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Angel Investor Due Diligence: What to Check Before You Invest in a Startup
Editor’s Note: No companies are named below. The questions come from real Star of Genesis sessions, and they travel well from one deal to the next. Picture the…

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Recommend a MemberWhat Is Genesis Business Humanity
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Investment
Editor’s Note: No companies are named below. The questions come from real Star of Genesis sessions, and they travel well from one deal to the next. Picture the…

Investment
Editor’s Note: No companies are named below. The questions come from real Star of Genesis sessions, and they travel well from one deal to the next.
Picture the deck. It is polished, the founder talks well, the market slide has a number with a lot of zeros on it, and the round closes in three weeks. Somewhere at the back of your mind, a small voice asks the question every private investor eventually learns to listen to: what am I not being shown?
Most people don’t have a good way to answer it. Diligence on your own usually means a few phone calls, a skim through the data room and a gut feeling, all squeezed into a deadline set by the person who wants your money. The founder has told this story many times. You are hearing it for the first time, which is why having a structure helps.
Here is something worth knowing before you start. CB Insights looked at 431 venture-backed companies that shut down since 2023 and found that 70% ran out of capital. That sounds like the answer, until you read what the report says next: running out of capital is “almost always the final cause of death, not the root problem.” The money ran out because something went wrong earlier. The product wasn’t needed, or the sales channel never worked, or the team couldn’t deliver. Good diligence goes looking for that earlier thing while it can still change your mind.
Start with the customers. Is anyone actually paying, and do they keep paying? Revenue, signed contracts and real shipping dates count as evidence. Interest, unfunded pilots and “conversations with several large players” do not. At Genesis, every company goes through the same four checks: traction, technology, market potential and fundraising strategy.
Then look at the people and the raise together. Find out what the team has actually delivered before, and call someone who has worked with the founder, ideally someone the founder didn’t suggest. Look at how much is being raised, what it is meant to achieve and how far it will go. A founder who can tell you exactly what the next milestone costs usually understands the business. One who can’t is telling you something too.
Do read the paperwork. The cap table tells you who already owns what, how much the founders have kept and whether earlier investors hold terms that could cut across yours. A founder who has given away too much too early is a risk no growth chart will fix. Ask for the latest numbers in writing and see how long they take to arrive.
When you finally sit down with the founder, ask what is hard to rehearse. Who pays, how much, and how often? What happens if the biggest customer leaves? Which approval or regulation stands between this product and revenue, and how long does each step take? What exactly does this round buy? Then watch what happens when you ask something they didn’t prepare for, because that is closer to how the company behaves when things get difficult.
Some of the best questions come from people who have worked in the founder’s industry. In Star of Genesis sessions, members have asked about regulatory categories, what a treatment costs and whether it can scale, and how a product actually reaches its customers. A deck can’t settle any of that, and an investor working alone might never think to ask.
Pay attention to how bad news lands, too. A founder who says plainly that a number came in lower than hoped, or that a milestone slipped, and explains what changed, gives you more to work with than one with a polished answer for everything. Every answer should be something you can check.
That is where a club like Genesis earns its place, because diligence there is shared. A company presents at Star of Genesis and walks members through its traction, technology, business model and commercial potential. Members question the founder live, talk through expansion, fundraising and regulatory issues, and offer advice and introductions. Every session ends with clear next steps, whether that means sending materials, arranging a site visit or making an introduction. Company details sit on the Dealum platform so members can review them at their own pace, and anyone who wants to go deeper is invited into a due diligence meeting.
You get to watch how a company handles other people’s questions, hear from members who know the sector, and decide with a lot more than a pitch in front of you. Membership comes mostly through referral, so if you would like to see companies this way, write to the Genesis team at info@genesisbh.net or visit www.genesisbh.net.
This article is for general information only and does not constitute investment, tax or legal advice.
Genesis is an invitation-only investment and social club with chapters in Miami, New York/New Jersey, and Los Angeles.

Member Highlight
Editor’s Note: Another in the series on the people behind Genesis, this one from the clinical side. It is built from Dr. Fedder's professional record and public reporting.…

