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CoverSelf Secures $8.2m to Drive Healthcare Claims, Scale Operations

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CoverSelf Beenext 3one4 capital $8.2m seed funding

By Dipo Olowookere

A unified platform for healthcare claims and payment integrity, CoverSelf, has obtained an $8.2 million seed round to expand its operations in the United States and drive healthcare claims and payment accuracy.

It was gathered that existing investors in the firm, BEENEXT and 3one4 Capital, led the funding round, with Z21 ventures and healthtech leaders coming in to invest in the organisation.

CoverSelf intends to use the fresh capital to build generative AI capabilities and increase headcount in sales and marketing as the business scales, especially at a time when the exponential growth of costs in healthcare remains hotly debated.

Over $4.1 trillion is spent on healthcare every year in the US alone, with administrative spending accounting for approximately one-quarter of the total amount.

In the last 12 months, the company has piloted the platform and successfully proved the platform’s readiness and effectiveness.

This has translated to two deployments for insurers where the platform processes 25 times more claims in the same time window than was done earlier.

Also, the platform has identified significant savings even after other vendors process claims. CoverSelf is in advanced discussions with 2 of the top 15 plans to collaborate. The current pipeline includes five of the top 15.

Traditional 3rd party payment integrity solution vendors exploit payment inaccuracies, which negatively impacts the provider’s experience and trust in payers and ends up ballooning waste and improper payments. With CoverSelf, payor payment integrity teams can reduce healthcare costs transparently and collaboratively with providers.

“The current claims integrity systems are very complex, and the deployed technologies are antiquated. Significant software innovation is needed to address the broken system that is currently creating out-of-control healthcare costs and waste.

“The cobbled-together software solutions result in scattered data and the inability to make real-time business decisions.

“Administrative complexity costs billions annually, an open and collaborative platform can significantly reduce the repetitive administrative costs,” the co-founder of CoverSelf, Rajasekhar Maddireddy, commented.

“Our solution offers multiple points of integration and intervention for all pre and post-pay payment integrity, effectively reducing waste.

“CoverSelf is empowering subject matter experts (SMEs) with a modern UX/UI that’s super easy to work with and aids them by eliminating technical dependencies thereby maximizing efficiency, and fostering rapid innovation.

“Speed to release has shifted from weeks to mere hours, thanks to our collaborative approach and operational efficiency,” the co-founder of the company, Raghavendra Pawar, also said.

Also commenting, the Managing Partner at BEENEXT, Dirk Van Quaquebeke, said, “CoverSelf’s vision to democratize the healthcare claims and payment integrity industry with their fully open and transparent solution built with a spirit of collaboration is truly inspirational,” while the VP for Investments at 3One4 Capital, Sonal Saldanha, noted that, “By bringing the payment integrity solution in-house, CoverSelf shifts the control of payment integrity from traditional outside vendors to payers. As payers start using CoverSelf, they will progressively need fewer external payment integrity vendors. Ultimately, CoverSelf will be the only payment integrity platform anyone will ever need.”

CoverSelf was established in 2021 by seasoned US healthcare domain experts to democratize the healthcare claims and payment integrity industry by creating a first-of-its-kind fully open and transparent solution that empowers payment integrity teams in health insurance companies (payers) to transparently resolve health claims with hospitals and medical practices (providers).

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Resident Doctors Suspend Proposed Indefinite Strike

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Resident Doctors

By Adedapo Adesanya

The Nigerian Association of Resident Doctors (NARD) has suspended its planned indefinite strike following the federal government’s reversal of the implementation of the reviewed Professional Allowance Table (PAT) and renewed assurances on outstanding payments.

The decision was announced in a communiqué issued at the end of an emergency National Executive Council (NEC) meeting held virtually on Saturday.

NARD had earlier resolved to embark on a total and indefinite strike over the government’s suspension of the reviewed allowance structure and other unresolved welfare concerns affecting resident doctors nationwide.

However, the association said it reconsidered its position after reviewing the outcomes of high-level engagements with key government officials and health-sector stakeholders.

According to the communiqué signed by NARD President, Dr Mohammad Usman Suleiman; Secretary-General, Dr Shuaibu Ibrahim; and Publicity and Social Secretary, Dr Abdulmajid Yahya Ibrahim, the Federal Government has now reversed its earlier decision on the allowance table.

“The NEC observed that the earlier decision to halt the implementation of the reviewed Professional Allowance Table (PAT) has been reversed, with implementation expected to reflect in the April salary and beyond,” the statement read.

The association also noted the government’s renewed commitment to settling outstanding promotion and salary arrears owed to resident doctors in affected institutions.

In addition, NARD said initial approval had been secured for the 2026 Medical Residency Training Fund (MRTF), with assurances that the disbursement process would be concluded.

“The NEC observed that the Budget Office has indicated its readiness to commence the process for the payment of the outstanding nineteen months’ arrears of the Professional Allowance,” the communiqué added.

Despite the progress, the doctors expressed concern about the continued delay in paying house officers’ salaries and called for urgent action to address the issue.

Following its deliberations, the NEC demanded the sustained implementation of the reviewed allowance structure, the prompt payment of all outstanding arrears, and the expedited disbursement of the residency training fund.

