What Myndshft Technologies Inc. does

Myndshft Technologies Inc. is a healthcare technology company that automates prior authorization workflows for both medical and pharmacy benefits, positioning itself as the only industry platform offering both in a unified system. Founded in 2016 and headquartered in Mesa, Arizona, the company serves healthcare providers, payers, pharmacy benefit managers, specialty pharmacies, diagnostics and molecular/genomics labs, infusion providers, and drug manufacturers. Distribution occurs through direct enterprise sales under Master Service Agreements, technology integration partnerships (including Zoll Data Systems, UiPath, and THSSi Group), and the Google Cloud Marketplace.

The platform is built on CognitiveBus, a patented proprietary technology combining generative AI, machine learning, and blockchain, deployed on HIPAA-compliant Google Cloud infrastructure. Core modules include Eligibility & Benefits Verification (covering 94% of U.S. covered lives), Coordination of Benefits, Insurance Discovery across 2,000+ payers, Patient Financial Responsibility, and the unified Prior Authorization engine. Myndshft maintains direct connections to 700+ payers representing 93% of U.S. covered lives and a self-learning rules library covering 600+ payers. Integration is delivered via HL7 FHIR APIs into EHR, LIMS, pharmacy management, and revenue cycle management systems, or through a stand-alone web portal.

The company monetizes through quote-based SaaS subscriptions on multi-year contracts. Myndshft received undisclosed investment from HCAP Partners in August 2021, reached one million patients served by July 2022, joined the Google Cloud Claims Acceleration Suite at HIMSS 2023, and was acquired by DrFirst in April 2024.

Name

Myndshft Technologies Inc.

Legal name

Myndshft Technologies, Inc.

Website

https://myndshft.com

Company type

Private

Founded year

2016

Operating status

Acquired

Headcount range

51–100 employees

Short description

Myndshft Technologies is a healthcare SaaS company that automates medical and pharmacy prior authorizations using its proprietary CognitiveBus AI and blockchain platform. It serves providers, payers, PBMs, specialty pharmacies, and labs across the United States.

Ownership category

akta.pro rank

Product category

Healthcare Prior Authorization Automation

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Financial Transactions Processing, Reserve, and Clearinghouse Activities (522320)

SIC

Services-Prepackaged Software (7372), Services-Computer Programming, Data Processing, Etc. (7370), Services-Computer Integrated Systems Design (7373)

akta.pro primary industry

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

akta.pro secondary industries

Eligibility & Benefits Verification (HLACACAD), PBM Technology Platforms (ePA/eRx/Real-Time Benefit Tools) (HLAEAKAL), Utilization Management & Prior Authorization Analytics (HLACAHAE)

Keywords

• Automated prior authorization
• Healthcare revenue cycle
• Benefits verification software
• Medical pharmacy automation
• Healthcare interoperability APIs

Headquarters

HQ city

Mesa

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Software

Cost components

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

Revenue model

1. SaaS Subscription: Software-as-a-service subscription model with access granted following payment of applicable fees as defined in Master Service Agreement and Statement of Work. Subscription period provides access to automated prior authorization platform with real-time benefits verification, eligibility checks, and prior authorization submission capabilities.

Pricing tiers

Go-to-market motion5 records

Distribution channels4 records

Marketing channels5 records

Core offering

Myndshft Technologies provides a unified automated prior authorization platform for the healthcare industry that handles both medical and pharmacy prior authorizations in a single system. The SaaS solution automates benefits verification, eligibility checks, coordination of benefits, insurance discovery, patient financial responsibility calculation, and prior authorization submission and adjudication. It is built on the proprietary CognitiveBus AI and blockchain platform, deployed on HIPAA-compliant Google Cloud infrastructure, and integrates with EHRs, LIMS, pharmacy management, and revenue cycle management systems via HL7 FHIR APIs.

Product overview

Myndshft Technologies Inc. offers a unified automated prior authorization platform that is unique in the industry for handling both medical and pharmacy prior authorizations. The core platform is built on the proprietary CognitiveBus technology—combining machine learning and blockchain—with modules including Eligibility & Benefits Verification (covering 94% of U.S. covered lives), Coordination of Benefits, Insurance Discovery, Patient Financial Responsibility, and the core Automated Prior Authorization engine. The platform is deployed on HIPAA-compliant Google Cloud infrastructure and integrates seamlessly with EHRs, LIMS, pharmacy management, and revenue cycle management systems via HL7 FHIR APIs.

