A healthcare-AI startup that turns operative notes into submission-ready claims - and leaves the button to a human.
There is a specific kind of money that healthcare loses without anyone stealing it. The surgery happens. The care is delivered. The note is written. And then the claim goes out slightly wrong - a missing modifier, an unmet payer requirement, a documentation gap - and it comes back denied. Multiply that across a surgery center's year and you get a number that would make a CFO wince: hundreds of thousands of dollars, gone not to fraud but to friction.
Exactrx, a company founded in 2024 and run out of Nashville and New York, is built around that leak. Its pitch is unglamorous in the best way: when a surgical case wraps, the software pulls the documentation from the electronic medical record, reads the operative note, codes the case, checks every charge against more than 80,000 payer-specific rules, figures out what's missing, routes the requests to the right people, and hands back a claim that is ready to submit. All of this, the company says, before a human on the billing team touches it.
The interesting part is where the automation stops. Exactrx does not hit submit. The AI prepares; a person reviews and sends. In an industry sprinting toward full autonomy, that is a deliberate speed bump - a design choice that says the company understands exactly whose signature is on the line. As founder and CEO Athena Doshi puts it: "We prepare your claims. You review and submit." It is the rare AI product that brags about knowing where to stop.
Doshi does not describe Exactrx as billing software. She describes it as "access-to-care infrastructure," which sounds like a reframe until you follow the logic: a denied claim is not just a finance problem, it's the reason a surgery gets delayed or a facility can't afford to keep its doors open. The revenue and the access are the same lever. That framing decides which fight the company thinks it's in.
"I watched denials quietly break the financial engine."Athena Doshi — Co-founder & CEO, Exactrx
Vision-language models pull documentation from the EMR and read the operative note the way a coder would.
The engine assigns codes and generates charges for the procedure performed.
A tri-engine system scores the claim against 80,000+ payer-specific rules and flags what's missing.
Requests route to the right people; a specialist reviews complex cases, then a human hits submit.
Plenty of healthcare startups ask you to trust a black box. Exactrx did the opposite and ran the study. Across 3,145 cases reviewed by MDs, DOs, RNs and APPs at Weill Cornell Medicine and Northwestern Medicine, the company reports 96% criterion-level accuracy - and, more strikingly, 0% clinical-criteria hallucination, against a 28-39% range it cites for standard large language models.
Source: Exactrx validation study, 3,145 clinician-reviewed decisions. Figures reported by the company.
Reads the note, codes the case, validates charges, and produces a submission-ready claim in under 30 seconds - humans review and send, specialists take the complex ones.
Denial tracking, payer-contract analysis, underpayment recovery, and root-cause analysis for every adjustment - so a facility can see where money leaks and why.
Embedded, AI-powered checklists surface payer requirements before surgery, cutting day-of cancellations and shaving prep time per case.
Hard problems tend to live at the seams between disciplines, and the Exactrx founding table is built out of seams. Athena Doshi is a two-time digital-health founder - her prior public-health SaaS platform was acquired in 2021 after growing to serve over 1,000 organizations - with a background in physiology and neuroscience. The rest of the team fills in the parts of the problem she can't cover alone.
Two-time healthtech founder, ex-Omada Health and Heartbeat Health. Named to Inc.'s 2025 Female Founders 500.
Professor of AI and computational biology at Weill Cornell Medicine; 15+ years in biomedical AI, NLP and large language models.
Software engineering leader with 15+ years across digital health and fintech; formerly a staff engineer at WePay.
Clinician with a PharmD from UCSF and experience across ASC, hospital, and outpatient settings.
"I think about clinicians who went into medicine to help people and spend half their day on paperwork instead."Athena Doshi — Co-founder & CEO
Exactrx is early and it isn't pretending otherwise. It carries a reported seed raise of around $170,000, backing from Techstars, Tampa Bay Wave, MassChallenge, Startup:NYC and Femovate, and in 2025 opened a Wefunder community round at a reported $12 million valuation. Sales are founder-led with minimal marketing - and by late 2025 the company reported roughly 85 qualified opportunities and seven pre-pilot commitments, with pilots slated to launch in the first quarter of 2026.
Athena Doshi named to Inc.'s 2025 Female Founders 500 list.
Launched a Wefunder community round at a reported $12M valuation; reported ~85 qualified opportunities and seven pre-pilot commitments.
Pilots scheduled to launch with surgical facilities.
Caption: The founders keep a house rule - the model never signs the claim. It drafts. A human sends. In a business built on trust with payers and patients, that last click is the whole product.