Avicenna Care
Free backlog review
A surgical team at work in a modern operating room

For surgery centers & the surgeon-owners behind them

AI billing for surgery centers

Agents built for the facility claim — implant line items, grouper rates, workers’-comp fee schedules — with a person signing everything that leaves. We prove it before you switch: a free audit of your written-off claims, paid only on what we recover.

Get a free underpayment audit

Recovery first, behind your existing biller — then, when we’ve earned it, the whole billing office at a fraction of what centers pay today. Revert switch in the contract. No recovery, no fee.*

*Contingency on commercial, Medicare & workers’-comp claims; Medicaid engagements are priced flat, as federal rules require.

Avicenna Care works the claims
your center already wrote off

Illustrative — not client data
WorkqueuesIllustrative
AetnaFollow-up$487K
BCBS DenialsAppeal$348K
UHC AppealsIn review$262K
CignaPaid$164K
AYou pay only on what we recover

The re-check

Closed doesn't mean paid right

Zero-balance accounts, implant carve-outs, lesser-of clauses, multiple-procedure discounts — we recompute what your closed claims should have paid, line by line, against your own contracts.

Illustrative — not client data
AAutomatic follow-up
Auto follow-up on aging claims
Resubmit corrected claims
Payer status checks
Escalate to specialist

The chase

Follow-up that never sleeps — with your hand on the wheel

Corrected claims, appeals, and status checks run continuously — and nothing goes out until someone on your side signs off.

Illustrative — not client data
CLM-8451264Denied · CO-97

AI-drafted appeal

Service is not bundled per NCCI edits. Attaching documentation supporting separate reimbursement under modifier 59…

AI AgentSpecialist reviewAppeal filed

The proof

Every number shows its source

Each finding traces to the contract clause, the implant invoice, the EOB line. Your administrator can verify any of it before anything moves.

Illustrative — not client data
Your workflow, your rules
High-value claimsPriority
Aging > 90 daysPriority
Timely-filing riskPriority
AMapped to your SOPs

When you're ready

The whole billing office, run by agents

Claims out the door, payments posted, denials fought — the entire revenue cycle at a fraction of what centers pay today, with human sign-off on everything and a revert switch in the contract. Recovery proves it; switching is your call.

Where earned revenue slips away

15%

of claims are denied on first submission (industry average)

15%

Denials are the norm, not the exception

And in a surgery center the stakes run higher — one total-joint case can carry five figures in facility and implant fees, and high-volume endoscopy or cataract days multiply small underpayments fast.

54%

Appeals work — when someone has the hours

The question was never whether denials can be overturned. It's whether a two-person business office has the time to fight them.

65%

The tail gets written off

When an appeal costs more in staff time than the claim returns, it gets abandoned. That's the money we go after.

365

Deadlines are money

Claims that age past timely filing are gone for good. We track every claim against its payer-specific window.

The work gets done.
You approve before we file.

Claim activity
CLM-4821Appeal filed2m ago
CLM-7742Paid5m ago
CLM-3391Follow-up8m ago
Avicenna CareEach claim worked from denial to payment, human-approved
Illustrative — not client data

Every closed claim, re-checked

AI agents recompute what each claim should have paid and draft the demand or appeal. A person reviews and signs before anything is filed.

Open A/R

$2.4M

tracked

In appeal

38

claims

Avg age

32d

A/R

CLM-7267389$4,200Paid
CLM-6488653$1,250Aging
Illustrative — not client data

One screen, every open claim

Every underpaid, denied, and stuck claim in one place — sorted by dollars at stake and what's about to hit its filing deadline.

Denials workflowRunning
Eligibility verified
Coding reviewed
Appeal packet built
Submitted to payer

Every step logged, every claim worked the same way

Illustrative — not client data

The same playbook on every claim

One playbook runs every claim the same way — endoscopy volume, cataract days, total joints, or two ORs of pain procedures.

CLM-5521Paid · $3,140.00
Owned
Worked
Resolved
Avicenna CareAccountable through to outcome
Illustrative — not client data

Chased until it's answered

We don't stop at "submitted." Every claim we take on is followed to payment — or a final, documented answer you can take to your board.

Every claim, and every payer, in one place

Which payers underpay you most

Patterns across every payer, procedure, and denial reason — so you can see what’s leaking and fix it upstream.

Deadlines you can't miss

Every claim tracked against its payer-specific filing window, so nothing quietly ages out.

Every claim's status in one view

Claims, payer replies, and what you're owed — in one place, always current.

Built so you can trust it

“If I can see exactly where it’s pulling from — an audit trail — I don’t see a reason I wouldn’t trust it.”— a physician in our discovery interviews (name withheld)

Read-only by default

We work from read-only exports and the payer-portal access you grant — without changing your chart. Nothing is edited behind your back.

Every action shows its work

See exactly where each code, number, and document came from — a full evidence trail on every claim.

Nothing is filed without your signature

The agent drafts the appeal and gathers the proof. A person on your side approves before anything leaves under your NPI.

Your biller stays

We work behind your billing company or business office, not instead of it. If you ever want more than recovery, that's your call — never a requirement.

Paid only on recovery

Percentage-of-collections billing has to prioritize the big, fresh claims — that's just the economics. We're paid only when we recover, so the small and aging claims are exactly the ones we fight. (Contingency applies to commercial, Medicare, and workers'-comp claims.)

Your data stays put

PHI stays in your systems. We sign a BAA with your center before we touch a single claim — and charts never leave your platform.

Claim CLM-4821 · appeal draftIllustrative
CPT 63030pulled from op-note, p.2
Modifier 25applied per NCCI edit
Dx M51.26from encounter diagnosis
Drafted by agent · approved by you · nothing filed until you sign

Every code and number links back to where it came from. That’s the audit trail.

Designed to work alongside the systems surgery centers already run

HST Pathways
SIS
Provation
Nextech
AdvantX
athenahealth

All product names are trademarks of their respective owners — listed for compatibility context only; no affiliation or endorsement implied.

What surgical practices tell us

We’ve been sitting down with surgeons, administrators, and billers across the Bay Area. This is what we keep hearing — names changed, words theirs.

Denials are one of the banes of our existence. The big insurers bounce claims back knowing you don't have the bandwidth to fight every one.
Dr. Marcus ReyesOrthopedic surgeon
That's what the insurance companies are banking on — for us to not follow up.
Dr. Alan WhitfieldSurgeon, independent practice
It's always the appeals process that's the hardest. If a claim passes the deadline — usually a year — I have to write it off.
Denise R.Practice billing manager

Quotes from physicians and billers we’ve interviewed. Names and identifying details changed for privacy; the words are theirs.

Backed by Y Combinator · Building with our first design partners — independent Bay Area surgical practices

See what your center is owed

Send us your remit files and top payer contracts — BAA first; an 835 export from your PM system is all we need. You get a written audit back: the recoverable dollars we found, and exactly where each one comes from. If the number is small, you’ve had a free second opinion on your billing. Facility claims are where we start — surgeon-office professional-fee books get the same treatment.

Get a free underpayment audit

Contingency pricing applies to commercial, Medicare, and workers’-compensation claims. Medicaid engagements are priced flat, as federal rules require. Prefer to estimate it yourself first?