Daffodil Health Claim Repricer

Daffodil Health is a San Francisco company that builds AI software for health plans and third-party administrators (TPAs). It focuses on claims pricing and payment integrity, an area where payers process large volumes of out-of-network and reference-based claims.

Its SaaS claim repricer accepts multimodal input, applies pricing rules configurable by employer and by code, and uses LLMs to generate pricing rationale and provider negotiation responses. The software also produces employer and provider reports. Target users are payors and TPAs in the United States.

• Claim re-pricer: multimodal input with user control over the pricing process.
• Configurable rules: pricing rules by employer and by code.
• AI pricing rationale: LLM-generated explanations and negotiation responses.
• Reporting: employer and provider value reports.
• SaaS delivery: web application for payors and TPAs.

Private health insurers could automate claims review and pricing validation. TPAs could produce explainable repricing responses for hospital billing disputes.

• Automates out-of-network and reference-based claim pricing.
• Gives payers control over pricing rules by employer and code.
• Generates AI-written pricing rationale for provider disputes.
• Produces reports that show value to employers and providers.

Payers seek AI to cut payment leakage and claims administration cost. Vietnamese insurers and health-insurance administrators handling growing private health claims could adopt similar automated claims pricing and review.

San Francisco, US. Series A of USD 16.3M in Feb 2026 led by Flare Capital Partners with LRVHealth and Maverick Ventures; total funding USD 20.9M.