Startups, Payers, Health Services

CredSimple raises $14M for better physician crediting

The company has created a cloud-based service for more efficient verification of a clinician’s qualifications, career history, education and training in order to ensure the maintenance of compliant and adequate physician networks.

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New York-based startup CredSimple has raised a $14 million Series B financing round led by Questa Capital to drive growth of the company’s credential verification platform.

Existing investors Windham Venture Partners and Primary Ventures also participated in the round, which will be directed at expanding the company’s team, accelerate sales and launch new products. As part of the financing, Questa Capital Managing Director Brad Sloan is joining the company’s board of directors.

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The company has created a cloud-based service for more efficient verification of a clinician’s qualifications, career history, education and training in order to ensure the maintenance of compliant and adequate physician networks.

“Our CVC platform eliminates credentialing backlogs, reduces compliance risk and administrative costs, and streamlines operations – delivering customers significant improvement in credentialing turnaround times and a seamless, cutting edge experience for their providers.” CredSimple CEO Mike Simmons said in a statement.

“We are thrilled to have a partner like Questa with deep healthcare domain expertise and appreciation for our mission of streamlining such a manual process for the industry.”

Founded in 2013, the company has raised around $28 million from investors.

CredSimple has helped to digitize applications and automate primary source verification to improve the turnaround time for the credentialing process.

The idea is then to create a better methodology to manage and maintain accurate provider data for applications like ensuring accurate provider directories.

Among the company’s customers, which include health plans, independent physician associations and telehealth companies are Providers Partners Health Plan, Oscar Health Insurance and Clover Health.

CredSimple addresses a costly recurring pain point for health plans, state agencies, and provider organizations, replacing what has historically been a labor- and resource-intensive process into an efficient, transparent and integrated credentialing solution,” Questa’s Sloan said in a statement.

“Health plans struggle with broader provider network management and in particular credentialing and monitoring. Having studied the space and seen the problem up close within our healthcare portfolio over the years, we believe now is the time to invest in innovative, technology driven solutions like CredSimple to address such an immense market opportunity.”

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