From Left to Right: Gal Frishman, Co-founder and CTO, David Talinovsky, Co-founder and CEO and Yossi Mansano, Co-founder and VP R&D
Company Overview
What inspired you to start this company?
We started Bluespine after seeing first hand how overbilling in medical and pharmaceutical claims inflate costs for plan sponsors and carriers alike. Our research confirmed a systemic issue: most claims contain costly errors that traditional payment integrity tools miss. With our background in fraud analytics and AI, we saw an opportunity to give payers a smarter, evidence-based way to eliminate overbilling, reduce waste, and control costs.
Product and Innovation
What is your main product or service?
Bluespine is an enterprise-ready AI-powered payment integrity platform that empowers carriers to discover medical overbilling and financial errors that legacy solutions overlook. By leveraging advanced technology and a deterministic, evidence-based methodology to synchronize complex data sources and deliver clear and actionable insights, Bluespine provides carriers with a smarter way to manage fraud, waste, and abuse (FWA) while reducing operational strain and provider abrasion.
How does your product differentiate itself from existing solutions in the market?
Bluespine is the first AI-powered payment integrity solution of its kind to generate provider-specific rulesets, enabling a customizable claims review process that yields precise, explainable, and defensible results.
Can you share any unique features or innovations your product offers?
Our platform synchronizes and analyzes complex data sources—provider contracts, medicare policies, plan designs, Machine Readable Price Transparency Files (MRFs), and carrier billing guidelines—to identify overbilling and instances of Fraud, Waste, and Abuse (FWA).
Bluespine’s deterministic, evidence-based AI-engine powers real-time data analytics, advanced anomaly detection, and sophisticated pattern recognition. Each flagged issue is backed by a clear citation to the applicable policy and the specific source paragraphs, equipping carriers with irrefutable evidence of overbilling. Bluespine can be deployed pre- or post-payment to help carriers maximize savings and minimize provider abrasion and reduce operating costs.
Market and Problem-Solving
What specific problem are you addressing in the insurance industry?
Bluespine is addressing the massive problem of fraud, waste, and abuse (FWA) in healthcare claims, which costs carriers billions of dollars annually and places immense pressure on payment integrity teams and Special Investigative Units (SIUs). Traditional rule-based FWA detection solutions are limited in scope due to their inability to learn from new data patterns. When potential FWA cases are flagged, payers are burdened with costly investigations that suffer from high rates of false positives and unnecessary friction with providers. Furthermore, due to a lack of standardization in billing practices, coding, and documentation across healthcare providers, reviewing complaints and managing caseloads demands significant human resources and expertise.
Who are your target customers, and how do you reach them?
Bluespine targets health insurance companies and independent TPAs. We are also serving travel TPAs. We reach customers through direct outreach to companies and through channels and technology partners.
What is the market potential for your solution?
For 2024, the amount of detected fraud, waste, and abuse in the US healthcare market was roughly $520B, which is 10% of the $5.2T spent annually on healthcare.
Business Challenges and Solutions
What are the main challenges you have faced so far within the insurance industry?
Our biggest challenge is the long sales cycle for health insurance companies.
How have you overcome these challenges?
We have an innovative approach to move from pilot to production, that enables us to swiftly demonstrate value, increase client engagement, and reduce the sales-cycle duration.
Current Status and Future Plans
What is the current status of your company?
Bluespine has a rapidly growing customer base, and we have expanded our partnerships considerably over the past year. We have received significant validation of our platform’s impact across TPA/carrier segments.
What are your key milestones for the next 12 months?
We aim to establish new sales channels and triple the number of customers we are servicing.
Do you have any upcoming product launches or major updates planned?
Bluespine recently launched a new product to detect FWA in pharmaceutical claims, and we plan to expand our footprint into dental, vision, and other health domains in order to increase our overbilling detection and prevention coverage.
Team and Culture
Can you introduce your founding team and their backgrounds?
My co-founders are CTO Gal Frishman and VP of R&D Yossi Mansano. Gal brings more than 15 years of experience in the cybersecurity industry, where he held senior roles as VP of Technology and Research at several startups and at IBM’s Trusteer division. Yossi has a strong background in cybersecurity and networking systems; prior to Bluespine, he served as General Manager of R&D Israel and VP of Engineering at Fortinet, leading complex system architecture and large-scale product initiatives for Fortune 100 clients. As for myself, I previously served as COO of SecuPi and have over two decades of experience running global operations at multinational technology companies. Collectively, our team combines deep technical expertise with proven leadership experience in scaling companies and delivering enterprise-grade solutions.
How does your team’s expertise contribute to your success?
Bluespine’s domain experts have decades of experience working ~40 carriers and TPAs. With deep knowledge of BUCA processes, they’re uniquely equipped to obtain the data needed for comprehensive claims reviews.
Funding and Investment
Have you secured any funding to date? If so, from whom?
Yes, we raised $7.2m in seed funding from Team8 and David Shields.
Are you currently seeking additional investment? If yes, how much and for what
Purpose?
No
Industry Insights and Trends
What are the biggest trends or changes you see happening in the insurtech industry?
We’re seeing insurance companies accelerate digital transformation by adopting AI to improve efficiency, accuracy, and decision-making across the value chain. In parallel, there’s a clear shift from on-premise legacy systems to cloud-based solutions that provide the scalability and agility needed to meet fast-changing market demands. Finally, carriers are expanding services that drive greater value, while keeping operational costs in check.
How do you see the insurance landscape evolving in the next 5 years?
Over the next five years, AI will play a dominant role in reshaping the insurance industry, transforming traditional workflows and redefining many operational roles. It marks the beginning of a new era for insurers, and I’m excited not only to watch it unfold but also for Bluespine to help drive that change.
Unique Selling Proposition
What is one thing you want potential customers or partners to remember about your
Company?
We’re the first solution to bring AI-driven capabilities to payment integrity at scale – delivering real business impact and addressing some of the most significant pain points insurance companies face today.
