Healthcare Tech Firm Develop Health Raises $14.3M to Revolutionize Prior Authorization Processes

Health secures $14.3M in Series A funding to revolutionize prior authorization using GenAI, streamlining medication access for patients and providers.">

Develop Health Secures $14.3 Million to Automate Prior Authorization with Artificial Intelligence

San Francisco,CA – August 23,2025 – Develop Health,a technology company focused on simplifying healthcare administration,today announced it has successfully raised $14.3 million in a Series A funding round. The investment will fuel the companyS expansion and further development of its Artificial Intelligence-powered platform designed to streamline the often-cumbersome process of prior authorization.

Addressing a Critical Pain Point in Healthcare

The company’s platform is engineered to automate coverage verification and prior authorization requests for a wide range of medications. It leverages generative AI to draft responses to authorization inquiries,allowing healthcare providers to review and submit them with increased efficiency. Notifications regarding payer decisions are delivered to providers in real time, accelerating the delivery of necessary treatments to patients.

develop health currently serves a growing client base including prominent digital health companies like Ro,LifeMD,and Sunrise.

How Develop Health’s Platform Works

According to Mel van Londen, Co-founder and Chief Executive Officer of Develop Health, the current manual process is deeply flawed. “Providers frequently expend valuable time locating necessary forms,completing them manually,and navigating protracted interaction with insurance payers,” Van Londen explained.”This inefficiency detracts from direct patient care.”

Develop Health’s solution integrates directly into existing Electronic Medical Record (EMR) systems and prescribing workflows. The platform provides real-time coverage checks, automatically populates required fields, submits authorization packages, and provides automatic follow-up, delivering results directly into the provider’s system.

Investment Details and Future Plans

Wing Venture Capital spearhead the Series A funding round, with additional participation from Afore Capital, J Ventures, and South Park Commons. This latest financing brings Develop Health’s total funding to $17.6 million.

Sara Choi, Partner at Wing Venture Capital, emphasized the importance of Develop Health’s innovation. “Develop Health is tackling a major source of frustration in healthcare-the delays patients experience while awaiting medication access due to administrative hurdles,” she stated. “Their application of Generative AI to this overlooked area of healthcare is poised to make them a vital resource for providers managing medication access complexity.”

The company plans to utilize the funding to enhance its integration with emrs and Pharmacy Benefit Managers (PBMs), and to extend its capabilities beyond medication access to encompass medical benefits like lab tests and imaging services. They also aim to expand their market reach to include customary healthcare provider settings.

Key Funding Details

Investor	Investment
Wing Venture Capital	$14.3 Million (Series A Lead)
Afore Capital	Participation
J Ventures	Participation
South Park Commons	Participation
Total Funding (to date)	$17.6 Million

Did You know? The prior authorization process costs the U.S. healthcare system an estimated $30 billion annually in administrative costs, according to a 2023 report by the American Medical Association.

The Broader Context of Prior Authorization Challenges

Prior authorization, a process requiring providers to obtain approval from insurance companies before prescribing certain medications or procedures, remains a contentious issue. While payers argue it’s a necessary measure for cost control and appropriate care, providers contend it leads to delays in treatment and increased administrative burdens.

For Mel van Londen and Benjamin Easton, the co-founders of Develop Health, the mission is deeply personal.Having previously worked at Canvas Medical and Rupa Health,they witnessed firsthand the detrimental impact of administrative delays on patient care. “We’ve seen how frustrating it is when the right treatment is delayed by paperwork,” Londen shared. “A prescription without coverage is ineffective, and these delays can have serious consequences.”

Several companies, including Cohere Health and Rhyme, are actively working to alleviate the complexities of prior authorization, indicating a growing recognition of the need for innovative solutions in this critical area of healthcare.

Pro Tip: Providers should actively explore technology solutions like Develop Health to streamline prior authorization workflows and improve patient access to necessary medications.

The Evolving Landscape of Healthcare Automation

The healthcare industry is increasingly embracing automation and AI to address longstanding challenges with efficiency and access. Prior authorization is just one area ripe for disruption. As AI technology continues to evolve, we can expect to see even more complex solutions emerge aimed at reducing administrative burdens and improving patient outcomes. The integration of these technologies with existing EMR and PBM systems will be crucial for widespread adoption and impact.

