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Alaffia Raises $55M for Health Claims Operations

New York-based Alaffia secured $55 million in a Series B round led by Transformation Capital, with participation from FirstMark Capital and Tau Ventures. The round brings total funding to over $73 million.

Led by CEO TJ Ademiluyi and COO Adun Akanni, Alaffia provides an agentic platform that forensically evaluates health plan claims against patient medical records. Unlike legacy “black box” automation, Alaffia pairs expert clinicians with transparent algorithms to extract facts with 97%+ accuracy. This shift toward high-stakes, mission-critical software layers mirrors the “universal operating system” approach seen in Skyryse’s autonomous flight technology.

Market Signal

  • The ROI Alpha: Alaffia solves the payer-provider “trust deficit.” By delivering 20%+ average savings on high-cost facility claims through defensible, clinician-overseen audits, the platform transforms payment integrity from a compliance hurdle into a direct margin lever.
  • The Sibling Advantage: Founded by a sibling duo with deep roots in revenue cycle management (RCM), Alaffia possesses a “lived-in” understanding of the friction between health plans and providers, allowing them to build tools that prioritize traceability—a critical requirement for regulatory scrutiny in 2026.
  • The Friction Risk: A primary execution hurdle remains the “Provider Backlash” factor; as AI-driven clinical reviews accelerate, insurers face increasing pressure from medical associations and regulators to ensure that automated denials do not compromise patient care.

Key Details

  • Funding: $55M ($73M total)
  • Lead Investor: Transformation Capital
  • CEO: TJ Ademiluyi
  • Use Case: Agentic payment integrity and clinical review for health plans

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