Banjo Health

Banjo Health — AI-adjudicated prior-authorization, appeal and grievance case data across BOTH medical and pharmacy benefits for payer and PBM clients: inbound request content harmonized from EHR, eligibility, claims and ePA feeds; automated vs human review routing; machine-generated decision-tree evaluation traces from the Computer Assisted Review Engine; approval/denial outcomes with cited criteria; appeal filing and overturn outcomes; and — unusually — the machine-readable clinical decision trees themselves, generated by the Composer tool from payer criteria documents. Small venture-stage f…

Banjo Health offers (Alternative, Operational, Reference) — Early-stage but dense: every case carries full request content, multi-step event history, decision-tree evaluation trace, decision rationale and appeal record. Estimate low millions of case records to date (consistent with ~$3M revenue and 46 staff since ~2020) plus a compact, high-value library of machine-readable clinical decision trees per payer client. Data value is per-case richness, not archive size.

Prior-authorization denial-driver and access-friction analytics, payer step-therapy and quantity-limit policy effectiveness measurement, AI-versus-human clinical decision agreement studies, clinical-criteria automation model training (criteria text to decision logic), appeal-risk and overturn prediction, administrative-burden and turnaround benchmarking for regulatory reporting, manufacturer market-access and time-to-therapy analytics, automated-decision safety and bias auditing

The data is with 5 years of history.

Coverage spans US; Health Care Technology, Application Software; alternative, operational, reference; equities.