Gynisus is an AI-powered insurtech-healthtech company improving health and fiscal outcomes by predicting medical conditions and associated financial impacts.
Through their proprietary technology platform, SPAI, Gynisus can ingest any type of data, in any format, from providers and payers alike. The High-Resolution AI Model within SPAI uses this data first to create a holistic view of each patient’s clinical condition. Then, at the highest level of precision in the industry today, can identify discrepancies between the clinical condition and the treatments ordered, conditions diagnosed (or not yet diagnosed), and how the claim was billed. In addition, this same model will use the derived clinical condition and create digital twins that are used to predict outcomes and potential risks accurately.
Gynisus has two key markets. The first is the health plans market, where payment integrity and prior authorization (PA) solutions are provided. Their deep analytics makes payment integrity possible, enabling them to confirm billing accuracy and identify potential errors or omissions. PA solutions offer automated, real-time insights into each request to verify each order is necessary for a patient's treatment and, if not, suggest viable options. Their second market is the life insurance and stop-loss industry, with cost containment solutions and medical underwriting solutions. Like payment integrity with health plans, their cost containment module uses the same deep analysis to ensure stop-loss carriers pay for essential and accurate billed services. Their medical underwriting solutions refer to the tools and technologies they use to assess an individual's health status and risk factors to determine their eligibility for life insurance coverage.
Meet the team behind Gynisus
At Gynisus, the core team comprises Hila Friedmann, CEO and Co-founder, and Nick Stone, Head of Growth and Strategy. Hila brings a wealth of academic expertise to the tablein physics, biomedical engineering, and AI, reinforced with coursework at Stanford. Meanwhile, Nick boasts a solid background and over twenty years of experience working for healthcare industry trailblazers in operations and growth leadership roles.
Why we’re excited to invest
Medical errors, bureaucratic processes, and other inefficiencies waste lives, money, and time. Payors suffer predictable and preventable financial losses due to these medical errors. The US reports 12 million medical and diagnostic errors annually and over $500bn in fraud, waste, and abuse attributable to the clinical integrity of treatment and claim billing. This is where SPAI comes in — SPAI is the most comprehensive platform in the industry when it comes to identifying and preventing healthcare waste.
We look forward to seeing more and more individuals solving this problem with Gynisus and are excited to support them on their journey.