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Alaffia Health, which creates agentic AI tools for health insurance claims, has secured $55 million in Series B funding, bringing its total raise to more than $73 million.
Transformation Capital led the round, with participation from FirstMark Capital, Twine Ventures and Tau Ventures.
Todd Cozzens, managing partner at Transformation Capital, will join the company's board of directors.
WHAT IT DOES
The New York-based company offers agentic AI agents to help with clinical workflows, including case reviews. It also provides AI that is designed to help preprocess clinical claims and charts, route claims based on complexity and value, generate clinical summaries and support clinician validation for decision-making.
Alaffia will use the funds for research and development, to launch new AI agents across various modalities and to scale its reach.
The company will also expand its engineering, product and growth teams.
"Healthcare doesn't need more automation that no one can explain – it needs AI that clinicians, operators and regulators can trust," Adun Akanni, cofounder and COO at Alaffia, said in a statement. "We founded Alaffia to bring transparency and clinical rigor to claims operations, and this funding allows us to scale that mission as we help health plans reduce waste and operate with confidence."
MARKET SNAPSHOT
Alaffia Health obtained $10 million in Series A funding in 2024, bringing its total raise to $17.6 million.
Other companies offering software for claims management include Bluespine, which offers an AI-driven platform for reducing claims costs for self-insured employers. The company raised $7.2 million in seed funding in 2024.
Optum also offers medical claims and reimbursement tools; athenahealth provides claims management as part of its revenue cycle management and practice management offerings; and Experian Health, Cognizant and Confer Health Solutions also provide claims management services.
