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Company creates a new class of solution to address financial complexity in healthcare

Alpha Health, the first Unified Automation™ company for healthcare, announced its Series A funding of $20 million, bringing total investment to $25 million. Both the seed round and series A funding were led by Andreessen Horowitz. Costanoa Ventures also participated in both rounds of funding and private investors, including Jim Momtazee, former head of healthcare investing at KKR, participated as well. The funding will support the company’s ability to accelerate sales and marketing activities while scaling product deployment and development.

Alpha Health provides revenue cycle management (RCM) teams at health systems with Unified Automation™ – a single solution to efficiently, accurately, and autonomously navigate the complexities of medical reimbursement in the U.S, enabling health systems to decrease their cost of care and be better stewards of the healthcare dollar.

“Complexity in medical reimbursement drives up hidden costs that we all pay; both in terms of dollars spent, and in the erosion of trust by the American public that our healthcare system can serve them well,” said Malinka Walaliyadde, chief executive officer and co-founder of Alpha Health. “Alpha Health will be a powerful force for restoring trust in healthcare, by bringing together the best of people, data and technology to address financial complexity in the U.S. healthcare system.”

The U.S. spent about $3.6 trillion on healthcare in 2018, more than $11,000 per person, according to the Centers for Medicare and Medicaid Services (CMS) — roughly twice the amount other developed nations spend. In fact, according to a report by the Center for American Progress, the U.S. spent an estimated $500 billion in 2019 on medical billing and insurance administrative costs alone. It is exceedingly burdensome and expensive for health systems and hospitals to navigate multiple, complex coding systems, along with the individual rules and requirements of the approximately 1,000 insurers or payers in the US, each of which may also have numerous regional or national plans.

Alpha Health’s pioneering Unified Automation™ solution for healthcare RCM addresses the challenges in medical reimbursement that drive costs. The company’s unique approach unifies proprietary machine-learning technologies, human judgment and subject matter expertise into a single solution.

Alpha Health’s proprietary Unified Automation™ technology is an artificial intelligence platform as a service that operates within a healthcare system’s existing electronic health record (EHR) and revenue cycle infrastructure. The solution is comprised of three distinct parts that work together seamlessly:

1. Proprietary technology captures multimodal data to provide a 360-degree view of current workflows and processes.

2. This data is then used to train machine-learning models, constructing complex flows that are impossible to script by hand.

3. Finally, the system gets to work, autonomously performing tasks within the revenue cycle function 24/7. It automates full functions and quickly takes on new tasks over time. If complexities or exceptions arise, Alpha Health’s teleoperations team of RCM experts are notified to triage the problem and resolve it in real-time while the system learns from their actions. Operations continue without disruption, continuous learning and human judgment are built in, providing peace of mind.

“We developed Unified Automation™ by deriving core principles from other industries where machine learning has successfully automated complex tasks, such as driverless cars,” said Varun Ganapathi, PhD, chief technology officer and co-founder at Alpha Health. “Unified Automation™ is a new category of solution which combines human oversight with machine learning. It continually improves and gains new skills as it encounters novel situations, which often occurs due to the complex and highly variable nature of revenue cycle management in healthcare.”

“Our vertically integrated solution includes every single component required for revenue cycle leaders to roll out the most secure, comprehensive and advanced automation solution available,” Ganapathi continued, “eliminating the need for a cumbersome patchwork of different technologies.”

Alpha Health uses HIPAA and HITRUST compliant web and cloud services. We follow National Institute of Standards (NIST) 800-53 at the moderate level and our BitSight rating of 790 makes us an industry leader in security practices. Data is encrypted in transit and at rest. The company can work with all electronic health record systems, and supports various connection methods. Alpha Health’s Unified Automation solution can be deployed entirely remotely, and no expensive per-user software licenses or costly, time-consuming upgrades are required. No additional investment in consultants to develop or maintain automation tools is required. Alpha Health uses a shared value model which ensures Alpha Health’s financial incentives are aligned directly with saving our health system customers time and money.

“Improving affordability is a primary focus at Sutter Health. Shielding our patients from the stress of surprise bills or dealing with billing errors is an important part of protecting their overall health and well being,” said Albert Chan, Chief of Digital Patient Experience at Sutter Health. “Billing is often the final touch we have with our patients and accurate and efficient revenue cycle operations help us ensure we provide a holistically positive experience for patients.”

“Alpha Health has been an innovative partner, bringing deep expertise of clinical and operational workflows to our automation efforts,” added Scott Abram, Vice President of Revenue Cycle at Sutter Health. “The alignment in focus for both teams and the efficiency of deployment has made this a highly effective collaboration for Sutter Health.”

About Alpha Health

At Alpha Health we believe every dollar spent on healthcare matters because healthcare matters to everyone. The first Unified Automation™ company for healthcare, Alpha Health uses the same machine learning approaches that made driverless cars possible to provide health systems with a single solution for revenue cycle management. Alpha Health’s Unified Automation™ brings together the best of people, data and technology to efficiently, accurately and autonomously navigate the complex state of medical reimbursement in the United States. This enables health systems to reduce their cost of care and be better stewards of the healthcare dollar. Alpha Health is based in the heart of Silicon Valley. Learn more at www.akasa.com.

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