Trying to Shore Up Medicaid Data, Ocrolus Raises $4M

It turns out that software designed to analyze and verify data related to loan applications can help payers. Ocrolus, a start-up that has made its name in the financial sector, earned $4 million in its Series A funding round, a boost that’s slated to help its artificial intelligence (AI) enter healthcare, according to the company.

The New York City-based company, founded in 2014, has locked down $7.3 million in venture capital thus far, according to the start-up tracker Crunchbase. Bullpen Capital led the most recent round of fundraising, with support from QED Investors, Laconia Capital Group, ValueStream Ventures, and RiverPark Ventures, according to an announcement from Ocrolus.

A portion of the money will aid Ocrolus in expanding its reach into healthcare. The organization noted that healthcare insurance applications share attributes with loan requests, making its solutions a fit for the industry.

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Ocrolus won a bid to “modernize Medicaid eligibility determinations,” a move that will put its Medicaid-Genius product in the hands of government agencies this year, the company said. Senior Planning Services, a private Medicaid application company, has already begun using the product to “automate financial lookbacks” for patients in nursing homes, according to Ocrolus.

“In order for programs like Medicaid to be sustainable as the population grows and ages, it’s essential that entitlements are granted only to truly eligible applicants,” Victoria Meakin, co-founder and president of Ocrolus, said in a statement. “Our technology enables a range of agencies to expedite processing time, cut costs, and reduce fraud, benefiting government and citizens alike.”

Ocrolus has been helping financial institutions analyze bank statements and similar documents through its computing power and “crowdsourced quality control.” The company claims it accomplishes such tasks with 99% accuracy, eliminating the need for clients to sample and spot-check.

What does that look like on the ground? Every day, Ocrolus and its AI analyze “millions” of data points, confirming financial information more effectively and efficiently than traditional means, according to the start-up. Its technologies verify, time-stamp, and source every line item.

The organization’s automated financial data verification product, PerfectAudit, provided the basis for Medicaid-Genius.

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