In the past few years, payers and providers have been engaged in an arms race when it comes to deploying AI, with insurers using the technology to deny claims faster and providers adopting it to challenge those decisions. On Wednesday, a New York-based startup seeking to help providers get ahead in this battle snagged $40 million.
Adonis, founded in 2022, closed its Series C round, bringing its fundraising total to more than $95 million. The round was led by Quadrille Capital, with participation from General Catalyst and Bling Capital.
The startup’s platform analyzes hospitals’ billing data to find the problems that are causing payers to deny or underpay claims. Its software can then automatically carry out tasks like researching those denials or preparing appeals to help providers recover the money they’re owed.
“The end goal is to really help our customers increase the revenue they collect, and also, over time, decrease the pressure that they have on the individual team members,” explained Adonis CEO Akash Magoon.
Magoon started Adonis with his brother Aman. This is the second health tech startup they have created — the first was Nayya, which the duo founded in 2019. Nayya sells to payers, offering a solution that helps walk people through the open enrollment process.
During the brothers’ time working so closely with payers, they were able to see firsthand how aggressively these companies have been investing in AI models to optimize their back-office operations.
“They’ve been building technology to deny claims at a really fast clip. So one of the reasons that we started Adonis is to flip everything we learned working with the payers on its head and help providers and their teams deploy and leverage the same type of capabilities. Seeing it from the other side in our past lives really motivated us to solve this problem,” Magoon declared.
Some of Adonis’ customers include Mount Sinai Health System, Baptist Health South Florida, AdventHealth and ApolloMD.
Salonia Brown, Mount Sinai’s vice president of revenue cycle management, said Adonis stood out from other vendors because of its dual approach. Its system combines AI agents to handle high-volume, manual tasks with an intelligence platform that continually provides visibility into trends, root causes and accounts receivable, Brown noted.
In practice, he said Adonis’ solution has allowed staff to focus on higher-value work while automating low-yield tasks, as well consolidated insights that were previously scattered across multiple systems.
In Brown’s eyes, throwing more staff at revenue cycle problems isn’t effective — instead, he believes hospitals need technology that automates manual tasks. By using Adonis’ platform, he said that Mount Sinai has been able to redeploy staff to higher-value work, which has in turn accelerated cash flow and increased collections.
“Now, it’s less whack-a-mole and more precision targeting,” Brown stated.
As payers and providers continue their AI arms race, he thinks Adonis’ platform can help hospitals gain some of the financial edge they need to stay competitive.
Photo: Thanasis, Getty Images
