Claim Health
AI native revenue operations platform for post acute care providers including home health, hospice, home care, and nursing homes, a segment the larger revenue cycle vendors largely do not serve. Automates the referral to reimbursement cycle across revenue assurance, smart intake, authorization autopilot, billing operations, and platform intelligence. The model identifies upstream data, documentation, and coverage risk inside the EMR to prevent denials before submission, centralizes and auto extracts referrals arriving by fax, email, and portal, automates prior authorizations from submission through renewal, and resolves claims to cash through posting, reconciliation, and prioritized denial follow up. Routine work is automated while exceptions surface to human billers who make the decisions. Voice agents for insurer information requests are in development. Founded 2025 by Kevin Calcado and JJ Ram; $4.4 million seed in January 2026 led by Maverick Ventures with Peak XV, Y Combinator, and executives at large post acute providers participating.
Capability Axes
The model does the work end to end: extracting referrals from fax, email, and portal, identifying coverage and documentation risk inside the EMR before submission, and automating prior authorization through renewal. The stated long term goal is a self driving revenue cycle.
The stated division is sensible: routine work is automated while exceptions surface to human billers who make the important decisions, which puts the human where judgment is actually required. Held back from A because the threshold separating routine from exception is not published, and that threshold is the entire control in a system designed to reduce human touches.
Very early with no external validation retrieved. Founded 2025, seed funded January 2026. Notably, C suite executives at large post acute providers participated in the round, which is a modest signal of operator conviction, but no customer counts, named references, or measured outcomes were available.
No public rate card. Contact the vendor. The commercial unit is undisclosed and materially important here: subscription versus percent of collections allocates risk very differently for a revenue recovery product, and buyers should establish which applies.
Narrow, deliberate, and underserved: home health, hospice, home care, and nursing homes. Post acute revenue cycle differs materially from acute and ambulatory in documentation requirements and authorization rules, and the large RCM vendors largely do not build for it. Confining scope to that segment is the right call and is stated plainly.
Pricing
Vendor-published figures are labeled as such. Figures labeled “Estimated” are derived from third-party sources and have not been confirmed by the vendor.
| Entry Price | Pricing Basis | BAA Tier | Implementation | Source |
|---|---|---|---|---|
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Contact the vendor
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Undisclosed; subscription or percent of collections | — | — | Vendor Published |
No public rate card. The commercial unit is undisclosed and materially important: subscription pricing and percent of collections allocate risk very differently for a revenue recovery product, and the latter aligns vendor incentives with aggressive claim pursuit. Establish which applies before contracting.