Ethermed

What Ethermed does

Ethermed, founded in 2021 and headquartered in Philadelphia, operates an AI-powered SaaS platform called EthermedAI that automates prior authorization workflows for U.S. healthcare providers and payers. The platform intercepts physician orders directly from electronic medical record systems, interprets payer-specific authorization requirements using language models trained on over 100,000 policies across 168 payers, gathers documentation and evidence-based justifications, completes forms, and submits authorizations automatically through a four-step Catch, Match, Fill, and Send workflow. Ethermed reports 89 to 90 percent full automation, a 91 percent first-time approval rate, and processing times of 3.9 seconds per authorization versus the 20 to 30 minute industry average.

The company's technology stack combines proprietary NLP and language models, integration with major EHR systems (Epic, Cerner, Athena Health, eClinicalWorks, iKnowMed, TopDoc), pharmacy platforms (CoverMyMeds, Surescripts), and HL7 FHIR and X12 interoperability to support both electronic prior authorization and emerging CMS-0057-F mandates. The platform is HIPAA compliant with SOC 2 Type II certification in progress. Ethermed pairs this core offering with a strategic partnership with VisiQuate that layers predictive analytics and robotic process automation onto its revenue cycle workflow.

Ethermed generates revenue through annual enterprise SaaS subscriptions sold via direct field sales to health systems and payers, with strategic channels including health system innovation arms such as Healthliant Ventures (Tanner Health). The company has raised over $15 million across a seed round of more than $6.5 million in 2025 and an $8.5 million Series A in April 2026 led by Enfield Capital Partners and Blue Marlin Partners. It employs approximately 40 people across engineering, data science, product, sales, and customer success functions, and its primary customer segments are healthcare providers and health insurance payers, with patients as indirect beneficiaries of faster authorization turnaround.

Name

Ethermed

Legal name

Ethermed AI Inc.

Website

https://ethermed.ai

Company type

Private

Founded year

2021

Operating status

Operating

Headcount range

11–50 employees

Short description

Ethermed is an AI-powered SaaS platform that automates prior authorization workflows for U.S. healthcare providers and payers, embedding directly into major EHR systems to submit authorizations in seconds rather than minutes. The company sells enterprise subscriptions and has processed millions of annual authorizations across its payer network.

Ownership category

akta.pro rank

Product category

Healthcare Prior Authorization Automation Software

NAICS

Computer Systems Design and Related Services (54151)

SIC

Services-Prepackaged Software (7372), Services-Computer Integrated Systems Design (7373)

akta.pro primary industry

Prior Authorization (ePA), Utilization Management & Coverage Verification (HLACAKAE)

akta.pro secondary industries

EHR/EMR Integration & Interoperability Middleware (HL7/FHIR) (HLALAKAD), Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment) (HLACABAK), EHR Extensions, APIs, App Marketplaces & SMART-on-FHIR Apps (HLACAAAN)

Keywords

• Prior authorization automation
• Healthcare AI platform
• Revenue cycle management
• EHR integration software
• Utilization management

Headquarters

HQ city

Philadelphia

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, Infrastructure

Revenue model

1. SaaS Platform Subscription: Ethermed operates as a SaaS platform offering AI-powered prior authorization automation to healthcare providers and payers. The subscription model likely follows an enterprise pricing structure based on volume or organization size.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels6 records

Core offering

Ethermed operates a SaaS platform called EthermedAI that uses AI and language models to automate the prior authorization workflow for healthcare providers and payers. The platform intercepts physician orders from EMR systems, analyzes authorization requirements, gathers documentation and evidence-based justifications, fills forms, and submits authorizations automatically. It integrates with major EHR systems (Epic, Athena Health, Cerner, eClinicalWorks, iKnowMed, TopDoc) and supports HL7 FHIR and X12 interoperability standards with direct API/EDI connections to 168 payers.

Product overview

Ethermed offers a single unified product called EthermedAI, an AI-powered prior authorization automation platform designed for healthcare providers, payers, and health systems. The platform operates invisibly within existing EHR systems and clinical workflows, using AI to intercept physician orders, analyze authorization requirements, gather documentation, complete forms, and submit authorizations automatically. EthermedAI achieves 89% full automation with 91% first-time approval success rates across 4.8 million authorizations processed annually. The company partners with VisiQuate for integrated revenue cycle intelligence and predictive modeling capabilities.

