Artificial intelligence startup Amperos Health continues to use AI to automate revenue cycle management, raising $16 million in Series A funding.
Bessemer Venture Partners led the Series A round, with participation from Uncork Capital and Neo. Sofia Guerra, a partner at Bessemer Venture Partners, told Fierce Healthcare that the company recognized that AI would be a “huge driver of automation” for RCM processes, adding that Amperos stands out for its quality, technical approach and results.
“When you’re on the phone with a customer and their reviews are rave, that’s what you really pay attention to,” Guerra said. “Ampelos had a lot of that.”
The company has raised $4.2 million in a seed funding round from Uncork Capital, Neo, and Nebular, along with strategic angel investors OpenAI, Twilio, and Stripe. It has raised $21 million so far.
Amperos Health CEO and co-founder Michal Miernowski told Fierce Healthcare that the company plans to use the newly announced funding to expand its existing organization.
“We’ve helped clients recover about $700 million a year in unpaid insurance claims, but if you look at how much revenue is denied in the industry, it’s about $262 billion a year,” Mielnowski said. “So we’ve just scratched the surface.”
The company said in an announcement that initial claim denials will reach nearly 12% in 2024, and that increased denials and subsequent revenue losses are costing providers more than $26 billion annually to collect on denied claims.
Miernowski said the funding will also help Amperos expand its platform. “Later this year, we plan to launch other modules across different RCM teams, including things like pre-authorization (and) insurance validation,” Miernowski said.
Alongside the funding announcement, Amperos announced the launch of what it calls the industry’s first AI-native end-to-end denial management and revenue collection solution for providers.
Mielnowski said the tool works “very similar to how a human would file an insurance claim,” adding that the solution sits within existing systems and has a variety of functions, such as browsing insurance websites and filling out disputes.
“We have a team of human experts ready to jump in, and what we deliver to our customers is an end-to-end executed claim,” Mielnowski said.
The platform uses large-scale language models (LLM) to complete the entire RCM workflow, maximizing reimbursement with the lowest collection costs. Miernowski said feedback on the tool has been positive across the organization, citing a “severe staffing shortage” at a large national provider.
“We can help raise over $60 million in collections in just eight weeks,” Mielnowski said.
Guerra said that while providers of all sizes are feeling pressure from payers, small and medium-sized providers are often stuck in a “never-ending loop” of work. “Amperos really takes on a lot of that labor and effort and uses technology to make it happen,” she said.
“It’s not just increased productivity for these teams,” Guerra said. “It’s also important to us that we can offer an end-to-end service with a high recovery rate and win rate, and at a much lower cost than other services.”
The company says it has served more than 3,000 clinical sites across the U.S. and generated nearly $700,000 in annual revenue with more than 500,000 claims.
DOCS Dermatology, based in Blue Ash, Ohio, is one of the providers affiliated with Amperos. Valerie DeCaro, RCM vice president at DOCS, told Fierce Healthcare that the group is looking for “solutions to enhance workflow” amid rapid growth, maintain “discipline around collection costs,” and seek policy changes and changes in administrative burdens.
“[We]now realize that if we want to continue to scale in a predictable way, we need some kind of automated AI to help us get there at the same time,” DeCaro said.
DeCaro said the organization is focused on “leveraging” Ampelos’ automated claims status tool and has had “great success.”
“This has allowed us to accelerate staff production and has increased visibility into claim status,” DeCaro said. “At the end of the day, it’s just driving more efficient follow-up and collection activities to help you hit your KPIs.”