Frequently Asked Questions about Prior Authorization

• What is prior authorization? Prior authorization is a process required by many health insurance plans where a provider must obtain approval from the insurer before a specific medication, service, or procedure is covered.
• Why is prior authorization necessary? Payers utilize prior authorization to manage healthcare costs and ensure appropriate utilization of medical resources.
• How does Develop Health simplify prior authorization? Develop Health’s platform automates coverage checks, generates responses to authorization requests, and streamlines communication with payers, reducing administrative burden for providers.
• What types of medications does Develop Health support? The platform currently supports a wide range of medications and is expanding to include medical benefits like lab tests and imaging.
• is Develop Health integrated with major EMR systems? Yes, Develop Health integrates directly with existing Electronic Medical Record (EMR) systems for seamless workflow integration.
• What is the potential impact of solutions like Develop health? Streamlining prior authorization can improve patient access to critical medications, reduce administrative costs, and free up providers to focus on patient care.
• What other companies are addressing prior authorization challenges? Several companies, including Cohere Health and Rhyme, are also developing solutions to streamline the prior authorization process.

What are your experiences with prior authorization in healthcare? Share your thoughts in the comments below!

How does Develop Health’s technology specifically reduce the administrative burden on healthcare providers related to prior authorization?

Understanding the Prior Authorization Challenge

prior authorization (PA) – the process requiring healthcare providers to obtain approval from insurance companies before certain procedures, medications, or services are provided – is a notorious bottleneck in the US healthcare system. It’s a significant source of frustration for patients, providers, and insurers alike. Delays in approvals can lead to delayed care, impacting patient outcomes and increasing administrative burdens. While intended to control costs, the current system frequently enough feels inefficient and opaque. According to a recent report by the American Medical Association, physicians spend an estimated 29 hours per week on prior authorization tasks.

As the search result indicates, while “prior to” and “before” have similar meanings, “before” is the preferred, simpler term for clarity. This principle of simplification is what Develop health aims to bring to the complex world of PA.

Develop Health’s $14.3M Funding Round

Develop Health, a healthcare technology company focused on streamlining prior authorization, recently secured $14.3 million in Series A funding. Led by Transformation Capital, with participation from existing investors, this funding will fuel the company’s expansion and further growth of its automated PA platform. This investment signals strong confidence in Develop health’s ability to address a critical pain point in healthcare administration. The company plans to use the funds to:

Expand its engineering and product teams.

Scale its sales and marketing efforts.

Integrate with more electronic health record (EHR) systems and payer networks.

Enhance its AI-powered automation capabilities.

How Develop Health is Disrupting Prior Authorization

Develop Health’s platform leverages artificial intelligence (AI) and machine learning (ML) to automate much of the prior authorization process. Hear’s a breakdown of how it works:

1. Intelligent Form Completion: The platform automatically populates PA forms with relevant patient data from the EHR, reducing manual data entry and errors.
2. real-Time Benefit Verification: Develop Health verifies patient insurance coverage and benefits in real-time, ensuring accurate PA submissions.
3. Automated Submission & Tracking: The system submits PA requests electronically to payers and tracks their status, providing providers with visibility into the process.
4. AI-Powered Clinical Documentation Support: The platform analyzes clinical notes and suggests relevant documentation to support PA requests, increasing approval rates.
5. Payer Connectivity: Develop Health connects directly with payer systems, enabling faster and more efficient communication.

This approach drastically reduces the administrative burden on healthcare staff, allowing them to focus on patient care.Key terms related to this include automated PA, PA automation, EHR integration, and payer connectivity.

Benefits of Automated Prior Authorization

Implementing an automated prior authorization solution like Develop Health’s offers numerous benefits:

Reduced Administrative Costs: Automation significantly reduces the time and resources spent on PA tasks.

Faster Time to approval: automated submissions and real-time tracking accelerate the PA process, leading to quicker approvals.

Improved Patient access to Care: Faster approvals mean patients receive the care they need more promptly.

Increased Provider Satisfaction: Reducing administrative burdens improves provider morale and allows them to focus on patient care.

Higher Approval Rates: AI-powered documentation support increases the likelihood of PA approvals.

Enhanced Revenue Cycle Management: Streamlined PA processes contribute to faster claims processing and improved revenue cycle performance.

The Impact on Key Stakeholders

Develop Health’s technology impacts several key stakeholders within the healthcare ecosystem:

Providers: Reduced administrative burden, increased efficiency, and improved revenue.

Payers: Streamlined processes, reduced costs, and improved data accuracy.

Patients: Faster access to care and reduced delays in treatment.

Healthcare Systems: Improved operational efficiency and enhanced patient satisfaction.

Real-World Applications & Case Studies

While specific, publicly available case studies from Develop Health are limited at this time, the company reports significant results with its early adopters. These include:

A large hospital system reduced PA processing time by 60%.

A physician practise increased