Problem

Sohar Health addresses the front-end revenue-cycle-management problem created by fragmented payer data and cumbersome insurance workflows. Providers often have to determine eligibility, benefits, network status, and patient responsibility through manual calls, portals, or unreliable electronic checks. The result is delayed care, intake drop-off, administrative expense, surprise-billing risk, and preventable claim denials. The economics are material: nearly one in five claims is denied on first submission, while 85% of denied claims—representing roughly $40 billion—are described as preventable.

The clearest use case is insurance clearance during intake, particularly for behavioral-health, primary-care, and telehealth providers. Behavioral-health organizations face complex payer carve-outs and historically weak eligibility accuracy, so a missed coverage detail can cause a patient to abandon intake or create a denial after care has already been delivered. Sohar aims to catch those issues before the appointment or claim, improving both access and provider revenue.

Product / Service

Sohar provides an API-first front-end RCM platform that embeds insurance intelligence into scheduling, intake, EHR, and billing workflows. Its Discovery product finds a patient’s active insurance from basic identity information; Verification performs real-time eligibility and benefits checks; Network Status determines in-network versus out-of-network coverage; and Cost Estimate uses benefit data and contracted rates to show patients an expected payment amount. The platform also supports bulk verification, payer-specific logic, and a portal for operational teams, with manual insurance expertise available as a backstop for difficult cases.

The benefit is faster, more consistent financial clearance with less manual work. Sohar reports a median eligibility latency of six seconds, roughly 90% of checks returned within 30 seconds, 95% automation, and 96% accuracy for benefits data. Its stated outcomes include fewer eligibility-related denials, better patient conversion, lower operating costs, and more revenue; the company reports a 12% increase in patient conversion and more than 8x client ROI within twelve months.

Market

Sohar competes in healthcare front-end revenue-cycle automation, specifically API-based insurance eligibility, verification of benefits, insurance discovery, network-status determination, and patient cost estimation. Its target customers include outpatient and specialty practices, behavioral-health organizations, primary-care groups, and digital-health or telehealth platforms. Functionally comparable API vendors include pVerify, which offers real-time eligibility and benefits APIs, and Stedi, which provides real-time and batch eligibility checks across thousands of payers. Sohar’s positioning is strongest where payer carve-outs, behavioral-health coverage, and workflow-level automation make generic eligibility tools unreliable.

The company appears commercially deployed rather than pre-revenue, although public revenue or ARR is not disclosed. Sohar was founded in 2023, participated in Y Combinator’s S23 batch, raised a $3.8 million seed round in March 2025 led by Kindred Capital, and said the product was already deployed with behavioral-health, primary-care, and telehealth partners. Publicly named customers include Talkiatry, Mindful Health Solutions, Monument, LunaJoy, Finni Health, Legion Health, and Stellar Sleep; Sohar also reports more than five million annual eligibility checks and more than 8x ROI for clients within twelve months.