The Canadian software company won by making the unglamorous machinery of a law firm work online. Its US$1 billion vLex deal is a much riskier bet: that the same company can help run the office and reason over the law.
Eric Schweiger began with one Midtown office and a consumer-grade complaint: seeing a dermatologist took too long. Six messy integrations and at least $155 million of disclosed growth capital later, his group has become a coast-to-coast test of whether convenience and clinical care can scale together.
How a group-buying network built by former pharma executives quietly became the largest independent community-oncology network in the country - and why staying small and independent is the whole point.
Most consolidators buy a practice and hand the surgeon a paycheck. Allied OMS handed them the boardroom instead - and built a national oral-surgery platform around who signs the votes.
Two Harvard MBAs sketched a med-spa roll-up between squash matches. Six years later, Aesthetic Partners runs the back office for 20-plus clinics - and lets every founder keep their name on the door.
United Aesthetics Alliance is assembling a national network of plastic surgery practices and medical spas without turning them into a single chain. Its wager is that shared capital, recruiting, marketing, and technology can scale - while clinical judgment and local reputations stay local.
PracticeTek has spent five years buying the software that runs America's dentists, orthodontists, chiropractors and dermatologists. Now more than 40,000 practices log in through its brands - and most patients never learn its name.
Advisors Excel began with three friends, a dentist-office basement and their pooled savings. Two decades later, its real product is not an annuity - it is the machinery that lets an independent advisor run like a much larger firm.
athenahealth doesn't see patients. It runs the billing, charts, and reminders for the clinicians who do - and it's betting the whole network on AI.
LPL Financial built a $2.6 trillion business by staying behind the advisor. Now its bet is that scale, open architecture and embedded AI can make independence feel less lonely - without making every practice look the same.
Cone is a YC S22 B2B SaaS company building an AI-powered work operating system for accounting and professional service firms. It unifies proposals, engagement letters, billing, payments, project management and client engagement into one platform so firms can go from proposal to payment without stitching together separate tools.
Toothy AI builds HIPAA-compliant AI agents that run the insurance side of a dental practice - verifying patient coverage, filing and correcting claims, chasing denials, and posting payments. Using voice AI to make payer phone calls and portal automation to check eligibility, Toothy aims to take the roughly 160 hours a month that clinics spend on insurance busywork off staff plates. A Y Combinator Winter 2025 company founded in 2024 by Johnny Chen and Matthew Kerrigan, it sells a subscription service to dental clinics looking to collect more, faster, with smaller back-office teams.
VSP Vision is the largest not-for-profit vision benefits and eye care company in the United States, founded in 1955 by a group of Northern California optometrists who pioneered the idea of prepaid vision insurance. Headquartered in Rancho Cordova, California, VSP now operates a vertically integrated portfolio spanning vision insurance, eyewear brands (Marchon, Altair, Marcolin), lens technology (VSP Optics), retail (Visionworks, Eyeconic), and practice-management software (Eyefinity). Backed by roughly 85 million members and a network of tens of thousands of independent eye doctors, the company frames its mission as empowering human potential through sight, and funds one of the industry's largest charitable arms, VSP Eyes of Hope.
Berry Street is a New York-based digital health company that connects patients with registered dietitians for insurance-covered, virtual nutrition therapy while giving those dietitians an AI-enabled 'business-in-a-box' to run independent practices. Founded in 2023 by Noah Kotlove and Jesse Rose, the platform pairs a consumer marketplace - where most clients pay $0 out of pocket - with back-office tooling that handles insurance credentialing, claims, documentation and patient communication. It works with a network of more than 1,000 dietitians and 1,250-plus insurance plans, and raised a $50 million Series B in early 2025.
CloudLex is a New York-based legal technology company that builds cloud-native case management software purpose-built for plaintiff personal injury law firms. Its platform runs a PI practice end to end - from client intake and matter management through medical records retrieval, client communication, e-signatures, and settlement - and layers in Lexee AI for demand drafting, medical summaries, and 24/7 client assistance, plus human-powered paralegal services. Founded in 2015 by Dev and Sudhir Shrotri, the company positions itself as a single ecosystem for personal injury firms rather than a generic legal tool.
Headway is a New York-based healthtech company building a software-enabled network that makes it easier to find a therapist and to pay for one with insurance. Its three-sided marketplace connects patients, mental health clinicians, and insurance plans: patients search for in-network providers with transparent copays, clinicians offload credentialing, billing, scheduling, and claims to Headway, and insurers gain a larger accessible network. Founded in 2019 by Andrew Adams and co-founders, Headway operates in all 50 states with roughly 34,000 clinicians and, after a $100M Series D in 2024, is valued at about $2.3 billion.
Ignition, founded in Sydney in 2013 as Practice Ignition, is a revenue and billing automation platform for accounting firms, bookkeepers, and professional-services businesses. It combines digital proposals, engagement letters, automated invoicing, and integrated payments into one system so firms can win clients, get paid on time, and reduce scope creep. More than 7,500 businesses use Ignition, and customers processed roughly $3.1 billion through the platform in 2025.
Barti builds an AI-powered electronic health record and practice management platform built specifically for eye care providers, replacing the patchwork of legacy tools optometry and ophthalmology practices use for charting, scheduling, billing, phones and payments with a single connected system.
I V Y Labs is a San Francisco mobile-first company building simple, HIPAA-secure tools for independent mental health providers. Its flagship product, Ivy Pay, lets therapists charge a client's credit, debit, HSA or FSA card on file with a single button push - no card readers, checks or monthly fees - at a flat 2.75% per transaction. Founded by former Yelp executive Mandy Silverman, the company set out to remove the awkward friction of getting paid so therapists can focus on care, and has expanded toward helping clients discover and connect with the right therapist.
