Lamar Health

What Lamar Health does

Lamar Health is a private, venture-backed software company that builds an AI-powered workflow automation platform for specialty medication prior authorization. The platform automates referral intake from fax, EHRs, portals, and email; verifies benefits and eligibility; validates clinical documentation against payer-specific requirements; assembles and submits prior authorization packets; and tracks them through final determination. Underlying technology combines three AI models and several datasets covering structured patient and payer data, clinical text, and multimodal document inputs, with a continuous-learning loop claimed to improve approval rates over time. The product is HIPAA-compliant, integrates with EHRs covering roughly 80% of health systems (including Cerner), and works alongside CoverMyMeds rather than displacing it.

The company sells primarily to enterprise specialty pharmacies, infusion clinics, and home infusion pharmacies, with a dedicated product line for life science companies and reference customers including Uptiv Health, CloudRx, Great River, Brooks Infusion, Nufactor, and Choice One Rx. Pricing is usage-based, scaling with monthly authorization volume and the modules deployed (prior authorization, intake, benefits investigation, custom automation), with one-time implementation services layered on top. The go-to-market is enterprise field sales with demo-led engagement; marketing is reinforced through a podcast, blog, case studies, and ROI tools. Lamar Health is headquartered in San Francisco (legal entity Quantification by Design Inc.), was founded in 2021, and has raised capital from Y Combinator, Plug and Play, Flex Capital, PennyJar Capital, Healthy VC, Dnipro VC, Shah Capital, and angel investors, with Eesha Sharma as CEO.

Quantified customer outcomes publicly cited include a 97% reduction in staff time per prior authorization, 98% intake accuracy, a 30% decrease in time to fill, an 11% increase in first-time approvals, and backlog elimination in named accounts. Reported scope is U.S.-only, with no disclosed revenue, ARR, or employee count beyond a 11-50 range, placing the company firmly in the Seed-to-Series A health-tech category.

Name

Lamar Health

Legal name

Quantification by Design Inc.

Website

https://lamarhealth.com

Company type

Private

Founded year

2021

Operating status

Operating

Headcount range

11–50 employees

Short description

Lamar Health is an AI-powered workflow automation platform that helps specialty pharmacies, infusion clinics, and home infusion providers complete prior authorizations faster, with deep EHR and payer integrations and usage-based enterprise SaaS pricing.

Ownership category

akta.pro rank

Product category

Prior Authorization Automation Software

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Services-Prepackaged Software (7372)

akta.pro primary industry

Specialty Pharmacy & Complex Therapy Management Platforms (HLACAKAG)

akta.pro secondary industries

Medication Pricing, Copay Assistance & Patient Financial Support Tools (HLACAKAN), PBM Technology Platforms (ePA/eRx/Real-Time Benefit Tools) (HLAEAKAL)

Keywords

• Prior authorization automation
• Specialty pharmacy software
• Healthcare workflow automation
• AI medical documentation
• Benefits verification platform

Headquarters

HQ city

Palo Alto

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

Personnel, Technology or R&D, Marketing or Sales, Operations, Infrastructure

Revenue model

1. Software Subscription (SaaS): Lamar pricing is based on operational load rather than flat fees. Pricing scales with monthly volume of authorizations and transactions processed, with lower per-unit costs at higher volumes. Additional factors include modules deployed (prior authorization, intake, benefits investigation, custom automation) and implementation scope.
2. Implementation Services: Implementation pricing reflects timeline and integrations, with an industry-leading deployment that minimizes internal lift and disruption.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels7 records

Core offering

Lamar Health sells an AI-powered SaaS workflow automation platform that automates prior authorization and related specialty medication workflows for specialty pharmacies, infusion clinics, and home infusion pharmacies. The platform centralizes intake from fax, EHRs, portals, and email; verifies benefits; assembles and submits payer packets; tracks status; and provides operational visibility, integrating with EHR systems covering 80% of health systems and with payer portals such as CoverMyMeds. A separate life science offering enables pharma manufacturers to support market access, field reimbursement, and provider-side workflows.

Product overview

Lamar Health offers an AI-powered workflow automation platform designed specifically for specialty medication workflows. The core platform serves as an integrated system connecting to major EHR systems (80% of health systems) and supporting both Pharmacy and Medical Benefit Prior Authorizations. The product portfolio includes the Lamar Health Platform (core), DoPriorAuth (prior authorization module), Intake Automation, Benefits Verification, Clinical Documentation Validation, and Custom Automation modules. For Life Science Companies, Lamar Health provides a specialized market access solution. The platform uses a proprietary combination of 3 AI models and multiple datasets to automate document processing, form population, and PA submission while reducing staff time by up to 97% and increasing intake accuracy to 98%. Founded by healthcare veterans from Stanford Medicine, McKesson, and CoverMyMeds, and backed by Y Combinator and notable investors.

