Grow Therapy

Sierra

Grow Therapy

Two-sided marketplace for mental health. Therapists join Grow Therapy's network and the company handles insurance credentialing, claims billing, scheduling, and compliance.

In return, Grow Therapy takes a percentage of each session's insurance reimbursement. Patients search Grow Therapy's directory to find in-network therapists by specialty, insurance plan, and availability.

The therapist gets to focus on therapy. The patient gets affordable care.

Grow Therapy gets a cut for handling the business side. Everyone wins except the old credentialing companies that charged therapists thousands of dollars to do what Grow Therapy does for free.

Sierra

Companies pay Sierra to run their customer service with AI agents instead of hiring rooms full of humans. The agent talks to your customers over chat.

It answers questions. It processes returns.

It updates subscriptions. Here is the clever part.

Sierra charges based on outcomes, not seats. Brands pay when the AI actually resolves a problem, not just for having the software installed.

That pricing is unusual. Most software charges a flat monthly fee no matter what.

Sierra only gets paid when the bot does the job.

Grow Therapy

Jake Cooper was working in healthcare operations when he saw the same problem from both sides. Patients couldn't find therapists who accepted their insurance.

Therapists wanted to accept insurance but the credentialing process took 6 to 12 months and the billing was a bureaucratic disaster. Most therapists just went cash-pay to avoid the headache, which meant only people who could afford $200 a session got care.

Cooper started Grow Therapy in 2020 to solve the plumbing problem. Not the clinical side — the administrative infrastructure that makes it possible for a therapist to see an insured patient without losing their mind.

He launched right as the pandemic made therapy demand explode and supply couldn't keep up.

Sierra

Bret Taylor had already done the impossible twice. He co-created Google Maps.

He later became co-CEO of Salesforce, chaired Twitter's board during the messy Elon Musk takeover, and became chairman of OpenAI in late 2023. Clay Bavor spent 18 years at Google, most recently running its Labs group.

The two friends left their big jobs in 2023 to build something together. They picked customer service on purpose.

It is the least glamorous corner of software. Their logic was simple.

Companies hate their support costs. Customers hate waiting on hold.

AI that actually resolves problems could fix both sides at once. They launched Sierra in February 2024 with $110 million from Sequoia and Benchmark.

Grow Therapy

Supply-side acquisition — recruit therapists by solving their biggest pain point (insurance credentialing) for free. Once therapists are in-network through Grow Therapy, patients find them through the directory.

The company expanded insurance partnerships aggressively, getting in-network with Aetna, Cigna, UnitedHealthcare, Anthem, and dozens of regional plans. State-by-state expansion tracking licensing requirements.

Content marketing targeting therapists frustrated with private practice admin. Referral loops from satisfied therapists bringing colleagues onto the platform.

Sierra

Sierra went straight for big brands, not tiny startups. SoFi, Ramp, ADT, Sonos and Brex signed up early.

By 2026 it said more than 40% of the Fortune 50 were customers. The trick was trust.

Enterprises are terrified of an AI bot going rogue and insulting a customer. So Sierra built guardrails and let each company control exactly how the agent behaves.

Bret Taylor's contacts did the rest. When the chairman of OpenAI calls a Fortune 500 CEO, they pick up.

Sierra hit $100 million in annual recurring revenue in November 2025, seven quarters after launch, and $150 million by February 2026. In April 2026 it launched Ghostwriter, which builds and deploys a new agent from a plain-English description.

Grow Therapy

Insurance reimbursement rates for therapy are low and getting lower in some states. Grow Therapy's margin depends on volume because per-session economics are thin.

Keeping therapists on the platform once they're credentialed is a retention challenge — some therapists use Grow Therapy to get credentialed, then leave to handle billing themselves. Competition from Headway, Alma, and others doing similar things means the race to sign up therapists is intense.

Quality control across 10,000+ providers is a real concern. And the fundamental tension remains: insurance companies want to pay less per session, therapists need to earn enough to survive, and Grow Therapy sits in the middle trying to make both sides happy.

Sierra

Everyone is building AI customer service agents right now. Decagon has raised at a multi-billion valuation.

Salesforce, ServiceNow and Intercom all shipped their own agents. Sierra is not the cheap option.

It sells premium AI to giant companies that move slowly. The bigger risk sits underneath the product.

Sierra does not make its own AI models. It rents them from providers like OpenAI and Anthropic.

If those model makers decide to compete directly, Sierra's edge gets thin fast, and its co-founder chairing one of them only makes that question louder. A $15.8 billion valuation on roughly $150 million in revenue leaves almost no room for a stumble.

Grow Therapy

Insurance credentialing — gets therapists paneled with major insurers in weeks instead of months. Automated billing and claims processing that eliminates the denied-claim nightmare.

A patient-facing directory with filters for insurance, specialty, location, and availability. Practice management tools including scheduling, intake forms, and session notes.

Telehealth platform built in so therapists don't need separate video software. Group practice support for therapists who want to scale beyond solo practice.

Sierra

The core product is the Sierra AI agent. It is a branded customer service bot that companies deploy on their website, app, and phone lines.

It handles the boring stuff. Order tracking.

Refunds. Password resets.

Account changes. Sierra also built its own tools to test and monitor these agents so they do not make things up.

In 2024 the company added a voice version that talks to customers on the phone. In April 2026 it added Ghostwriter, a tool that builds and deploys a new agent from a plain-English description.

The whole pitch is one AI agent that carries your brand's name and never sleeps.

Grow Therapy

Investors include Sequoia Capital, TCV, Signalfire, and SVB Capital. Series C in 2023 valued the company at over $1 billion.

Sierra

Sequoia Capital and Benchmark wrote the first checks at launch in February 2024, $110 million between them. Greenoaks Capital then led both the $175 million round in 2024 and the $350 million round in September 2025.

In May 2026 Tiger Global and Google's GV led a $950 million round at a $15.8 billion valuation, with Benchmark, Sequoia and Greenoaks back in. That takes total funding to about $1.6 billion.

That is partly the product and partly Bret Taylor. Investors bet on founders who have already built billion-dollar things.