About 12% of complaints were refused in 2024, which led to $262 billion loss of revenue for suppliers. Providers spend approximately 26 billion dollars every year to collect on denied claims, but only 70% is paid.
That’s what Amperos Health hopes to change. The company offers a denial management and revenue recovery solution that helps suppliers combat denials. He announcement On Wednesday, it secured $16 million in Series A funding.
Amperos serves outpatient clinics and physician group practices in all 50 states. Amperos’ AI platform manages denied provider claims by processing associated follow-ups, appeals, appeals and paperwork. It also provides insights for providers to improve their billing and collections processes and avoid denials in the future.
“The AI used by Amperos works directly within the provider’s existing billing software, acting as a member of their team rather than a separate platform to manage,” said Michal Miernowski, CEO of Amperos. “The result is that providers capture more revenue, at lower cost, without hiring more staff. »
The Series A round was led by Bessemer Venture Partners, with participation from Uncork Capital and Neo. This brings the company’s total funding to $21 million.
“Denials are one of the fastest growing problems in healthcare: a growing share of denied claims, hundreds of billions in lost revenue, and chronically understaffed RCM teams. This is a broken process ripe for AI transformation,” Sofia Guerra, partner at Bessemer Venture Partners, said in a statement. “What sets Amperos apart is that it’s the first truly agentic AI platform we’ve seen to automate this end-to-end workflow, from portal follow-ups and appeals to remediated claims and appeals, without handoffs or gaps. »
With this funding, Amperos will expand its team to serve more providers in additional specialties and geographies. He currently supports orthopedics, ophthalmology, durable medical equipment, dermatology and behavioral health.
Amperos will also expand its analytics capabilities to help providers understand why claims are denied and continue to develop the platform, Miernowski said.
“This means applying the same agentic AI approach to other revenue cycle workflows beyond denial management, which prevents denials and automatically addresses root causes,” he added.
Ultimately, the company aims to become “the native AI infrastructure layer between providers and payers,” Miernowski said.
“RCM today is a manual and ever-changing field,” he said. “New rules for payers, new procedures, and constant staff turnover. It’s almost impossible for a billing leader to stay ahead of the curve without AI. …We don’t just want to automate the work, but continually optimize it, to ensure providers can maximize reimbursement. We can make this possible by identifying where denials are occurring and making process changes up front to prevent them in the first place.”
Photo: doyata, Getty Images
