payer-rules-engine
(2)
RapidClaims
RapidClaims is a New York-based healthcare technology company building autonomous AI agents for medical coding and revenue cycle management. Its platform helps hospitals, physician groups, ACOs and community health centers automate coding, prevent claim denials, recover underpayments and improve documentation - reducing operating costs by up to 70% while capturing earned revenue. Founded in 2023 by three IIT Kharagpur alumni, the company raised $11M led by Accel and Together Fund to expand across 25+ medical specialties.
Exactrx
Exactrx is a Nashville- and New York-based healthcare AI company that automates revenue cycle management for ambulatory surgery centers and outpatient providers. Its platform reads the operative note, codes the case, validates each charge against more than 80,000 payer rules with a tri-engine system, and generates a submission-ready claim in under 30 seconds - leaving humans to review and submit. Founded in 2024 by Athena Doshi and a clinician-and-engineer team, the company positions itself as access-to-care infrastructure rather than billing software, aiming to recover the revenue that denials and documentation gaps quietly drain from surgical facilities.