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Simplify Healthcare Acquires Virtical.ai, a Pioneering AI Company, Accelerating AI Integration and Innovation at Payers

Simplify Healthcare, a leading provider of enterprise SaaS solutions to Payers (health insurance companies),announced the acquisition of Virtical.ai, a pioneering Artificial Intelligence (AI) company. This strategic move strengthens Simplify Healthcare’s commitment to empowering its Payer customers with cutting-edge AI technology and reinforces its position at the forefront of the AI revolution.

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The acquisition will provide significant benefits to both companies’ customer bases. Simplify Healthcare’s established cloud based platform – Simplify Health Cloud™, combined with Virtical.ai’s innovative AI platform, will create a powerful suite of tools that unlock new levels of innovation, efficiency, and growth enablers at Payers. By leveraging the power of AI for data extraction and comparison using an AI model trained on thousands of Health Plan specific documents such as the SBC (Statement of Benefits and Coverage), the Virtical.ai platform enables Payers to offer hyper-personalized plans and benefits to their members in employer and individual segments. This empowers a Payer’s broker community as well to serve their mutual customers with the most optimum offerings, ultimately serving members.

Additionally, the Virtical platform assists in identifying gaps in Payer networks — holistically as well as by customer and prospect — by comparing provider and member locations, allowing Payers to strategically promote their network coverage strengths as well as address deficiencies to ensure members have access to adequate providers within their area. Payers can also compare negotiated provider rates with those of their competitors, helping them to gain insight into how their rates stack up against other networks and where to immediately target marketing spend.

Mohammed Vaid, CEO of Simplify Healthcare, expressed his enthusiasm for the acquisition, stating, “We are thrilled to welcome Virtical.ai to the Simplify Healthcare family. This strategic move underscores our unwavering commitment to AI and its potential to transform how Payers operate. Together, we will equip our customers with the tools they need to seamlessly integrate AI into their workflows and unlock its full potential. With AI models that are able to consume and make sense of the complex documents at Payers, such as SBCs to radically transform plan comparison and selection; and ingest the hard to understand Machine Readable Files (MRFs) around price transparency, we will now be able to fuel the growth strategies for Payers. In concert with the Simplify Health Cloud, this creates a crucial value proposition for our customers. I am excited about the tremendous value we can bring to Payers, together with Deepak and his team.”

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Vinay Nadig, Chief Strategy Officer at Simplify Healthcare, echoed this sentiment, highlighting the acquisition’s role in executing the company’s vision. “This acquisition represents a significant step forward in our strategic roadmap. By combining Simplify Healthcare’s industry-leading platform with Virtical.ai’s cutting-edge AI innovations in both Health Plan Sales Solutions and Network Management Solutions, we will empower Payers to achieve growth even as they face disruptive market and regulatory forces. Using both GenAI and Machine Learning (ML) algorithms on unstructured document content (such as SBCs, EOCs, etc.) as well as structured data (price transparency MRFs, Geo data, etc.), we will be able to deliver outstanding solutions to Payers as they grapple with harnessing the power of AI to serve their members.”

Deepak Bandi, CEO of Virtical.ai, expressed his excitement about joining forces with Simplify Healthcare. “We are incredibly excited to embark on this journey with Simplify Healthcare. The combined strength of our teams and technologies represents a game-changer for Payers. We share a common vision for empowering businesses with AI, and together, we will accelerate its adoption and unlock its transformative potential. Our AI models, built on multiple decades of learning and experience at Payers and positioned to drive membership growth and revenue, in conjunction with Simplify Healthcare’s enterprise SaaS platform, will provide a tremendous competitive advantage to Payers. I look forward to working with Mohammed and Vinay to amplify our collective value to our customers.”

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