Zaya Care is a New York-based healthcare company building the largest network of in-network maternal and wellness specialists in the United States. It negotiates insurance contracts on behalf of independent practitioners - pelvic floor therapists, lactation consultants, dietitians, mental health therapists and acupuncturists - and handles credentialing, eligibility and billing so those providers can accept insurance without the administrative burden or financial risk of doing it alone. Inspired by the comprehensive European model of maternity care, Zaya gives small practices the leverage and efficiency of a large health system while letting them stay independent, and gives patients affordable, whole-person care beyond the standard OB-GYN visit.
Apero Health is a San Francisco-based, Y Combinator-backed healthcare software company that folds scheduling, clinical visit notes, revenue cycle management, patient billing, e-prescriptions, and financial reporting into a single API-first platform. Founded in 2019 by Jacinda and Nick Shelly, Apero aims to bring transparency and speed to the notoriously opaque business of getting doctors paid - promising implementation in under a day, claim denials cut through custom validation rules, and payer enrollment across all 50 states.
Billables AI is a San Francisco startup that runs quietly in the background of a lawyer's workday, watching the email, documents, calls, and calendar entries flow past, and turning them into finished, billable time entries - descriptions and all. Founded in 2023 by a team from SambaNova, Pinterest, and Mya Systems, the company argues that law firms lose real money not because lawyers do not work, but because they forget to write down that they did. It has raised roughly $14 million across a 2024 seed and a 2026 Series A, and now sells its passive, API-based timekeeping to hundreds of midmarket law firms.
Grapevine Technologies is a healthcare procurement software company that acts as an intelligent purchasing agent for medical buyers. Founded in 2021 out of the University of Pennsylvania by Luka Yancopoulos and William Danon, Grapevine grew out of their pandemic-era supply venture and now helps specialty practices and physician groups compare vendors, cut ordering time, and reduce medical supply spend - in some categories by more than 50%.
Quadrant Health builds AI voice and agentic workflows that run natively inside the electronic health records clinicians already use - Epic, athenahealth, eClinicalWorks and Medent. Founded in 2021 out of Y Combinator's Winter 2021 batch, the company started by analyzing EHR and messaging data to predict disease before it occurs, then pivoted into AI agents that handle the operational grind of a medical practice: an AI scribe that drafts EHR-ready notes in real time, and administrative agents that answer calls 24/7, book appointments, collect intake, process refill requests and close care gaps in 20+ languages. Led by co-founder and CEO Anin Sayana, Quadrant sells HIPAA- and SOC2-compliant software to providers, payers and life sciences organizations.
Reviva is an AI-native practice management platform and EHR built for cash-pay health and wellness practices - medical spas, longevity clinics, IV therapy bars, and functional medicine providers. It folds scheduling, charting, payments, memberships, CRM, and marketing automation into a single system you can operate by telling it what to do. Founded in 2024 by Valerie Huynh and Jane Jeong, the daughters of immigrant small-business owners, Reviva aims to give solo and small wellness practices the kind of software leverage that used to belong only to big hospital systems.
NexHealth is a San Francisco-based health technology company building the patient experience platform for medical and dental practices. Its software gives doctors EHR-integrated online scheduling, patient messaging, digital paperwork, recalls, reviews and payments, while its Universal API and proprietary Synchronizer let developers read and write data across 20+ practice management systems in real time. Founded in 2017 by Alamin Uddin and Waleed Asif, NexHealth reached unicorn status in 2022 with a $125M Series C at a $1B valuation and serves more than 10,000 practices.
Develo is a Los Angeles-based health technology company building an AI-native operating system exclusively for independent pediatric practices. Its FHIR-native platform unifies scheduling, clinical charting, billing, charge capture, and family engagement, with embedded AI scribes that cut documentation time. Founded in 2022 by Dr. Aaron Sin and Han Ke, Develo serves hundreds of pediatric providers across 25+ states and raised a $14M Series A in 2026.
Monograph is a San Francisco-based software company that builds cloud practice-operations software for architecture and engineering firms. Its platform replaces spreadsheets with real-time tools for project budgets, staffing, time tracking, invoicing and profitability forecasting, giving design professionals live financial visibility into their work. Founded in 2019 by three architectural designers, Monograph serves thousands of A/E firms and has helped manage hundreds of millions of dollars in projects.
PatientFi is a healthcare fintech that lets patients pay for elective medical treatments over time through simple monthly payment plans. Its point-of-sale platform partners with medical practices - across plastic surgery, dermatology, dentistry, ophthalmology, fertility and medical spas - to offer instant, soft-credit-check financing so patients can afford care without upfront strain, while practices grow revenue. Headquartered in Irvine, California, the company markets itself as 'The Friendly Way to Pay.'
Sikka.ai is a San Jose-based AI and API platform for the retail healthcare market - dentistry, veterinary, optometry, audiology, chiropractic and more. Its ONE API connects to over 400 practice management systems and roughly 96% of the market, giving developers and practices a single integration point to pull patient data, post payments, and tap 300+ KPIs. Built on de-identified data from tens of thousands of practices over two decades, Sikka also ships practice-facing analytics (Optimizer) and DentalLLM, a dental-specific large language model. Founded in 2004 by Vijay Sikka, the company processes large transaction volumes daily across more than 35,000 practice installations.