Member Highlight
Editor’s Note: Another in the series on the people behind Genesis, this one from the clinical side. It is built from Dr. Fedder's professional record and public reporting.
Every medical device company eventually runs into a question it can't answer from the inside: would a surgeon actually use this? The answer decides whether a product earns a place in the operating room, and it almost never comes from the company that built it.
Dr. Ira Fedder spends his working life on the other side of that question. He is a fellowship-trained orthopaedic spine surgeon with more than 35 years of clinical experience, a Genesis member and part of the medical advisory board behind Genesis MedTech.
His practice covers operative and non-operative care of spine and neck conditions, so he sees the full range of options a patient has, which is exactly the context any new device has to compete in. That breadth matters in a device conversation, because a surgeon's day is made of trade-offs, and a product is judged against them. Public reporting has described his clinical focus as including cervical disc herniation, myelopathy, cervical stenosis, lumbar stenosis and sciatica. He is affiliated with University of Maryland St. Joseph Medical Center in Towson, Maryland, and has been named a Top Doctor in Spine Surgery by Baltimore magazine.
He has also advised a device company directly. Becker's Spine Review reported in 2013 that Tyber Medical, a New Jersey medical device company, added him as a surgeon advisor. For a founder, that kind of experience is practical, and here is why.
A clinical advisor can answer what engineers and investors can't. Where in the procedure does this device sit? What does it replace, and what would make a surgeon change a technique they have used for years? What evidence would a colleague need to see before trying it? Those are the questions a hospital committee will ask, and a founder who has already heard them from a practicing surgeon can answer them calmly.
That matters because hospitals don't buy on regulatory clearance alone. A value analysis committee of clinical and administrative staff reviews each new product. Clinicians assess how it would be used, and administrators weigh the cost against clinical, patient and process outcomes. So clinical credibility sits right in the middle of the purchasing decision, and a founder whose product has never faced a practising surgeon's questions meets them for the first time in front of the committee.
Reimbursement raises the stakes. A hospital can only use what it can be paid for, and if no suitable billing code exists, the application for a new CPT code can take up to 24 months. How clinicians describe a procedure, and where a device fits inside it, shapes how that case gets built.
The same goes for investors reading a medical deal. It is easy to tell a clinical story and much harder to test one. Claims about clinical benefit sound equally confident in every pitch, and the people best placed to test them are the ones who treat patients. A board of working clinicians gives a medical company a way to check its clinical story before capital or customers depend on it.
That is the job of the advisory board at Genesis MedTech, a co-ordinated market entry programme for medical device, health-tech and software companies that takes them from first market assessment to first signed contract. Alongside the partners, six practising physicians and clinical leaders help shape how each product is positioned for clinical adoption, reimbursement alignment and health system credibility. Dr. Fedder's spine expertise is one part of a board that spans pain medicine, internal medicine and nephrology, dentistry and orthopedic spine surgery.
The partners bring the commercial side: group purchasing organisation relationships, health system contracting and enterprise sales experience. The advisory board brings the clinical side, which is the half a founder is least likely to have in house. You need both, because a product can satisfy a purchasing contract and still fail to win a surgeon's confidence, or win the surgeon and stall at purchasing.
For a founder, that means physicians with decades in practice can look at how your product is positioned before it meets a hospital committee. For an investor, it is a reason to trust that the clinical case behind a medical company has been looked at by people who treat patients. If you are building a medical device, health-tech or software company and want that perspective on your US plans, write to the Genesis team at amiel@genesisbh.net or ranny@genesisbh.net, or visit www.genesisbh.net. A short note about the product and the stage it has reached is enough to start.

Business
Discover how Genesis MedTech helps medical device companies navigate the complexities of the U.S. healthcare market and turn regulatory clearance into commercial success.

Business
Editor’s Note: If you have ever watched a cleared product sit unanswered in a hospital inbox, this one is for you. The team named below is current as of October 2026.
The clearance finally came through. Your device is legal to sell in the United States. So you start contacting hospitals, and almost nobody replies. The few who do reply ask questions nobody prepared you for. Which group purchasing organisation are you on contract with? Has the product been through a value analysis committee? Which billing code does a hospital use when it uses your device? Every one of those questions points at a part of the US healthcare system that has nothing to do with how good your product is.
If that is where you are, the product isn't the problem. US medical device market entry is a structural challenge, and the companies that move fastest treat it like one from the start. Genesis MedTech, a division of Genesis Business Humanity, was built to take them through it.
Here is what is going on. Clearance tells a hospital that a device is legal to sell. It doesn't tell the hospital to buy it. Between clearance and a first contract sit gatekeepers who decide on more than product quality.
The first is the group purchasing organisation, or GPO, which negotiates supply contracts for many hospitals at once. A study published in JAMA Health Forum in September 2026 found that just three of them, Vizient, HealthTrust and Premier, were the primary GPO for more than 80% of US hospitals in 2024. Inside the hospital, a value analysis committee of clinical and administrative staff weighs each new product's cost against its clinical, patient and process outcomes. Integrated delivery networks, which are groups of hospitals and clinics run as one health system, add their own financial, operational and clinical criteria on top. The GPO and the health system are separate processes that call for separate relationships, and a contract with one doesn't open the door at the other.
Reimbursement is the next gate, because a hospital can only use what it can be paid for. Clearance doesn't make a device billable. Hospitals are paid through a coding framework, and if no suitable CPT or HCPCS code exists, the application for a new CPT code can take up to 24 months. US health systems also expect domestic accountability at every point in the supply chain, so distribution, billing, a legal entity and in-market representation are prerequisites too. Handled one at a time, each of these adds its own delay.
Genesis MedTech closes those gaps as a co-ordinated market entry programme for medical device, health-tech and software companies. It doesn't hand over a report and step back. The Genesis MedTech team builds, sells and delivers alongside your company until your product is moving.
The programme starts with an honest evaluation of your product's US fit across regulatory pathway, reimbursement positioning and competitive landscape. Target health systems and GPOs come next, chosen from direct institutional knowledge rather than secondary research, followed by a sequenced strategy and the commercial build itself: GPO contracting, IDN engagement, value analysis navigation and enterprise sales. The reimbursement case is built alongside the regulatory submission, so no months are lost waiting.
What makes it work is the people. Dan Romano spent nearly 30 years in healthcare, including more than 20 years with Arjo/Getinge Group and Zimmer Biomet, and founded HSUS in 2016 to help companies accelerate US market adoption. Don Webster, a former Regional VP at Vizient, builds the GPO and IDN relationships that open procurement. Geoff Rohrer, a former VP of Sales at two top-25 medical device companies, leads enterprise sales execution. Jon Berger, a middle market investment banker, connects companies to capital. And a medical advisory board of six practising physicians and clinical leaders, including Dr. Joseph Pergolizzi, helps shape how each product is positioned for clinical adoption and health system credibility.
Genesis MedTech suits a company with a validated product, early clinical evidence and a genuine commitment to a durable US commercial presence. It holds particular relevance for Israeli and international companies, given Genesis's direct connections to global innovation ecosystems, and it is open to any company that meets those criteria. To talk through your US market entry, write to the Genesis team at amiel@genesisbh.net or ranny@genesisbh.net, or visit www.genesisbh.net.
This article is for general information only and does not constitute investment, tax or legal advice. Past performance is not a guarantee of future results. Please consult your own professional advisors before making investment decisions.
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