He grew up reconciling insurance claims in the back office of his parents' medical practice. He is still doing it, only now the office is on Broadway and the reconciliation is done by machines.
Arrow sells software to the people who spend their weekdays fighting with insurance companies. The pitch is that a lot of what happens between a claim being submitted and a claim being paid is, in a technical sense, wrong: a modifier code omitted, a payer contract misread, a denial that should have been appealed and wasn't. Arrow's software watches this pipeline and tries to catch the errors before they cost money, and to explain, after the fact, why they cost money when they do.
This is the boring middle of American healthcare, which is where most of American healthcare's money goes. Roughly $300 billion a year is lost to billing errors and denials, a number Patel likes to cite and which is difficult to disprove. Arrow is trying to catch a fraction of it. If it catches even a small fraction it will be a very large company. That is the whole thesis, and Patel has been executing on some version of it since 2020.
The company was called Walnut then. Walnut was buy-now-pay-later for medical bills. It raised $110 million from Gradient Ventures, part of Google, in May 2022, at what turned out to be roughly the peak of enthusiasm for consumer BNPL. Then consumer BNPL got quiet, and Walnut got quieter, and in 2024 it emerged with a new name and a new customer: not patients but providers. Same team, same money, different bet.
Patel was born and raised in Peterlee, a small town in the north east of England named, more or less, after the local trade union leader who agitated for it to exist. He moved to the United States, studied mathematics and physics at the George Washington University, and then, somewhat improbably, added a master's in finance from Vanderbilt on top.
He spent the early part of his twenties inside venture funds, as an associate at Space Capital (a firm that invests in space startups; Patel does not, as far as anyone can tell, invest in space startups anymore) and then as a principal at H/L Ventures. He also did a stint as a product manager at Google. This is a career that looks purposeful in retrospect and probably felt like drift at the time.
The problem that would eventually become Walnut and then Arrow came from home. His parents ran a medical practice; the billing was, as it is for most small medical practices, a mess. When a close relative faced a stack of medical bills he could not easily pay, Patel started reading about medical debt and personal bankruptcy in the U.S., which turn out to be the same subject. He built the first version of Walnut on nights and weekends and joined Plaid's inaugural startup accelerator with it.
The consumer BNPL thesis was straightforward: American healthcare has coverage gaps; patients fall into them; better payment mechanics would reduce the number of people driven into bankruptcy by a hospital visit. It worked well enough. Revenues grew roughly fifty percent month over month for a six-month stretch. Default rates, Patel said at the time, held up in line with mature lenders. Gradient wrote the check.
Then the macro turned. Consumer lending got expensive; BNPL got scrutinized. Patel took the same team and pointed it upstream, at the provider side of the equation, where the money is bigger, the buyers are enterprise, and the work looks less like consumer fintech and more like unglamorous back-office software. Arrow was the result.
The specifics of what Arrow sells depend on who you are. If you are a hospital system's revenue cycle director, it is an error-detection layer that reads claims before they leave for the payer and flags the ones that will get denied. If you are a billing manager at a specialty practice, it is a queue that tells you which denials are worth appealing and which are noise. If you are a CFO, it is a set of dashboards that translate all of the above into money.
Underneath it is a set of models trained on EOBs and ERAs (the documents insurers send explaining what they will and will not pay), payer contracts, and prior denials. The models learn what a given payer tends to reject and why. The stated goal, in Patel's phrasing, is to move claims adjudication closer to real time, so a provider does not have to wait weeks to find out that a claim was submitted with a wrong modifier.
Arrow lists 110 employees on its roster, works out of 1460 Broadway in Manhattan's garment district, and has begun publishing customer case studies, including a mental health platform called MyWellbeing that cut denials by 85% using Arrow's software. Publishing case studies is what companies do when they have graduated from the phase where the pitch is aspiration to the phase where the pitch is proof.
He grew up helping run billing operations at his parents' medical practice. This is the kind of biographical detail that founders sometimes invent for pitch decks. In Patel's case it appears to be true, and it explains most of what he has done since.
The first version of Walnut was built while Patel was still a Google PM. He kept the day job until the accelerator cheque cleared. Most founders romanticize this phase; Patel talks about it as a matter of accounting.
In the 2022 Series A process, Patel noticed investors starting to ask about profitability and unit economics. He noted, in an interview, that these were topics that "really never came up before." Six months later they were the only topics.
Payer contracts are dense, boring, and where the money is. Patel is one of the small population of healthcare-tech founders who has clearly read them for pleasure.
The Walnut-to-Arrow rebrand happened without a press cycle. This is unusual. Most founders treat a rebrand as a story; Patel treated it as an operational task.
Peterlee, County Durham, population roughly 20,000. Broadway, Manhattan, population somewhat larger. Patel has kept the accent light and the New York address current.
Real-time, frictionless payments in healthcare. Patients see what care costs before they get it. Providers get paid without manual work. Health plans run leaner, with less fraud, waste, and abuse. That is the pitch. If any part of it comes to pass, Arrow will be worth a great deal of money.
The co-founder and CEO of Arrow, a New York-based healthcare payments and revenue cycle company that was previously known as Walnut.
An AI-powered platform for healthcare claims and revenue cycle management. It focuses on catching claim errors, accelerating reimbursement, and giving providers visibility into what payers are doing.
Patel's earlier company, a buy-now-pay-later product for medical bills founded in 2020. It rebranded to Arrow in 2024 with a broader provider-side focus.
About $113.6M in total, with a $110M Series A led by Gradient Ventures in May 2022.
He was born and raised in Peterlee, England, and now lives and works in New York City.