
Mahmoud views Anterior's competitors in two categories, the first being point solutions for specific health plans workflows. "We have a lot of respect for what they do. We might intersect on some workflows, but Anterior is building something broader: a clinical AI brain that works across the full range of health plan workflows, from prior authorization to care management to payment integrity to risk adjustment," he explained. The second group is the Big Tech companies. Mahmoud says that Anterior's relationship to companies like Anthropic and OpenAI is more "co-petitive" than competitive, as he sees them as potential partners.
— By Katie Adams | 
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