It also called for the immediate commencement of the process to clear the 19-month arrears and the convening of an urgent stakeholders’ meeting to resolve delays affecting house officers’ salaries.

“In light of the above developments, the NEC resolves to suspend the proposed total, indefinite, and comprehensive strike action, with a review of progress to be undertaken at the May Ordinary General Meeting (OGM) in Kano,” the statement said.

NARD expressed appreciation to President Bola Tinubu, Vice President Kashim Shettima, and several ministers, government agencies, and stakeholders for their interventions in resolving the dispute.

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Over 1.5 million Nigerian Children Living With Sickle Cell Disease—Report

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sickle cell disease

By Modupe Gbadeyanka

More than 1.5 million children under the age of 15 are living with sickle cell disease in Nigeria, a new international study published in The Lancet Child & Adolescent Health, one of the world’s leading medical journals, has revealed.

In the report made available to Business Post, it was disclosed that Nigeria carries the highest burden of disease globally, far exceeding other high-burden countries such as the Democratic Republic of the Congo and Ethiopia.

The findings highlight both the scale of the challenge in Nigeria and the opportunity for the country to lead Africa in tackling one of the most preventable causes of childhood illness and death.

The study shows that nearly nine million children across sub-Saharan Africa are living with sickle cell disease in 2023, including around 1.17 million infants and 2.75 million children under five, who face the highest risk of early death without treatment.

Sickle cell disease is an inherited blood disorder present at birth. With early diagnosis and access to simple, low-cost interventions such as newborn screening, penicillin prophylaxis, routine vaccinations, malaria prevention, and hydroxyurea, most complications and deaths can be prevented.

However, in Nigeria, access to these essential services remains limited. Many children are only diagnosed after severe and avoidable complications, while others are never diagnosed at all, contributing to high levels of preventable illness and early childhood deaths.

The researchers emphasise that strengthening Nigeria’s health system response will be critical. This includes expanding newborn screening programmes, improving access to essential medicines, and integrating sickle cell care into primary healthcare services.

They called for urgent and coordinated action across government, health institutions, and development partners, including expanding newborn screening programmes, improving access to essential medicines and vaccines, and embedding sickle cell care within primary healthcare services.

The researchers, led by Professor Davies Adeloye, Professor of Public Health at Teesside University, United Kingdom, and Director of the International Society of Global Health (ISoGH), also called for increased domestic investment, supported by international partnerships, as well as stronger data systems to improve surveillance and guide policy decisions.

They concluded that even modest improvements in early-life screening and treatment in high-burden countries like Nigeria could transform child survival and significantly reduce preventable deaths.

“Nigeria now stands at the centre of the global sickle cell crisis. With over 1.5 million children affected, the scale is enormous, but so is the opportunity to act. We already know what works. Newborn screening and early treatment are effective, affordable, and can be delivered through existing health systems.

“If Nigeria prioritises sickle cell disease within its national health agenda and integrates care into routine maternal and child health services, we could save hundreds of thousands of young lives and significantly reduce avoidable deaths.” Professor Adeloye noted.

It was learned that the study analysed data from 40 studies across 22 African countries to produce the most comprehensive country-level estimates of childhood sickle cell disease to date.

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Helical Secures $10m Funding Package for Expansion

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Helical

By Dipo Olowookere

A $10 million capital has been raised by Helical to support expansion across more top-20 pharma programmes and growth of its deployed science engineering team.

The firm will also use the money to build the compounding evidence layer that improves performance across diseases, as its mission is to make every scientist able to test hypotheses at the speed of inference and to turn in-silico discovery into a reliable engine for R&D throughput.

The funding package was from redalpine, Gradient, BoxGroup, Frst and notable angels, including Aidan Gomez (CEO Cohere), Clement Delangue (CEO HuggingFace) and Mario Goetze (pro soccer player).

Helical has a product known as the virtual AI lab for pharma, an application layer that turns biological foundation models into decision-ready, reproducible in-silico discovery workflows.

The platform has two product surfaces — the Virtual Lab for biologists and translational scientists, and the Model Factory for ML engineers and data scientists — built on the same data, the same models, and the same results.

By putting both sides in the same system, Helical closes the gap between computational predictions and biological decision-making, so teams that traditionally worked in silos can collaborate on the same evidence.

Helical was founded in early 2024. It was created by three school friends who took different paths to the same problem.

Rick Schneider built tech at Amazon and later helped the German enterprise Celonis scale in France and Japan. Maxime Allard led data science teams at IBM before pursuing a PhD focused on reinforcement learning and robotics. Mathieu Klop became a cardiologist and genomics researcher.

When bio foundation models emerged, the trio saw the chance to build the missing application layer that would let pharma teams move from model experimentation to reproducible, production discovery.

“The models alone don’t discover drugs. The system does. Pharma teams need a system that turns foundation models into workflows scientists can run, validate, and defend.

“We built Helical to make in-silico science reproducible at pharma scale, so teams can go from hypothesis to decision in days instead of months,” the co-founder of Helical, Mr Rick Schneider, said.

“We are at a unique point in time where biological foundation models and general language reasoning models are converging.

“We backed Helical because we strongly believe they have what it takes to build the pharma AI orchestration platform that will drive this transition from siloed AI models to integrated virtual AI labs,” the General Partner at redalpine, Mr Daniel Graf, stated.

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