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Anterior, an AI platform to automate prior authorization for health plans, raised $40 million, CEO Abdel Mahmoud tells Axios Pro exclusively.

Why it matters: Prior authorization has long been a manual, drawn out and costly process in health care admin.

Follow the money: NEA and Sequoia Capital participated as return investors, alongside new investors FPV and Kinnevik.

Anterior has raised $64 million, after a $20 million Series A in 2024.

The funding gives Anterior more than three years of runway, but it will likely raise before then, Mahmoud says.

How it works: The company mostly helps payors ease prior authorization, but also helps with risk adjustment and utilization management.

Anterior puts records such PDFs and medical record entries into its AI and references medical literature, guidelines and other best practices to produce answers.

It currently works with customers on clinical areas such as outpatient, home health, oncology and musculoskeletal health. 

What they're saying: "If you're hiring a nurse as an insurance company, that's often a proxy for a manual data problem and that's where we help," Mahmoud says.

State of play: Anterior competes in a buzzy space. Other companies operating AI for prior authorization include Cohere Health, Develop Health and Basys.ai.

What's next: Anterior plans to target other conditions, as Mahmoud says its AI has been trained on many different clinical areas.

Exclusive: Anterior raises $40M for health plan AI

Prior authorization has long been a lengthy and costly process in health care admin.

Illustration of a red pen held by a robot hand marking up a medical bill.

Anterior, an <a class="gtmContentClick" data-vars-link-text="AI platform" data-vars-click-url="https://www.axios.com/pro/health-tech-deals/2023/09/11/cohelm-raises-3m-seed-healthcare-admin-prior-auth" data-vars-content-id="f804e7e8-12ee-4beb-9192-b41a505dd5bb" data-vars-headline="Exclusive: Anterior raises $40M for health plan AI" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/pro/health-tech-deals/2023/09/11/cohelm-raises-3m-seed-healthcare-admin-prior-auth" target="_self">AI platform</a> to automate prior authorization for health plans, raised $40 million, CEO Abdel Mahmoud tells Axios Pro exclusively.Why it matters: Prior authorization has long been a manual, drawn out and costly process in health care admin.

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Exclusive: Anterior raises $40M for health plan AI

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