Key Business Breakdowns
Products & Services
Prior Authorization Solutions
Solutions that handle the prior authorization process for payers, integrating clinical and claims data, AI-powered clinical data extraction, and auto-•••••••••• ••••••••••••• ••••••••.
Enrollment Management
••••••••• •••••••••• •••••••••• ••••••••• ••• •••••• •••••.
Encounter Management
••••••••• •••••••• ••• ••••••••, ••••••••••, ••• •••••••••••••• •• ••••••••• •••• ••• •••••••• ••• ••••••••.
FHIR Gateway
FHIR Gateway solution used across commercial, Medicare, and Medicaid lines of business to provide APIs for patient data using HL7 FHIR standards and c••••• •••• ••••••• ••••••••••••.
Smart Trading
Smart Trading is an EDI interoperability solution for handling EDI gateway and HL7 ADT file intake and normalization, parsing and validating EDI trans••••••• ••• •••••••••• •••• •••• ••• •••• ••••••••••••••••.
Risk Adjustment Solutions
Analytics solutions for Medicare Advantage and ACOs, supporting risk adjustment workflows including suspecting, prospective and retrospective assessme•••, •••••••••, ••••••, ••••••, ••• •••••••••••.
Pricing & Go-to-market
Typical Contract Length
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Average Sales Value
$••• - $••••
Average Sales Cycle
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Growth Review
Customer Overview
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Customer Concentration
••• • ••••••••• •••••••••• •• - ••% •• •••••••.
Customer Retention
•. ••%.
| Company Name | Revenue | FTE | Proprietary Insights | HQ | Ownership Type |
|---|---|---|---|---|---|
 Edifecs | - | •,••• '•• | - | USA | A••••••• |
 Smile Digital Health | - | - | - | - | - |
 Change Healthcare | - | - | - | - | - |
 Innovaccer | - | - | - | - | V•••••••• |
 1upHealth | - | - | - | - | - |
Relevant Companies
Benchling
Cloud-based R&D platform that integrates Electronic Lab Notebook (ELN) and LIMS (Laboratory Information Management System) systems for biotech, pharmaceutical, and agritech sectors to manage experimental workflows, centralize scientific data, and accelerate research through tools for molecular design, lab automation, and collaboration.
HQ
Ownership
Investors
CareMetx
Patient access and support solutions for pharmaceutical, biotechnology, and healthcare organizations to manage patient assistance programs, insurance verifications, and reimbursement processes.