Differentiator

Problem solved

Functional benefit

Products and services

• Lamar Health Platform AI-powered workflow automation platform for specialty medication prior authorization, intake, benefits verification, and custom workflows. Connects to major EHR systems and continuously learns to improve authorization processes for specialty pharmacies, infusion clinics, and home infusion pharmacies.
• DoPriorAuth Prior authorization module within the Lamar Health platform that automates submission, tracks status through final determination, and provides real-time feedback on payor policies and approvals; accessed via dedicated login for customers.
• Lamar Health for Life Science Companies Market access solution for pharma and life science companies, enabling immediate eligibility verification, PA criteria checks, simplified submission, integrated services, and actionable analytics for field reimbursement agents to reduce friction at provider workflows.

Quantifiable outcome

• 97% decrease in staff time per prior authorization
• +7 more outcomes

Named customers6 records

Segments5 records

Ideal customer profiles5 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration5 records

AI capability7 records

Feature7 records

Partnerships

Two partnerships are on record, tiered core.

• Uptiv HealthcoreStrategic or Co-development Partner · 25 March 2025Strategic partnership where Uptiv Health, a leader in integrated infusion and chronic care management, implements Lamar Health's AI-powered automation for referral intake and prior authorization processes. Collaboration aims to transform the infusion care model by combining clinical and tech-forward operational excellence with patient-first approach. Key benefits include faster time to care, lower administrative costs, enhanced patient experience, and seamless EHR integration.
• CoverMyMedscoreTechnology or IntegrationIntegration partnership where Lamar Health works alongside CoverMyMeds by coordinating PA work across it and other systems, rather than treating submission as the entire workflow. This enables comprehensive prior authorization management.

Scale indicators11 records

Recent moves6 records

Expansion highlights5 records

Emerging players

• Adonis Intelligence: Adonis is a healthcare revenue cycle automation platform with AI-driven prior authorization and claims management. Comparable emerging player targeting providers, with overlap in automated PA workflows.

Broad incumbents

• Waystar: Waystar provides healthcare revenue cycle management, including prior authorization and eligibility verification, to large provider organizations. Competes with Lamar for health system budget allocated to PA and intake workflow automation.
• CoverMyMeds: CoverMyMeds (a McKesson company) is the largest electronic prior authorization platform serving pharmacies, providers, and payers. It is both a Lamar Health integration partner and the dominant incumbent against which Lamar competes on PA workflow automation.
• Surescripts: Surescripts operates the dominant e-prescribing and clinical information network in the US, increasingly expanding into prior authorization and Real-Time Prescription Benefit. Its network breadth makes it a broad incumbent competitor and potential partner for Lamar.
• Experian Health: Experian Health offers prior authorization, eligibility, and revenue cycle management solutions to hospitals and health systems. Overlaps with Lamar's EHR-integrated PA automation offering for health systems.

Direct peers

• Cohere Health: Cohere Health is a digital prior authorization platform working with health plans and providers to streamline medical and pharmacy benefit authorizations. Comparable to Lamar in PA workflow automation, though with a stronger payer-side orientation.
• Anterior (formerly known as FormSort Health): Anterior is an AI-native prior authorization automation company serving specialty care providers and payers. It directly overlaps with Lamar Health's PA automation focus and competes for the same specialty pharmacy and health system buyers.
• Arrive Health: Arrive Health (formerly RxRevoke) provides real-time prescription benefit, prior authorization, and care decision support at the point of prescribing. Directly comparable to Lamar in automating PA and benefit workflows for providers and pharmacies.
• Infinitus Systems: Infinitus automates benefit verification and prior authorization phone-based workflows using AI voice agents. It competes directly with Lamar's benefits verification and PA automation modules, particularly in specialty pharmacy and provider settings.

Regional players

• Humana Pharmacy / CenterWell Prior Authorization Solutions: Large payer-owned specialty pharmacy and PA operations serving vertically integrated populations. They are simultaneously potential customers and competitors, given they operate their own PA automation at scale.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/lamarhealth

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds3 records

Investors3 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Lamar Health