Mendelia: Streamlining US Healthcare Approvals with AI Automation
TL/DR –
Mendelia, an artificial intelligence (AI)-based workflow automation solution for healthcare insurance preapproval, was developed by Aaron Cullen and Jaylem Brar. The platform pulls eligibility data, authorization requirements and cover details from a clinic’s electronic health records and payer portals, automatically tracking authorization progress and catching issues before they result in denials. The start-up was backed by the US-based Y Combinator accelerator, which provided Mendelia with $500,000 in start-up capital.
AI Startup Mendelia Streamlines Medical Preapprovals in the US
In the United States, countless medical procedures are postponed daily as clinics await insurance approval. This inspired Aaron Cullen and Jaylem Brar to develop a solution to streamline the process.
Unlike health insurers in Ireland, US insurance companies require prior authorisation for medical treatments. This can be a difficult task for clinic administrative staff due to varied requirements among over 1,100 health insurers.
To alleviate this, Cullen and Brar launched Mendelia, an AI-based automation tool designed to simplify preapproval processes. Their system submits, tracks, and follows up on authorisation requests, freeing up time for clinic staff and expediting patient care.
Prior to founding Mendelia, Cullen, originally from Dublin, and Brar, a software engineer, worked at New York-based healthcare startup Brellium. Their shared interest in reducing administrative burdens in clinics led to the creation of Mendelia.
The US-based accelerator Y Combinator backed Mendelia, providing $500,000 in start-up capital. They spent time observing back-office staff in clinics to understand the processes and challenges involved in prior authorisations.
Mendelia uses AI to integrate with a clinic’s electronic health records and payer portals, automatically collating eligibility data, authorisation requirements, and coverage details. It also tracks authorisation progress, alerts for rule changes, and catches potential issues.
With the complexity and variance of prior authorisation requirements, existing solutions largely involve providing clinics with software to manage the process themselves. However, Mendelia’s approach is to automate the entire process, relieving clinic staff of these tasks.
AI has been instrumental in Mendelia’s development, allowing for quick integration with their clinic customers. They remain focused on specific surgical specialties with high prior authorisation requirements, such as orthopedics and ophthalmology.
Mendelia’s first paying customers came from clinics they visited with doughnut deliveries, and the company has been growing through peer-to-peer recommendations from clinicians since then. They charge per authorisation, offering volume discounts for heavy users. Currently based in New York, Mendelia employs six people and while there are no immediate plans for an Irish rollout, it hasn’t been ruled out.
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