Falls Church’s CMT Solutions Inc. is expanding beyond its bread-and-butter business of helping doctors secure insurance coverage for lab tests — and changing its name to reflect that.
The company has rebranded as careviso — lowercase “c” —“because we needed a new name that would allow our company to grow and be seen as providing a more holistic approach to patient access rather than one segment of the process,” co-founder and CEO Andrew Mignatti said.
The startup — which up to this point has focused on prior authorizations, or getting a health plan to approve coverage of a diagnostic, drug or medical service — now also verifies insurance status and provides cost data around tests and services. That includes determining what a patient’s out-of-pocket payment would be, which is often unclear at the point of care. Its platform, called seeQer, pulls benefits information and pricing data from health plans, providers and facilities, according to Mignatti.
The goal, he said, is to offer better financial transparency on top of its existing prior authorization support — and, in doing so, help lighten physicians’ administrative burden while providing patients with a clearer picture of the cost of care.
“We are very focused on being able to eliminate the uncertainty that exists in health care about, ‘How much is this going to cost me?’ and ‘Will my health plan covered any or all of the cost?’” Mignatti said. “We are all consumers of health care and I would say all of us have been in that situation of the unknown.”
It’s the second identity shift for the startup since it launched in 2017 as CoverMyTest, then changed its name to CMT Solutions within a couple of years. That rebrand “was, quite frankly, a very slow process,” Mignatti said. “We are going to rip off the Band-Aid with this one and commit to our new name from Day 1.”
The name careviso blends “health care” and “vision,” to reflect that care is “at the forefront of what we do, combined with the vision for providing the answers that patients and health care professionals are looking for,” Mignatti said.
The company’s core therapeutic areas for prior authorizations include oncology, and obstetrics and gynecology. But because seeQer’s financial transparency tool can be applied to testing and services across areas, the company is “actively expanding” into others now, Mignatti said, without sharing further details. Moving forward, careviso is looking to work directly with health plans, he added. The company has existing contracts with more than 40 labs, including industry leaders Quest Diagnostics Inc. and LabCorp.
The business is seeing “rapidly increasing” demand with consistent growth month over month, he said. It’s looking to fill a number of positions, including software developers, authorization specialists and sales team members to join its more than 140 employees — up from 30 in spring 2019. Mignatti declined to disclose a target headcount, as well as revenue figures or fundraising plans. The startup has raised about $16.7 million to date, including $10 million in Series A financing in March 2021.
Mignatti, who has experience running laboratories, founded the company with Chief Business Officer Perry Dimas. They set out to fill a hole in the marketplace, as insurance companies increasingly required prior authorizations from labs and doctors to process and pay for lab testing, particularly as molecular diagnostics became more prevalent in women’s health and cancer.
The company, which reports serving more than 1 million patients and 120,000 doctors up to this point, was formerly part of Inova Health System’s now-defunct accelerator. It previously moved its headquarters from Cabin John to its current 3,200-square-foot base on Leesburg Pike. It also has an operations hub in Orlando, Florida.
