The bill was always the problem.

Here is a fact about the U.S. healthcare system that sounds made up but isn't: providers deliver the care, and then a meaningful chunk of the money simply never shows up. Not because patients are deadbeats, but because the bill arrives weeks later, in an envelope, referencing codes and adjustments and an "amount due" that bears no obvious relationship to anything that happened in the exam room. Faced with that, a lot of people do the rational thing, which is nothing. Estimates put the industry's leakage from this in the neighborhood of $200 billion. That is the problem Collectly decided to work on.

Collectly was founded in 2017 by Levon Brutyan and Maxim Mizotin. The origin story is refreshingly literal: Brutyan, who holds a J.D. and an M.B.A., moved to the United States, received a medical bill, and could not make sense of it. This is a common experience. The uncommon part is that he treated the confusion as a market rather than a grievance. If the bill is unintelligible, the reasoning went, patients won't pay it, and providers will write it off, and everyone loses - so the fix isn't a better collections agency, it's a better bill.

The company went through Y Combinator and set up in San Francisco. What it built is, in the flattering telling, an "AI-powered patient financial engagement platform," and in the plainer telling, software that sits between a medical practice and its patients and handles money. It connects to the electronic health record and practice-management systems that clinics already run - more than 20 of them, including the big ones like Epic and Cerner - pulls the balance and coverage information, and then does the parts humans are bad at or hate doing: sending a clear digital statement, nudging at the right time, offering a payment plan, and taking the payment.

The unsexy moat

There is a temptation, with any 2020s startup, to say the product is the AI. It isn't, or not only. The genuinely hard and defensible thing Collectly did is the integration work - the unglamorous plumbing that lets a patient see one coherent bill instead of a stack of statements, and lets a clinic's staff stop making awkward phone calls about $80 copays. Anyone can put a chatbot on a website. Getting real-time balances out of twenty different legacy medical systems is the part competitors can't fake.

The metrics Collectly markets follow from this. Clients report collections rising two to three times, cost-to-collect falling by roughly two-thirds, and days-to-collect shrinking. Those numbers should be read the way you read any vendor's numbers - as the good cases, self-reported - but the direction is the point. If you make the bill legible and the payment frictionless, more people pay, and they pay sooner. It is not complicated as a thesis. It is just hard to execute.

Enter Billie

In June 2025, Collectly launched Billie, which it describes as the first AI voice agent built specifically for patient billing and revenue cycle management. The name is a pun on "bill," which is either endearing or exactly the kind of thing a billing-software company would name its robot. Billie works around the clock across voice, chat, text, and email. It knows a given patient's visit, coverage status, and outstanding balance, and it can actually do things - explain a charge, send a statement, set up a payment plan - without a staff member touching it.

The claim from early adopters is that Billie resolves about 85% of patient billing inquiries on its own. If that holds up at scale, it is a genuinely large deal for provider back offices, where billing questions are a bottomless source of phone calls. In October 2025 the company extended Billie to eligibility and benefits, automating insurance verification and calculating copays in real time - pushing the whole apparatus earlier, to before the visit, where money conversations are less painful.

The business underneath all this is straightforward B2B software sold to medical groups, blended with payment-processing economics: Collectly earns as it moves and collects patient balances. It has raised about $34 million, anchored by a $29 million Series A in 2023 led by Sapphire Ventures. That is a reasonable amount of money for a company attacking a very large, very boring, very real problem - which, historically, is exactly the kind of problem that makes for a durable business.