Differentiator

Problem solved

Functional benefit

Products and services

• Automated Prior Authorization Platform Unified platform offering both medical and pharmacy prior authorizations built on generative AI and machine learning. Automates the entire prior authorization workflow from requirement identification through submission, status monitoring, and adjudication for healthcare providers, payers, PBMs, and pharmacies.
• Eligibility & Benefits Verification Automated, real-time patient-specific benefits and eligibility verification covering 94% of covered U.S. lives across 700+ payer connections. Instantly accesses co-insurance, copay, deductible, and other plan details for healthcare providers and patients at the point of care.
• Coordination of Benefits Real-time identification of other payers — even when not included in eligibility verification requests — and returns detailed information on primary, secondary, and tertiary payers in a consolidated response via a single API call for healthcare providers and payers.
• Insurance Discovery Intelligent algorithms search patient-specific information across 2,000+ payers, clearinghouse databases, and direct connections infrastructure to identify active coverage and increase revenue recovery for healthcare providers.
• Patient Financial Responsibility Real-time calculation of patient financial responsibility and price transparency at the point of care, enabling assessment of patients' propensity to pay, collection of payments up front, or extension of financing options for healthcare providers and patients.
• CognitiveBus Platform

Quantifiable outcome

• 93% improvement in prior authorization turnaround time (from 12 hours to 50 minutes)
• +8 more outcomes

Named customers1 record

Segments9 records

Ideal customer profiles4 records

Technology focussed Yes

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration6 records

AI capability8 records

Feature8 records

Partnerships

Three partnerships are on record, tiered core.

• DrFirstcoreStrategic or Co-development Partner · 18 April 2024DrFirst acquired Myndshft Technologies in April 2024 in a pioneering move to unite medical and pharmacy benefits, enhancing access, affordability, and adherence for specialty medications and procedures. Myndshft's capabilities complement DrFirst's medication management solutions.
• Google CloudcoreStrategic or Co-development Partner · 18 April 2023Myndshft prior authorization software part of newly launched Google Cloud Claims Acceleration Suite, announced at HIMSS 2023 Global Health Conference.
• Google CloudcoreStrategic or Co-development Partner · 9 November 2022Strategic collaboration with Google Cloud to advance value-based care using intelligent automation and secure data exchange. Myndshft platform is now available on Google Cloud Marketplace, leveraging Google Cloud's Healthcare API for automated, point-of-care benefits verification, eligibility and coordination, patient financial responsibility calculation, and electronic prior authorization in a secure, interoperable cloud environment.

Scale indicators14 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• Surescripts: Operates the dominant pharmacy health information network and electronic prior authorization for prescriptions. Direct overlap with Myndshft's pharmacy PA capabilities.
• Avizia (now part of Cohere Health): Earlier-stage PA automation platform that merged into Cohere Health; directly comparable to Myndshft's PA workflow offering.
• Cohere Health: Direct competitor offering AI-powered prior authorization and utilization management for health plans and providers. Closely aligned with Myndshft on PA automation for medical services.
• Infinx Healthcare: Specializes in prior authorization and revenue cycle automation for healthcare providers and imaging centers, directly overlapping with Myndshft's PA and benefits verification modules.

Broad incumbents

• Experian Health: Provides healthcare eligibility verification, insurance discovery, and patient access solutions that overlap directly with Myndshft's Eligibility & Benefits Verification module.
• Waystar: Cloud-based revenue cycle management platform with eligibility verification and prior authorization capabilities comparable to Myndshft's offerings.
• Change Healthcare (Optum): Incumbent healthcare transaction network now owned by Optum, offering eligibility, claims, and prior authorization at massive scale across payers and providers.
• R1 RCM: End-to-end revenue cycle management provider serving large health systems, with prior authorization and eligibility capabilities that compete with Myndshft's automation suite.

Emerging players

• Olive AI: Healthcare automation AI platform targeting revenue cycle and administrative workflows with overlapping use cases to Myndshft's CognitiveBus-driven automation.
• AKASA: AI platform for healthcare revenue cycle operations, including prior authorization and eligibility, competing with Myndshft for payer and provider automation spend.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/myndshftllc
• LinkedInlinkedin.com/company/myndshft
• Facebookfacebook.com/myndshft

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles3 records

Funding overview

Funding rounds1 record

Investors1 record

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 Myndshft Technologies Inc.