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

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Coverage

Universe, instruments and categories.

Industry: Health Care TechnologyApplication Software
Instruments: equities
Categories: AlternativeOperationalReference
Regions: US
Sample tickers: UNHELVCVSHCAMCKCAHLLYNVOISRGABMD

Dataset card

Type: not stated
Format: Tabular case and event records behind an API-connected platform (the product is explicitly described as data-repository-friendly through API connectivity, ingesting EHR, eligibility, claims and ePA inputs), plus a distinct structured artifact: machine-readable clinical criteria decision trees (no-code drag-and-drop node graphs) generated from payer policy text
Volume: 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
Users: N/A — enterprise software licensed to health plans and PBMs, no registered-user population of its own; the human users are client operations and clinical-review staff. Case-volume proxy: ~$3M revenue at typical per-case UM software economics implies an early but real payer book, plausibly hundreds of thousands to a few million PA cases routed annually
History: 5 years
Update frequency: not stated
Growth: Active — venture-backed ($14.5M raised), product marketed as "the industry's first" end-to-end PA platform, current-dated web assets, and an actively expanding module set spanning PA, appeals, grievances and criteria automation
Launched: not stated
Delivery: not stated
Entity mapping: not stated
Sample: not stated
Point-in-time: not stated
Licence: not stated

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