Differentiator

Problem solved

Functional benefit

Products and services

• EthermedAI AI-powered prior authorization automation platform that operates invisibly within existing EHR systems (Epic, Athena Health, Cerner, eClinicalWorks, iKnowMed, TopDoc). It intercepts physician orders from EMR, analyzes authorization requirements, gathers documentation, fills forms, and submits authorizations automatically across medical and pharmacy benefits. Targets healthcare providers, payers, and health systems to reduce turnaround times by 50%, achieve 91% first-time approval rates, and automate 89-90% of authorizations.

Quantifiable outcome

• Reduces prior authorization turnaround time by 50%
• +7 more outcomes

Named customers1 record

Segments3 records

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration13 records

AI capability7 records

Feature5 records

Partnerships

Three partnerships are on record, tiered core.

• VisiQuatecoreTechnology or Integration · 12 March 2026Strategic partnership to modernize prior authorizations and streamline revenue cycle operations. The combined solution integrates VisiQuate's predictive models, data engine, and robotic process automation with Ethermed's embedded authorization automation. Enables automatic prior authorization execution within clinical workflows and continuous model refinement. Joint clients gain access to integrated dashboards, automated form submissions, predictive authorization guidance, and end-to-end transparency.
• Healthliant VenturescoreStrategic or Co-development Partner · 8 February 2026Partnership with Healthliant Ventures (innovation arm of Tanner Health) to pilot integration of Ethermed's prior authorization automation platform into Tanner Health's Epic-based care delivery systems. The partnership aims to eliminate prior authorization delays directly within provider workflows, processing 13,150 authorizations daily at 3.9 seconds average processing time.
• Tanner HealthcoreStrategic or Co-development Partner · 8 February 2026Tanner Health partnered with Ethermed via Healthliant Ventures to pilot the prior authorization automation platform in their Epic-based care delivery systems. Achieved 90% automation, processing 13,150 authorizations daily with 3.9 second average processing time, completing over 4.8 million authorizations in 2025.

Scale indicators13 records

Recent moves6 records

Expansion highlights6 records

Direct peers

• Infinitus Systems: Infinitus uses AI voice agents to automate phone-based prior authorization and benefits verification calls to payers. It directly competes in the PA automation category, though its approach (voice bots) differs from Ethermed's document/policy-engine approach.
• AKASA: AKASA builds AI-driven revenue cycle automation for health systems, including prior authorization, eligibility, and claims. It competes for the same health system budget Ethermed targets and offers adjacent automation capabilities.
• Myndshft Technologies: Myndshft provides AI-driven prior authorization and eligibility automation for healthcare providers and payers. It targets the same workflow Ethermed automates (benefits verification, PA submission) and competes for similar health system customers with comparable EHR-integrated SaaS.
• Cohere Health: Cohere Health is a digital health company offering AI-powered prior authorization and utilization management solutions to health plans and providers. It directly competes with Ethermed on automating PA workflows and integrating with EHR systems to reduce manual review.

Others

• Waystar: Waystar provides a broad cloud-based revenue cycle management platform used by health systems, with prior authorization as one module. As a scaled RCM incumbent, it competes for the same enterprise IT budget Ethermed targets.

Broad incumbents

• Olive AI: Olive AI is a healthcare AI company that automates revenue cycle and administrative workflows for hospitals, including prior authorization. As a broader incumbent with multiple workflow products, it overlaps with Ethermed's PA automation but is not narrowly specialized in it.
• Surescripts: Surescripts operates a national health information network for e-prescribing and prior authorization across pharmacy and medical benefits. Ethermed integrates with Surescripts to accelerate patient access to therapy, making it an adjacent incumbent in PA routing.
• R1 RCM: R1 RCM is a large revenue cycle management provider serving hospitals and health systems, with growing automation capabilities spanning PA, eligibility, and claims. It competes for enterprise RCM spend that overlaps with Ethermed's PA automation budget.
• CoverMyMeds: CoverMyMeds (a McKesson business) is an established prior authorization platform widely embedded across EHRs and pharmacies. Ethermed explicitly integrates with CoverMyMeds to complement its flows, positioning it as both a partner and indirect competitor in the PA stack.

Emerging players

• Anterior: Anterior is an AI-native prior authorization company that automates clinical review for specialty treatments. It focuses specifically on high-complexity prior authorizations and overlaps with Ethermed's provider-side automation ambition.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks2 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/ethermed-ai

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles10 records

Funding overview

Funding rounds1 record

Investors6 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 Ethermed