Health IT, Hospitals, Startups

Infomatics in Context raises $1.65M to streamline prior authorization process between payers and providers

Infomatics in Context, a cloud-based health analytics company that seeks to automate the referral and […]

Infomatics in Context, a cloud-based health analytics company that seeks to automate the referral and prior authorization processes between payers and providers, has raised $1.65 million, according to a filing with the SEC.

The Boston-based startup, founded in 2011, offers the real-time analytics for both the insurance and provider side. Under the Affordable Care Act, prior authorization must comply with what’s known as the EDI 278 standard in an effort to reduce costs. Prior authorization can often be a lengthy and costly process for both the payer and the provider.

For providers, Infomatics in Context says before submission, prior authorization requests are reconciled against payer policy guidelines to reduce the possibility of denials. For payers, the company says its EDI 278 engine automatically examins all prior authorization requests based on the payer’s policy guidelines and evidence-based medicine to insure compliance.

The company is headed by founder and CEO Simha Vikram. The company could raise up to $1.93 million in equity, according to the Form D filing.

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