Operant Health

Doctors practice medicine. We run the rest.

The AI-native EHR for independent practices, starting with orthopedics.

The problem

Every independent surgeon also runs a small business.

Practicing medicine
Consults Surgery Follow-ups
Running the business
IntakeEligibilityNotes OrdersFormsAuthorizations FaxesClaimsDenials Paying staff
with patients
on EHR and desk work
of EHR work per 8 hours of orthopedic patient time
/ weekprior auths per physician, of staff and physician time
of patients delayed or skipped care because of admin
of referrals end in a completed appointment
Why now

Four forces, at once.

1

More patients

Americans are 65+. Ortho supply covers of demand by 2038.

2

Payers armed with AI

initial denial rate, up from in 2016. One payer's algorithm reviewed claims in each.

3

AI can now do the work

→

AI agents on real computer tasks, 2024 to 2026. Portals, legacy EHRs and fax no longer need an API.

4

Services are being rebuilt

R1 RCM taken private. billing companies, none above share, are being rolled up.

The practice is outnumbered on volume, outgunned on denials, and the tools to fight back just arrived.

Why now

The denial arms race.

Payers automate denials. Practices answer by phone and fax.

of private-payer claims initially denied, each to fight
of appealed Medicare Advantage denials are overturned, yet only get appealed
  • Cigna's PXDX: per claim reviewed
  • UnitedHealth post-acute denials: → in two years
  • Medicare's WISeR model brings AI prior auth to knee arthroscopy in 2026
  • of physicians say payer AI is raising denials

Practices need their own agents, and agents need evidence.

Why now

Whoever owns the record wins.

Every denial is won or lost on documentation: what was said, examined, ordered and authorized, and when. Today that evidence is scattered across a legacy EHR, a scribe, a fax inbox and a billing company that never saw the visit.

So we built the AI-native EHR.

Why ortho first

Ortho is the wedge.

of orthopedic surgeons are in private practice, second only to ophthalmology ().

The aging wave lands here first: joints, spines and fractures. And every visit spins off orders, forms and authorizations.

Win the hardest workflow and every specialty is easier.

What we do today Live

An AI-native EHR for every step of care.

Readiness agent

Before the visit

Intake, insurance and eligibility, a pre-visit briefing.

Scribe

During the visit

The note, the codes and an assistant in the room.

Admin agent

After the visit

Orders, forms, authorization tasks and the fax inbox.

One record, from the first form to the last fax.

Before the visit Live

Ready before the patient walks in.

Visit header with intake, recording and signing status
During the visit Live

The note writes itself.

A finished note with every segment highlighted by its source
Every segment shows its source AI-written From transcript tap to hear that moment Manual edit Chart field Macro
After the visit Live

Every order, form and authorization, from one signed note.

  • Clinical orders, with authorization tasks and forms to track them
  • Hospital forms filled on the original PDF, field for field
  • A document inbox and faxing, matched to the patient

Every artifact links back to the visit evidence that justifies it.

Post-visit checklist
Orders, forms and fax status for the visit
Product Live

Real software, in clinic today.

The day's schedule
The day's schedule, visits marked as seen
Visit header with status
Every visit's status at a glance
A finished note with source highlights
Every sentence shows where it came from
Orders, forms and fax status
Forms and fax, per visit
Post-visit checklist
A checklist that closes out the visit
Operant Health website
The website

Tap any screen to enlarge.

Time back

Four minutes, thirty-five times a day.

Write the note
Operant drafts it in
Look up ICD and CPT codes
Operant suggests them, with evidence
Place orders
Imaging, DME, PT
Authorizations and hospital forms
per auth
of EHR time per patient, all told
× patients a day
a day, from the note alone. And more for codes, orders and authorizations.
Traction Live

Already in clinic.

notes generated across practices in about months.

≈ hours of note-writing replaced
staff hours back, reported by our practices
Also running in those practices
IntakeVisit readinessOrders Hospital formsAuthorization tasks

Ambient scribes alone save about a quarter hour a day in published trials. Operant writes the whole report and does the admin around the visit.

Unit economics Roadmap: next tiers

The cost to serve trends to zero.

Time given back, per surgeon-month
LLM cost to serve it

patients a month: to serve each one, against of time back.

One encounter
Frontier models write the note, today
Decision APIs codes as typed choices, at to per M tokens (Jev, OpenAI Decisions)
Fine-tuned models trained on every provider edit

The price of a fixed level of AI capability falls .

We don't need the bleeding edge to do admin work. Every model generation makes the same work cheaper.

Market

Usage-based, on two meters.

All US physician practices
Independent practices, every specialty, self-serve
Independent orthopedics: the beachhead
per encounter, for the EHR and scribe
of collections, for RCM, at the industry floor

RCM is most of every ring. The EHR is how we get in; RCM is the market.

Independent ortho→ MSK neighbors spine, pain, podiatry, PM&R, sports medicine→ Procedure-heavy independents

Same journey, same RCM work. Only the templates change.

Go to market Live

Live in a day. No implementation team.

  1. Sign upA surgeon creates the practice.
  2. Practice setupProviders, locations and the schedule.
  3. Templates and voiceImport past notes so drafts sound like the surgeon.
  4. First visitRecord, review, sign.
Practice onboarding
The bigger prize Roadmap

The practice's money.

Today
PayerClaimsBatch ledgerPractice
Weeks of lag, reconciled by hand
Operant
PayerClaimsReal-time ledgerPractice
Live and continuous, tied to the visit
RCM and denial defenseReal-time ledger and reconciliationPoint of sale and patient paymentsCost-sharing collectionPayroll

The EHR holds the evidence, so the claim, the appeal and the ledger all start from the same source of truth.

AI-native services Roadmap: our thesis

RCM is being rolled up. We'll rebuild it AI-native.

US revenue cycle market
R1 RCM, taken private by TowerBrook and CD&R
revenue: New Mountain's Smarter Technologies roll-up
General Catalyst, set aside to buy services firms and run them on AI
billing companies, none above share

Their thesis: offshore labor and automation, without the clinical record.

One biller covers clinics instead of , because the agent does the chasing.

Then acquire billing businesses and run them on Operant: software margins on a services market, priced at of collections.

The plan Roadmap

Land, expand, own.

Land Today
  • AI-native EHR and scribe
  • Before, during and after the visit
  • Independent orthopedics
Expand
  • RCM and denial defense
  • Payments and point of sale
  • MSK neighbors: spine, pain, podiatry, PM&R
Own
  • Real-time ledger, reconciliation, payroll
  • AI-native RCM services
  • Procedure-heavy specialties beyond MSK

We run the business so doctors can practice medicine.

Operant Health

Doctors practice medicine. We run the rest.

Varun Murthy · Founder, Operant Health

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