Fortuna Health raises Series A to build TurboTax for Medicaid enrollment

on camera embarrassed. Uh, thank you so much for hopping on, Harper. This is fantastic. Great chatting. We will talk to you soon. Have a great one. Bye. Up next, we have Nikita Single ready. Uh, good friend of mine Fortuna Health. Got a little news. She's in the We reream waiting room. Let's bring her in.

Nikita, how are you doing? Sorry we're late. Sorry we're late. We're running late today. Great to hang out with you. Welcome to the stream. Kick us off with a little bit of an introduction. Who are you? What do you do? I'm Nikita. Uh, I'm one of the co-founders and CEO of Fortuna Health. where Turboax for Medicaid.

So, I can go into what that means, but much like how Turboax uh helps people understand their taxes, all the different rules and regulations for taxes in different states, we're doing the same thing for government health coverage where all the rules are different in every state.

Um, and I'm really excited to be here, excited to support the ratio, one woman to men, and inspiring little girls everywhere that you can achieve your big dream, which is being on TVPN. Let's go. There we go. There we go. It's great to great to have you. You have news today. Yeah. Break it down. Yes. Yes.

You want to do the honors? I will do the honors. Yes. Uh so we announced our series A led by Jason today which we're There we go. How much? How much? There we go. Congratulations. Fantastic. Fantastic. Wait, so give give us the backtory. When when did you start the company?

Was there was there like a specific insight that you had or like I imagine you're be kind of crazy if you weren't using a lot of AI to do this but uh so maybe there was a catalyst there. How how did it come together? Yeah.

So two and a half years ago we started working on this problem and I think one of the crazy things about a lot of health care is that you look at it from an outsers's perspective and someone else every time we talk about this idea they say why wasn't there a turbo tax for for Medicaid like when I shared the analogy earlier it seemed like of course someone should have built this five years ago eight years ago but nobody had um shockingly so as we were looking at ideas to build and particularly we wanted to build a big uh we want to solve a big problem, but specifically a tech problem in healthcare.

There's a lot of stuff like physician shortages, right? That's a different sort of problem to solve. Or helping people find and get connected to a behavioral health clinician, that's a different sort of problem. We looked at is there big important consumer tech to be built here and then triangulated onto this.

And Jordy, we do use um AI, but it's not the core part of our product. I would say the big part is helping guide people step by step through what's a really scary uh challenging process for folks processes that sometimes involve faxes or going in person right to the healthcare version of the DMV um for Medicaid.

So the DMV if you like if you like the if you like the DMV if you love the DMV love healthcare by the same people that brought you the DMV absolutely legend. Talk to me about the the the different counterparties and people involved. There's uh traditional insurance companies.

It sounds like in this case you're dealing with the government. Are doctors an important piece of this. Is it just direct to consumer? How do you acquire those customers? How do you make money from them? Yeah, good question. So, every state has their own Medicaid program.

So, if you're in California, it's called medical. If you're in Oregon, uh has has a different name. In Pennsylvania, Medicaid is called medical assistance. So every state has its own program and then multiple programs they're under.

And then some of those states outsource that work of running the Medicaid program to insurance companies. So you have United Medicaid, Centine Medicaid, Elevance, Anthem Medicaid, etc.

So a lot of our customers are those insurance companies to make it easier for their members to understand the steps that they have to take to enroll and renew. So we're not DTOC, we're more B2B TOC, if that makes sense. Makes sense. Um, what what about customer acquisition? How do you actually get people on board?

Full 18 million on three Super Bowl ads. Yeah. Yeah. Hell yeah. So, mostly we get texted out or we're like listed on the website or we get emailed out. So, it's really easy.

So, you just click a link that let's say um a health plan, health plan TVPN, you're you're insured by TBPN Medicaid um and they send you a link saying, "Hey, you need to renew your New York or your Illinois Medicaid. Click here so that you can stay renewed with TBPN Medicaid.

" And so that's how people would get access to Fortuna that way. Okay. Interesting. Wait, so yeah, how how do the employers fit in?

because I I feel like a lot of Medicaid uh users or or the the the insured folks on Medicaid are like it's it felt it always felt like it was independent from the from the corporation that they work for. Is is that not the case? Yeah. No, it kind of is. So, you don't get it through like your job, let's say. Okay. Okay.

Yeah. Usually, because your job doesn't cover Sure. Sure. Your job doesn't cover. Got it. And then you go on Medicaid. Got it. So, you're getting it through them. Yeah. Y that makes sense. And then um and then how do you actually get paid? It's a great question.

So the same insurance company as I was mentioning earlier or hospitals, let's say let's say you come in and you don't have insurance. Sure. And so they say, "Hey, do you want to try or use Fortuna to help you get Medicaid? " So those are the two types of entities that that pay for us. Okay, cool.

Um yeah, what is the state of the fax machine in the medical insurance industry? We've heard it's alive and well, but it also feels like it's got to be wrapped with APIs at this point. Are they wrapped? Are they wrath at this point?

You know that that meme from the uh why am I forgetting the name of the movie where they throw the fax machine on the ground and everyone's like that's office space. Don't worry. I actually have seen that. Oh, you have? That's impressive. My dad's favorite movies. One of the five movies you've seen. Great. Exactly.

