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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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Sault Tribe Enacts Smoking Ban in Kewaunee

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Ban smoking Sault Tribe

Health and comfort have become increasingly essential issues lately, and this has not gone unnoticed in entertainment venues. The Sault Tribe, which operates the Kewadin Casino, has decided to ban smoking in five gambling establishments. This innovation is aimed at creating a healthier environment for all visitors and employees.

Health and comfort come first

Tribal representatives emphasized that people’s health is their top priority. The decision to ban smoking was a logical step toward positive change. “As a tribal government, we are focused on improving health, and the move to ban smoking in casinos is the right step forward,” notes one tribal speaker. This means caring about the health of visitors and the well-being of the employees who work in these facilities daily.

The Sault Tribe has been actively gathering opinions from its customers and employees, and the results have been unequivocal: many are in favor of banning smoking. “We have heard from many customers and employees that a smoking ban is the right step forward,” states a tribal spokesperson. Such feedback confirms that concern for health and well-being is becoming increasingly important to the gambling industry.

What will change at Kewadin casinos?

In the weeks following the passage of the amendments, Kewadin casinos located in Sault Ste. Marie, St. Ignace, Manistique, Christmas, and Hessel will begin implementing the new policy. The smoking ban will be in effect in all establishments, including gaming rooms, restaurants, and recreational facilities. This approach will not only make the casino experience more enjoyable for non-smoking visitors, but it will also create a safer environment for employees who spend much time in the gaming rooms.

Positive implications for business and society

The adopted initiative will not only bring health benefits but will also affect the success of businesses in the long run:

  • The actions taken also emphasize the Sault Tribe’s social responsibility. They are not just in business but also show concern for the well-being of their customers and employees, making them an example for other gambling establishments.
  • Banning smoking in Kewadin casinos will create a more pleasant environment for both non-smokers and those looking to quit smoking. Smoking in public places often makes other visitors uncomfortable, and this move will help eliminate the unpleasant odour and smoke, thus creating a more pleasant atmosphere throughout the gaming rooms, restaurants, and other recreational areas.
  • The changes may attract a new audience interested in entertainment but previously avoided visiting casinos because of the smoking environment. This can lead not only to an increase in the number of guests but also, as a result, to increased profits for the establishment.

At the same time, avid smokers, which are still quite a lot, will be less likely to visit land-based casinos, where they are forbidden to relax in the usual way. Especially since today, they do not have to visit these establishments to satisfy their gambling needs.

Analyzing the search engine allows you to quickly find many popular operators, including 1win, with the largest number of gambling entertainment. And you can access these games without having to leave home. To register on 1win, it is enough to fill in a few fields in the appropriate window and develop a password. It takes less than a minute to do this and deposit money into your account. Moreover, most of the games can be played in a free demo.

Chippewa Tribe aims to create a “smoke-free” space that combines a healthy environment with the opportunity to relax and enjoy gambling. The new approach to business reflects and supports global trends aimed at caring for public health and reducing the negative impact of tobacco smoke on the health of others.

Recall that earlier, scientists told us about the new harm of smoking. According to new data, the negative impact of this bad habit on the immune system persists for several years after a person quits smoking.

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SpecSMART Eye Clinic Takes Affordable, Quality Care to Ikeja, Environs

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SpecSMART Eye Clinic

By Modupe Gbadeyanka

The dream of residents of Ikeja and its environs enjoying affordable and quality care has now become a reality as a result of the opening of a new branch of SpecSMART Eye Clinic in the Opebi area of the capital of Lagos State.

SpecSMART Eye Clinic, a leading provider of optometry services in Lagos, commenced operations in Nigeria’s commercial capital in 2022.

Since then, it has been offering top-notch eye care to residents of the metropolis, especially those living on the Island. It has built a strong reputation for delivering high-quality primary eye care and optical products.

However, to extend its services to Lagosians living on the Mainland, it has now opened a new branch in Ikeja, reinforcing its commitment to providing accessible, affordable eye care to a wider community.

Business Post gathered that the clinic’s state-of-the-art services are supported by a team of skilled optometrists and opticians, utilizing cutting-edge digital equipment.

The new Ikeja location will offer a wide range of services, including Automated Eye Examinations using advanced digital equipment for precise diagnosis and personalized care.

In addition, clients will enjoy on-the-spot lens glazing for single vision, bifocals, and varifocals, with additional lens coatings, with services to be rendered seven days a week from 9 am to 9 pm on Mondays to Saturdays, and on Sundays and public holidays from 10 am 7 pm.

Also, the clinic has over 950 frames, ranging from affordable home brands to premium designer options, priced from N18,000, and has flexible appointment scheduling with 24-hour online booking via SpecSMART’s website.

The facility has partnerships with leading HMO providers in the country and offers glaucoma management and other essential eye health services.

According to the company, its introductory packages start from N30,000 and include consultation, frame, and single-vision lenses.

“With the opening of our Ikeja branch, we are ready to serve more individuals who need accessible, cost-effective, and reliable eye care.

“Our aim is to create a positive impact in Nigeria’s optometry sector by combining advanced technology with a patient-centred approach,” the Practice Head and Medical Director of SpecSMART, Dr Adaeze Nwoko, stated.

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FG Begins Vaccination Against Mpox in FCT, Six States

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Monkeypox mpox

By Adedapo Adesanya

The Federal Ministry of Health and Social Welfare through the National Primary Health Care Development Agency (NPHCDA) has commenced the vaccination against Monkeypox, now known as Mpox.

Business Post reports that Bayelsa, Rivers, Cross River, Akwa Ibom, Enugu, Benue, and the Federal Capital Territory, were selected as pilot states for the vaccination.

An average of 631 persons are expected to be vaccinated across the seven states with two doses of the Mpox vaccine. A buffer for 50 persons will be kept at the national in case of an upsurge in other states.

NPHCDA in a statement posted on its verified X account confirmed the exercise, stressing that the vaccination will help to protect communities and safeguarding health of the people.

In a related development, according to the latest update by the Nigeria Centre for Disease Control (NCDC), there are 1,442 suspected cases of Mpox from 36 states and the Federal Capital Territory, while the number of confirmed cases of the infection was 118 from 28 states and the FCT.

“To prevent the spread of Mpox, we strongly advise the public to avoid contact with animals that may carry the virus, including sick or dead animals in affected areas, avoid handling materials that have been in contact with infected animals, limit unnecessary physical contact with individuals who are infected, practice frequent handwashing with soap and water, and ensure that animal food products are thoroughly cooked before eating.

“It’s also important to use protective clothing and gloves when handling sick animals or their tissues. Similarly, health workers are advised to follow standard safety protocols including droplet precautions when treating patients, use protective equipment including masks, gloves, and gowns, during patient care, and be vigilant for symptoms of Mpox, especially fever and rash, among other measures.”

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