While most startups have been trying to digitise faxes out of existence, Tennr has raised $18M to bridge healthcare’s problems in an unconventional way: working with, not against, the fax machine.

Tennr’s $18m series A funding round was led by a16z with participation from Foundation Capital and The New Normal Fund. Other investors (from the seed round) include YCombinator, Zaza Pachulia, Jennifer Kaehms, and other notable health and AI focused investors. With this funding round, Tennr has now raised over $25m.

Tennr’s founders, Trey Holterman, Diego Baugh, and Tyler Johnson, met as freshmen at Stanford where they worked together studying machine learning. They saw early on how good contextual models were becoming at doing repetitive, manual tasks and how much power this had to ‘magic away’ busywork in traditional industries. After graduation, the team dedicated years to building powerful, robust systems for reading unstructured documents, automating data entry, and applying them specifically to healthcare. Today, practices nationwide are using Tennr to automate referral processing, payment posting, claims auditing, medical record management and more.

Many thought faxes would face their end in 2009 when the HITECH Act put $27 billion towards encouraging healthcare to use EHRs, become ‘paperless’, and set up integrations. Fifteen years later, most providers and hospitals have implemented EHRs, but still default to e-faxing for sending or receiving patient records, audit requests, and referrals back to coordinate patient care. This manual work triggers an endless cascade of issues for practices: it’s time-consuming, takes longer for patients to receive critical care, is vulnerable to human error, leads to expensive claim denials, creates needless back-and-forth between practices delaying care, and increases employee burnout and turnover.

While most products that streamline healthcare workflows attempt to sever the dependency on faxes, Tennr is taking a different approach. Instead of expecting practices to change, Tennr meets them where they are – working inside the solution they already know and trust. When a practice receives a digital fax through email or their EHR inbox, Tennr reads the documents and automates the work associated with processing them. This act of finding and moving information quicker and with more accuracy resolves most of the problems digital faxes cause.

For example, when a patient is referred from a primary care provider to a specialty practice through a faxed referral, Tennr, in real time, extracts the key patient information and coordinates with the patient so they can be scheduled quickly and accurately; if a fax or referral is incomplete, Tennr automatically requests the missing information. As a result, patients get the care they need, allowing practices to maintain stronger referral relationships, provide continuity of care and improve patient outcomes.

“When building Tennr and this healthcare integration, we looked at what’s actually needed and saw what was possible with technology. Our number one integration today is across fax providers, on-prem file storage systems and EHRs from the 90s. And this is the real life need of the industry. But beyond that, what people miss the most in all of this is that it’s not about just automating work or making teams faster. Lots of people can build tools that make admins marginally faster – that just doesn’t move the needle. Instead, our research team is building models based around this very complex information flow, being able to parse it for one practice at a time, and then do the work so well that you can turn it into very clear growth for a business. And yes, the e-fax ends up being in the middle of it all,” said Trey Holterman, CEO, and Co-Founder of Tennr.

Insurance denials are often the result of poor or unclear information which impacts the provider and patient. Tennr works on both sides of the insurance/provider relationship, automating the flow of information to commercial payors, as well as reading the information that’s returned. Ultimately, this helps service providers catch and correct wrong information before they submit to a commercial payor. Moreover, when Tennr identifies wrong information it’s able to request the correct information, in the correct format – minimising insurance denials and helping practices get paid faster. And since Tennr is automating this work, there are no manual errors, less employee burnout, and crucially, returns time back to staff.

The hard part is of course, actually reading the faxes, and integrating with archaic systems. Documents that can be many pages long with dozens of patients attached are unstructured, messy blobs of data that are nearly impossible for computers to work with. To make matters worse, actually getting data where it needs to go (onto an electronic health records system) requires maintaining integrations with archaic and fragmented systems.

Rommy Foteh, the Chief Operations Officer at NMA, a national specialty practice serving tens of thousands of patients a month said: “It's been about effectively seeing more patients while being the kind of partner our customers need. When we’re able to respond to our partners as quickly as we do now using Tennr, and ensure we have everything we need to see a patient, those patients remember their great experience with NMA, encouraging our surgeons and hospitals to continue to refer to us.”

Commercial health plans like Prominence Health have begun to excitedly embrace this new technology as well, seeing it as a driver for better experiences for providers which means a better experience for patients subscribed to Prominence Health. Dominic Henriquez, Chief Development Officer at Prominence Health said: “At Prominence Health, we lead the charge in innovating value-based care, constantly seeking disruptive technologies to enhance operational efficiency. The Tennr product seamlessly aligns with our mission to deliver higher value to our customers. By eliminating traditional administrative burdens like scanning medical records and data entry, Tennr enables us to prioritise elevating patient experiences, improving health outcomes, and enhancing care coordination.”

Cleaning up the messy data coming in from faxes to automate patient intake and insurance communications is just the beginning of Tennr’s vision. If Tennr can read faxes, understand what information needs to be extracted from them, and where that information needs to go, it can chip away at many of the most costly problems within the US health system. For now, Tennr is using this investment to grow its team, scale its operations, and help organisations automate everything that starts with a fax.

“Amidst the theoretically unbounded possibilities of AI, the Tennr team has impressed us with their unwavering focus on building applications solving specific, tangible problems for their customers,” said Kristina Shen, General Partner at Andreessen Horowitz.