Crosby Health Pockets $2.2 Mn to Automate Clinical Claim Management

Founded in 2022 by Rishi Gowda, Crosby Health uses AI technology to address major pain points in healthcare administration especially insurance claims denials.

Crosby Health, a healthtech company based in New York City, has raised $2.2 million in pre-seed funding to further develop its AI technology aimed at automating administrative tasks in healthcare.

The funding round was led by Amplo Ventures, with additional participation from NOMO Ventures and various angel investors.

The fresh infusion of capital will enable Crosby Health to expand its development efforts and extend its business reach, focusing on its proprietary AI revenue cycle expert known as Apollo.

This advanced system specializes in denial management and revenue cycle optimization, offering significant benefits to healthcare providers.

Highlighting the potential of its AI, Rishi Gowda, founder and CEO of Crosby Health model, said, “Our AI is transforming administrative tasks in healthcare, allowing clinical resources to focus on patient care rather than back office duties. Provider appeals and medical coding are just the beginning.”

Streamlining Claim Management Process

Founded in 2022 by Rishi Gowda, Crosby Health uses AI technology to address major pain points in healthcare administration. Insurance claims denials mount a significant financial burden on healthcare providers.

Per the MGMA stat poll, as per the industry average, nearly 20% of all claims in medical practices are denied, and up to 60% of those denials end up never being resubmitted for payment.

Hospitals too face a similar challenge, having an annual expenditure of $20 billion on managing claims denials with 10% of claims initially rejected.

Apollo, Crosby Health’s advanced clinical language model, is designed to improve denial recovery rates, enhance tracking intelligence, and optimize the overall revenue cycle for healthcare providers.

With its sophisticated capabilities, Apollo automates the entire process of clinical appeals, from generating initial appeal letters to submitting and tracking the outcomes.

How Does Apollo Help?

As per Gowda, Apollo addresses these issues by streamlining the denial management process and saves over 98% of the time typically required to generate robust appeal letters.

This efficiency allows clinicians to focus on reviewing and editing appeals, enabling healthcare providers to pursue all denials rather than selectively choosing which ones to appeal.

Apollo also supports AI medical coding, chart reviews, and other related services.

“With our advanced language models, we enable healthcare providers to maximize their revenue by appealing all denials with greater success, automating chart audits, and streamlining medical coding processes,” CEO Gowda added.

Crosby Health offers Apollo's services through its denial management platform or via tailored partnerships that address specific organizational needs.

For example, community wellness startup EmpowerMe has reported a 300% acceleration in its denial appeals process since licensing Apollo, compared to traditional human efforts.

Sam Garcia, partner at Amplo Ventures commenting on the funding emphasized the potential impact of Apollo on healthcare operations.

“We are proud to support Crosby Health’s groundbreaking approach to denial management and revenue cycle automation. The team has built an industry-leading AI model that propels the technology forward and they’ve engineered unique use cases to maximize its impact for people and institutions who need it,” Garcia said.