Wisedocs raises $9.5M to automate medical claims

The company uses AI and ML to automatically sort, index, and summarize medical records

Despite major advances in technology for the healthcare industry, especially with artificial intelligence and machine learning, the medical claims industry is still in the dark ages: it's completely manual, resulting in a significant backlog, which then causes a ripple effect with all those involved. Insurers, doctors, case managers, and the individual all have to deal a frustrating process. 

Wisedocs is solving that problem with its AI and ML service, which automatically sorts, indexes and summarizes medical records, reducing the need for human effort and minimizing errors. 

"Our innovative platform addresses the frustration experienced by all those involved in the claims process by erasing the headache of manually analyzing medical records to create a more positive experience for insurance companies, legal firms, healthcare providers, and their claimants," Connor Atchison, founder and CEO of Wisedocs, told VatorNews.

This week, the Toronto-based company announced a $9.5 million USD ($12.7 million CAD) Series A funding round led by Information Venture Partners, Thomson Reuters Ventures, and ManchesterStory. This brings Wisedocs’ total funding to $16 million, following its $4.1 million seed round in 2022.

The Wisedocs’ platform allows medical records and other data to be processed in real time, with advanced, customizable machine learning outputs. It tackles the issue of duplicate records, using intelligent OCR (ICR) to identify and remove redundant information with automated custom workflows, saving time for all parties involved. The company utilizes ICR and machine learning to extract key information from medical records and generate indexed insights and generate medical summaries.

"These features streamline the laborious manual process and facilitate faster decision-making for insurers, doctors, case managers, and legal entities dealing with the medical record. By eliminating the need to manually review lengthy documents, Wisedocs enables stakeholders to process claims with greater speed, accuracy, and efficiency," Atchison explained. 

The company also recently launched an AI Medical Summary Platform to allow companies in the insurance ecosystem to quickly summarize thousands of pages of medical records while gaining insights across documents to enable fast and inexpensive reviews of and decisions on medical records.

The idea for Wisedocs came from Atchison's time in the Canadian Armed Forces; during his twelve years of military service under the Department of National Defence, he served in the infantry and aided in healthcare administration. It was here, and through a personal experience with the claims process, that Atchison saw a need for change in the medical claims industry.

"Seeing first-hand the challenges thousands of claimants and veterans undergo as they move through the broken and difficult to navigate claims process, he knew there was a need for change. Wisedocs understands the lasting personal impact a slow claims resolution can have on the claimant, many of whom will be unable to return to work until they receive the care and treatment they need," he said.

"The current manual process that exists in the insurance ecosystem today needs an upgrade, and Wisedocs is here to help. We know that when all stakeholders in the process can streamline their workflows – everybody wins."

Wisedocs indexes and sorts medical records using machine learning for insurance carriers, healthcare providers, laws firms, and TPAs. It serves the auto, liability, disability, and workers' compensation markets. 

The company currently has over 50 customers who been able to save up to 70% of their time processing records, have their document organized into a searchable medical record index, and get insights pulled from the medical record review. Wisedocs can process 100 pages in under 10 minutes compared to an hour for human review, 6x faster than a human.

Now that it has raised this new funding, Wisedocs plans to build on the success of its medical summaries launch, Atchinson said.

"Our customer demand has been overwhelming as the market looks for a solution that can allow them to understand medical records in real time. Our goals are to continue investing in this product, providing more insights and analytics to customers to truly understand an individuals medical history," he explained.

The company also plans to make product investments in LLM technology, while also building out its team

"Wisedocs is looking to double down and focus on delivering for our customers that are coming to Wisedocs looking for an intuitive solution like this. In the near future, we aim to expand our partnership network and distribution as the industry continues to be fragmented," said Atchinson.

"Success to the Wisedocs team is about delivering on new product offerings to help automate more of the claims process and all the stakeholders involved in the insurance ecosystem. We are passionate about building a world class company culture with incredible talent and employee engagement."

(Image source: wisedocs.ai)