Cenote - Back office automation for specialist medical clinics

tl;dr

We work with specialist clinics to identify their biggest administrative blockers and deploy custom AI to resolve them. Right now, we’re automating referral intake, reducing the time it takes for clinics to process new patients and accelerate revenue collection.

https://www.youtube.com/watch?v=u403AnLMSNE

Problem

Specialist clinics struggle with slow, manual referral processing, leading to revenue delays, administrative overload, and patient drop offs. The biggest bottlenecks we've uncovered:

• Referral processing is manual and slow. Clinics receive thousands of referrals per month, requiring extensive manual effort to extract and enter data.
• Medical necessity verification is tedious. Clinics must determine if a referral meets insurance criteria, often requiring days of back-and-forth with primary care providers for missing information.
• Insurance approvals are a major roadblock. Clinics waste days negotiating with insurers to confirm reimbursement eligibility before scheduling treatment.

These inefficiencies cause 40-60% of referrals to drop off and costs the U.S. healthcare system over $150 billion annually. The administrative burden is also immense, with an average of 4.3 administrative staff per doctor in the American healthcare system.

Solution

Cenote eliminates the referral-to-treatment bottleneck, allowing clinics to focus on patient care while accelerating revenue collection.

• Automated data extraction: We categorize and extract key referral details the moment they hit the clinic’s inbox.
• Seamless medical necessity verification: If critical referral data is missing, our system auto-requests the necessary information via the preferred form of digital communication.
• AI-powered insurance authorization: Our AI callers handle insurance approvals, freeing clinic staff to focus on higher-value tasks.

Validate page allows staff to easily confirm extracted data

Team

Kofi was formerly a software engineer for Promise (YC W18), a gov-tech company. He is leveraging his experience building AI products for state governments to delight folks in the healthcare industry.

Ajani spent 2.5 years before this as an early stage VC at Base10 -- investing $30M in seed and series A stage companies

Kristy worked on carbon accounting engines at Watershed Climate and is experienced in working in highly regulated spaces. She developed a wide set of engineering expertise from her time at several tech companies, including Google, PayPal, Cockroach Labs.

ASK

If you know someone who owns or works at a specialist medical practice (e.g. sleep centers, specialty pharmacies, medical supply store), please introduce us. You can reach us at founders@joincenote.com.