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Sohar Health Secures $3.8 Million to Transform Health Care Access

In a significant move to improve healthcare accessibility, Sohar Health, an innovative provider specializing in eligibility determination and verification of benefits (VoB), has announced the successful raising of $3.8 million in seed funding. This funding round was led by Kindred Capital, with participation from notable investors including Y Combinator, Rebel Fund, and Concept Ventures. The financial boost aims to expedite Sohar's mission of dismantling insurance-related barriers that often hinder timely care delivery and overwhelm healthcare providers.

Many patients face frustrating obstacles before even reaching a healthcare provider. For instance, a parent trying to book a therapy session for their child might discover that the provider cannot confirm insurance coverage. Similarly, individuals suffering from chronic conditions often find themselves spending valuable time searching for in-network specialists, only to be met with unexpected claim denials. These issues often stem from outdated systems and inaccuracies in provider directories, with around 45% of insured adults reporting receipt of medical bills for supposedly covered services. Furthermore, approximately 60% of individuals tend to postpone treatment after being denied coverage.

The ramifications of such barriers are both significant and tangible. Failed insurance verifications not only cause delays but also lead to increased medical debt, which currently amounts to about $140 billion in unpaid bills in the United States. For providers, the inefficiency of reprocessing denied claims—averaging $118 per denial—can impact revenue, causing wasted efforts and lost time. Additionally, delaying treatment can aggravate health conditions, resulting in further costly interventions down the line, such as emergency room visits or hospital admissions. On a larger scale, these frustrations breed distrust and anxiety, particularly among vulnerable populations dealing with chronic health issues, exacerbating existing complexities in navigating the healthcare system.

To counter these challenges, Sohar Health is pioneering a new interface for healthcare access—utilizing real-time, AI-driven eligibility and benefits verification. This technological advancement enables healthcare providers to seamlessly confirm insurance coverage, thereby diminishing administrative burdens and allowing them to devote more focus to patient care. For patients, this translates into a more straightforward journey to receive necessary medical attention with minimal delays or denials.

Cutting-Edge Solutions for Overwhelming Challenges

Sohar Health’s flagship verification product is poised to transform the insurance landscape through numerous impressive features:

• - Real-Time Eligibility Checks: With a median response time of six seconds, 90% of eligibility verifications are completed within 30 seconds, ensuring a smooth integration into existing provider intake processes.
• - High Accuracy Rates: The company boasts a remarkable 96% accuracy rate for benefit data, including co-pays and coinsurance details, effectively reducing instances of claim denials.
• - Bulk API Capabilities: Sohar can perform up to 1,000 verification checks with a single API call, ensuring consistent coverage confirmation throughout the patient care period.

Ashish Mandavia, M.D., co-founder and CEO of Sohar Health, expressed the company’s vision, stating, “At Sohar Health, we believe the future of healthcare is seamless, efficient, and patient-focused. The funds raised will further develop our product suite to help healthcare organizations streamline insurance workflows, allowing them to focus on what truly matters—patient care.”

By prioritizing automated insurance verification, Sohar Health’s solutions promise to enhance patient connections with in-network care while simultaneously boosting revenue for providers. Their services are currently being utilized by premier behavioral health providers, primary care organizations, and telehealth platforms, proving that insurance verification does not have to be an obstacle to better healthcare.

Leila Zegna, Founding Partner of Kindred Capital, remarked on the necessity of updating healthcare systems, emphasizing that, “Fixing healthcare isn't just about introducing new treatments — it's also about modernizing the infrastructure that allows care in the first place. Insurance verification represents one of the most overlooked chokepoints in the revenue cycle, creating delays and inefficiencies that impact both providers and patients.” Zegna voiced confidence in the experience and capabilities of Sohar’s founders to address this critical sector of healthcare.

Looking Ahead

Sohar Health was conceptualized by a physician and an engineer and officially launched in 2023. Its mission revolves around redefining the intricacies of insurance claims for healthcare organizations through innovative AI solutions. By developing specialized APIs targeted at minimizing insurance claim denials and enhancing price transparency, Sohar aims to elevate patient access to healthcare across the United States. The efficacy of its eligibility service is underscored by its impressive accuracy rates and rapid response times, revealing a commitment to ensuring that access to care is no longer impeded by administrative hurdles.

To learn more about Sohar Health and their innovative solutions dedicated to improving patient care, visit www.soharhealth.com.