CoPatient Raises $3.6 Million Series A For Medical Bill Review Service

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Boston, MA-based health IT startup CoPatient announces a $3.6 million Series A round led by .406 Ventures, and with additional participation from returning investors Cambia Health Solutions, and Jonathan Bush, CEO of nearby EHR vendor athenaHealth. The round follows a 2013 seed round that netted $1.1 million, and brings CoPatient’s total raised to just under $5 million.

Founded in 2012, CoPatient is building a service that connects medical billing experts with patients that have incurred significant out of pocket medical expenses. Consumers upload their medical bills to the CoPatient website, where the company uses optical character recognition and data pattern identification to find and flag abnormalities within the bill. Next, a billing expert physically reviews the bill for errors, unreasonable provider pricing, or other inappropriate billing practices. This information is then used to draft a report detailing the errors found. For a price, CoPatient will go so far as to appeal insurance denials and negotiate prices concessions with hospitals and doctors offices on behalf of its customers.

The company reviews medical bills for free and monetizes itself on the appeal and patient advocacy services it provides. Rather than charging an upfront price, CoPatient keeps 30 percent of whatever it is able to save its customers. The platform is also offered as an enterprise solution for employers, where it keeps 25 percent of the savings, but also charges a monthly per-member subscription fee.

Bringing billing experts directly to consumers and employers is an interesting business model that certainly has the potential to help address the very real problem of overbilling non-insured and out-of-network patients. Without advocates familiar with medical bills, there is little a patient can do when confronted with an unexpected denied claim or an exorbitant medical bill from an out-of-network provider. CoPatient claims its platform uncovers savings for the patient in 80 percent of the cases it handles, which means that it may have found a sustainable monetization strategy that will make billing expertise available to patients  in need.


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