Um healthcare, you're right, has been keeping faxes alive for a really long time. Um there's so many stupid and silly reasons for that. Um, a lot of it is you can't even if you're, let's say, the state government, sometimes you're not allowed to procure a new contract with a non fax company.

So, you've been living on Xerox for 30 years because it's that hard sometimes to contract with the government. Um, but yes, people are wrapping, we're wrapping around um automating faxes, tracking those faxes, etc.

So we sort of have like um a bunch of different uh automations around are we submitting things to fax machines, are we submitting them via snail mail, are we submitting them to digital portals, email, etc. and then tracking all of that because some different types of Medicaid accept different uh submission formats.

But absolutely fax is alive and well. Are you going state by state or trying to do all 50 at once? Like what what are the trade-offs there? Is there a common pattern?

I remember a lot of the teleaalth companies needed to get their their doctors certified in different states and so there was actually another company called Medallion that was set up just to do doctor licensing in all 50 states. Um what's the actual roll out and what are the considerations there? Yeah.

So we are largely going state by state as we roll out with new customers. But the classic thing is when you get really good out of state like we have a lot of customers in New York. We started getting more customers in New York because we got to go to New York.

So, it's more like patchwork sequencing like absolutely we want to go to all 56 uh in case you didn't know state and territory medic. Yes. What What are the last six? Break it down. The others are like Guam and Central Islands. Oh, the islands. Interesting. Are you going to visit Are you going to visit all six?

I feel like you got to make the You got to expensive. Oh yeah. It's like every entrepreneur has got to go to Delaware and just take it in. You know, I need to do like you know how Zuck when he wanted to sort of run for president. We have to do that. I got to do that at some point. Yeah. Yeah, that makes sense.

Um what else is um obviously you you you follow the industry broadly. What else is interesting in healthcare in AI?

where where are you either partnering with existing companies or you see some lowhanging fruit that if you weren't building this you'd be you kind of see it on the road map of someone else or you see some like white space where you're like wow that's a really unsolved problem I'm busy but that's interesting. Yeah.

Um I mean there's a ton of lowhanging fruit.

I would say there's a lot of people that are doing conversion of in the way that somebody writes a doctor's note that needs to be written up in a very specific way inside the EHR that needs to be written up and converted in a very specific way to how you know insurance companies convert and accept that information.

I still think that there's a tremendous amount just to be done in that space. Sure. Um I think that obviously voice AI is just in its infancy honestly. um especially because you need to get more specialized for each field. So I'd say there's a lot that you could do um and can be done in that space.

And I'm really bullish on AI nurses. Like clearly we have a doctors and nursing shortage. Like that's obviously a problem that has not been solved by policy. I'm perfectly fine getting my care particularly, you know, low-level low acuity care by an AI.

That's probably much better than a doctor who has or a nurse who has no time to see me. I'm just, you know, coming in, coming out. I'm one of a hundred people that day. I think there's still a huge opportunity there. Yeah.

Or even just someone who's like there can still be a human in the loop, but they're like you're chatting with an AI and then at the end of the day, the doctor kind of looks through, okay, they made seven different recommendations. I have most of the context. I can just see that nothing went crazy off the rails.

Makes sense. Last question from my side. Um, and I'm I'm curious if it came up during the fund raise or or how you guys think about it, but I can imagine a world in the future where somebody would go to chatgpt agent and they would say, "I need to sign up for Medicaid. Uh, help me do it.

" And then it just starts going, you know, goes and spends 15 minutes and figures out the steps and things like that and then eventually could take action. Do you worry about that as like a competition? Well, I'm sure you don't worry because you're a killer, but do you think about that as like a competitive vector?

Are there reasons why that's just like going to be an edge case that for many many many years is like not something that, you know, a general agent would be able to do? How do you think about that? Yeah, it's a good question.

I think it solves like 30% of the problem, which is okay, what website should I go to to do this? But then you run into problem number one, which is what happens if you forgot your password from four years ago? AI can't really solve that, you know, problem number one.

And then let's say second problem, maybe you were the child and your parent had the Medicaid. So now you actually have to split your account from a prior account.

So all of these interesting weird problems that yeah if you put like the Medicaid rule manual through AI sure you could get highle steps but it doesn't solve these very real world tangible problems that only get solved from building this Turboax experience that can connect into state systems or know where you need to go to route those types of I wouldn't even call them edge case it's just all of the complexities that get wrapped up and compounded are people's real world scenarios so definitely AI solves 30% of what is the basic rules, but that longtail stuff of okay, I switched my job 3 days ago.

How exactly am I supposed to report that? But now the state has a new fax line that nobody has listed publicly. Yeah, I can't solve that, but we Yeah, that makes total sense. Awesome. Well, congratulations to you and the team on the raise. Thank you.

Wait, I if I have one minute, I want to share um some receipts from from 2022. Oh, yeah. When I sent John a message. Um so, Jordy, I think this might have been before you were involved, but I said, "Hey, John, props to the storytelling work you're publishing on YouTube.

I think most people we know are still sleeping on YouTube's reach. " There we go. October 12th, 2022. And he said, "Hey, thanks. It's crazy. I've been pulling in over a million views per month, but no one has really noticed. Look at Look at you now. No one knows. Yeah. John basically