Anterior, a clinician-led AI platform for health plans, has raised $40M in a Series funding round led by New Enterprise Associates (NEA) and Sequoia Capital. The platform provides modular AI actions and end-to-end solutions like prior authorization automation, delivering workflows with 99.24% KLAS-verified accuracy. The capital will accelerate AI adoption across health plans and payers.
Payer AI Adoption Accelerates
The timing reflects surging investor confidence in AI for healthcare administration. Anterior's round brings its total funding to $64M, positioning it to expand its deployments currently processing 6M prior authorizations annually for organizations covering 50M lives. This clinician-led approach stands out by prioritizing affirmative decisions and full auditability amid rising demand for reliable clinical automation.
Prior authorizations create enormous administrative drag for health plans, payers, and utilization management organizations. Customers using Anterior handle 6M prior auths per year, underscoring the volume across systems serving 50M covered lives. Legacy processes rely on manual reviews prone to errors, delays, high costs, and staff burnout, while many AI tools risk hallucinations or opaque denials that invite regulatory scrutiny.
Affirmative AI Ensures Clinical Accuracy
Anterior's solution flips the script with 'affirmative AI' that only approves cases or escalates them—never denies—backed by transparent reasoning chains for full auditability. Its modular AI actions handle intake, accuracy checks, logic interpretation, output condensation, and data linking, powering end-to-end prior auth from intake to adjudication. Deployments happen in just 5 days via forward-deployed clinicians who embed with customers.
This delivers 99.24% end-to-end clinical accuracy (KLAS-verified), a 76% jump in auto-approvals, 75% shorter review cycles, 85% lower admin costs, 56% reduced staff burden, and 90%+ staff satisfaction. Compared to traditional machine learning models, Anterior's LLM-native architecture better captures clinical nuance, as highlighted in its recent insights on AI hallucinations and ML vs. LLM differences.
NEA and Sequoia Back Scalable AI
NEA and Sequoia leading the round signals strong validation for Anterior's model, blending clinician expertise with scalable AI. These top-tier investors recognize the strategic shift toward auditable automation in payer workflows, where compliance and ROI matter most. The funding aligns directly with Anterior's strategy of rapid deployments and FHIR-native, API-first integrations with systems like HealthEdge GuidingCare and MCG.
Payer Market Ripe for AI Disruption
Health plans increasingly seek tools to tame prior auth chaos, with Anterior already proving ROI from day one. The company's rebrand from Co:Helm in 2024 and focus on enterprise providers highlight momentum in a fragmented market. As payers cover vast populations—Anterior supports 50M lives—the push for precise, transparent AI grows, fueled by regulatory pressures and cost containment needs.
Anterior's traction, including KLAS validation and massive scale, positions it to capture more share as AI matures in healthcare.