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The company focuses on specialty drugs and uses a combination of AI and human expertise to automate the process.
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The prior-authorization process is one of the most important steps in a patient’s healthcare journey. It can often times be the most frustrating step. Ensuring that patients are properly covered can slow down the process and delay them from getting to see the doctors or medications that they need.
SamaCare provides a cloud-based platform that specializes in automating the prior-authorization process for specialty drugs. Since these medications can often have more difficult approval processes, this platform provides medical practices and patients awaiting treatment with a much-needed tool.
The company announced that it has completed one million prior authorizations using its platform.1 According to a press release, the combination of AI technology and human expertise provides faster and more accurate results.
In a press release, SamaCare CEO Syam Palakurthy said, “We’re excited to reach this milestone in our journey to help providers streamline the script-to-therapy process, and get patients the critical treatments they need, when they need them. By combining the power of AI and human expertise, we can leverage insights from over one million resolved prior authorizations to make SamaCare exponentially better at understanding and eliminating the friction patients and providers face from the time a diagnosis is made to the time treatment is administered.”
Palakurthy continued, “The reasons why a prior authorization is delayed or even denied are often vague and perplexing. SamaCare provides in-workflow intelligence to help practices proactively avoid common mistakes that lead to delays and denials, and helps pharmaceutical manufacturers gain insight into access challenges associated with their product.”
SamaCare first announced that it had secured $17 million is a Series B investment for the platform in May of 2024.2 At the time, Questa Capital had invested in the company, joining fellow investors Vive Collective and South Park Commons. At the time, SamaCare noted that the prior-authorization process was fragmented and still heavily relied on manual processes that still required physical paper forms to be completed.
In a press release issued at the time, Palakurty said, “By digitizing the current manual paper-and-fax-heavy process, our platform reduces the administrative burdens that harm patient care, drive healthcare providers crazy, and raise costs for the system. The support of Questa Capital and our current investors will help us accelerate much-needed change to a cumbersome system."
The CEO continued, “We live in a time of medical miracles, but administrative and financial barriers to care are becoming more painful and time-consuming, impacting patients during their most challenging moments. The Script-to-Therapy Operating System aims to address these obstacles and provide treatments at the moment of need."
In the same press release, Questa Capital partner Dr. Aabed Meer added, “As a physician, I've navigated various administrative processes to secure vital medications for patients. Our team's extensive experience with investments within the specialty pharmaceutical ecosystem has deepened our appreciation for SamaCare's pivotal role in helping patients start and stay on their treatment regimens, ultimately leading to better outcomes."
Vive Collective CEO Cherly Cheng also said, “The complex, targeted, and expensive nature of novel therapeutics creates friction in the system. SamaCare is a prime application of software and data intelligence that delivers clear ROI and benefit to all parties in the network. Vive Collective remains committed to supporting SamaCare's journey to improve patients' access to essential medications."
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