RCM Deals & Raises

Health Velocity Capital leads. Procode's fine-tuned hybrid LLM for surgical CPT coding hits 86.7% overall accuracy vs. 42.5% for professional auditors and 35.8% for OpenAI GPT-5 in a peer-reviewed PRS Global Open study. On hard cases (4+ CPT codes): 80% vs. 5–12.5% for general-purpose LLMs. The $10M funds two additional surgical billing acquisitions. Procode bills on contingency. Total raised: $14M. Serves 350+ plastic surgery and dermatology providers via The Auctus Group acquisition.

Charlotte-based Prochant, a technology-enabled RCM partner for HME, DME, infusion, and specialty pharmacy providers, has secured a strategic growth partnership with Longshore Capital Partners. Leadership team stays intact; capital targets AI, automation, operational scale, and tuck-in acquisitions within the home-based care continuum.

Sixth Street Growth leads at 3x Candid’s 2025 valuation. 190% ARR growth YoY. ~200% net revenue retention. Oak HC/FT, 8VC, and Y Combinator all returned. Total raised: $219M+. Talkiatry cut manual billing work 40% and now collects 98.3% of what payers owe. Nourish auto-processes 96.7% of claims without adding billing headcount. Cofounders met at Palantir — they’re treating billing as a data integration problem, not a workflow problem. The $280B billing administration market is the explicit target.

$120M Series C led by Menlo Ventures brings total funding to $222M. In 15 months: 20x revenue growth, 200M+ patient interactions processed, 115% labor capacity lift for customers. Assort automates the full patient journey — scheduling, intake, referrals, prior auth, payments — natively integrated with Epic and Athena. New CRO from Samsara (1,220% enterprise ARR growth). Health systems are standardizing on a single AI patient access platform. Front-end RCM roles in scheduling, intake, and eligibility verification are directly in the crosshairs.

Pender Ventures leads a $12.6M growth round with Round13 Capital and Graphite Ventures. InsideDesk builds AI RCM exclusively for dental service organizations — claims processing, collections, and denial management purpose-built for DSO scale. MB2 Dental (one of the nation’s largest DPOs) is a named customer citing improved insurance AR recovery across their organization.

Raintree Systems acquires Spike Technologies (SF, 2022; backed by NVIDIA Inception, Practica Capital, Plug & Play) to embed agentic AI voice agents natively inside its rehab/PT EMR — automating payer calls, prior auth, eligibility, and claim follow-up. Terms undisclosed. Target: fully autonomous RCM at 1% cost-to-collect for rehab and physical therapy organizations.

GTCR-backed Experity (~50% of U.S. urgent care centers) acquires Exdion Healthcare, an AI-driven chart-to-cash SaaS platform. Claims: 86% denial reduction, autonomous claim processing. Terms undisclosed. TripleTree advised.

Cleargate Capital Partners (founded 2025, healthcare-focused lower middle market PE) made a strategic investment in Fellow Health Partners, a Bay Shore, NY-based RCM services provider to physician groups and ASCs nationwide. Terms not disclosed. Another data point in the ongoing PE consolidation of independent physician group RCM.

Apollo-backed Thoreau Group (Matt Holt, former New Mountain Capital) in advanced talks to acquire Ensemble Health Partners at ~$12B. Ensemble manages $46B in patient revenue annually across 12,000 employees. Warburg Pincus, Berkshire Partners, and Bon Secours Mercy Health would exit. One of the largest PE-backed healthcare services deals in recent history.

Innovaccer's fifth acquisition embeds 30 years of ambulatory RCM expertise into its Flow agentic platform. CaduceusHealth manages $5B in gross patient charges annually across ~4,000 providers. Combined platform targets $20B in avoidable annual denials — predicting and resolving rejections before claims are submitted.

Led by General Catalyst with Sequoia, Morgan Stanley, and Kirkland & Ellis. Commure runs end-to-end RCM across 130+ health systems including HCA and Tenet, processing tens of billions in annual claims. The claim: 85%+ autonomous. Capital going toward replacing legacy BPO and billing vendor infrastructure.

Led by Temasek with $200M total raised. Cohere processes 12M+ prior auth requests annually and auto-approves 90% of them. Expansion into broader clinical decision-making use cases next.

A fresh round targeting denial management automation — one of the most active sub-segments in RCM venture capital right now.

PE capital continues to flow into AI-enhanced revenue cycle platforms as the managed services model evolves.