Product Overview
Security and Compliance Certifications: HITRUST CSF, HIPAA
Banjo Health streamlines the prior authorization process for health plans and pharmacy benefit managers. BanjoPA is their prior authorization platform for health plans that consolidates prior authorization requests, provides decision recommendation based on predefined clinical decisions trees, and creates documentation to support appeal processes. Banjo Composer takes clinical criteria as inputs and creates clinical decision trees by automatically identifying decisions points and delivering in a platform that supports editing and testing.
Customers Served
Categories
Company Info
HQ Location
Washington DC
Founded
2019
Headcount
11-50
Total Funding
$25M
Latest Round
Series A-2
Latest Round
09/30/2022
Company Socials
Vendor’s Notes
Use Cases
Provides mission critical workflows for health plans, PBMs, and TPAs for the management and administration of prior authorizations and medical policies.
Core Differentiators
Composer is the industry's first auto translator of complex clinical policies into decision trees and question sets. BanjoPA offers the first cloud-native PA Management software integrated with AI and NLP, streamlining the review of PAs for Health Plans and PBMs.
Demos
Customers
Showcased Customers
See all (4)Anterior
Anterior
Company Info
Founded: 2022
Headcount: 51-200
Customers
Customers Served: Health Plan
Product Overview
Security and Compliance Certifications: HITRUST CSF, HIPAA
Anterior is a generative AI platform for payer organizations, providing a co-pilot dashboard to empower UM nurses to get all of the right data summarized and presented so they can make the right decision faster.
Basys.ai
Basys.ai
Company Info
Founded: 2021
Headcount: 1-10
Customers
Verified Customers: 1
Customers Served: Health Plan
Product Overview
Security and Compliance Certifications: HIPAA
Basys.ai
is an AI-powered platform that streamlines prior authorization (PA) for health plans using GenAI for policy encoding and request processing. It enables rapid payer onboarding and policy updates, automates complex policy rules and decision logic, and allows UM nurses to verify recommendations while making decisions. The platform recommends alternative care pathways when requests don’t match existing policies and records overrides for analytics and model improvement. It features a portal for direct document submission, API integration with Epic, and OCR for handling document types like fax.
Cohere Health
Cohere Health
Company Info
Founded: 2019
Headcount: 501-1000
Customers
Verified Customers: 2
Customers Served: Health Plan
Product Overview
Security and Compliance Certifications: HITRUST CSF, HIPAA
Cohere Health automates and optimizes the prior authorization process for health plans by integrating with EHR systems, digitizing authorization requests, and applying AI and clinical intelligence to automate decisions and improve efficiency. The platform supports real-time analytics and interoperability, facilitating faster patient care and reducing administrative costs.