Hospitals are finding it harder than ever to collect payment for the care they provide, which is one of the many factors causing widespread financial strain among the nation’s providers. Many hospitals have invested significantly in revenue cycle optimization technologies, be it standalone tools or those integrated with EHR systems — but the situation hasn’t improved.
This week, New Mountain Capital launched a new company that will compete with established revenue cycle management companies and try to beat them at their own game. The private equity firm formed the new entity, called Smarter Technologies, by combining three separate platforms it had already acquired: SmarterDx, Thoughtful.ai and Access Healthcare.
With established players like Epic, Change Healthcare and R1 RCM already vying for customers, one might wonder: does healthcare really need another revenue cycle management company?
Jeremy Dekinsky, CEO of Smarter Technologies, thinks the answer is yes — and he explained why on Tuesday during a fireside chat with Arundhati Parmar, MedCity News’ editor-in-chief, at the publication’s INVEST conference in Chicago.
Dekinsky’s company promises to improve payment accuracy and deliver measurable cost reductions through AI-powered automation.
Healthcare accounts for nearly 20% of the nation’s GDP, yet it delivers a frustrating, opaque experience for patients — often involving surprise bills and finger-pointing between providers and payers, he pointed out.
“We’re at a moment of profound societal fear about how care is delivered in this country,” Dekinsky declared.
He described something that happens every day in the U.S.: despite having insurance, a patient receives a confusing surprise bill months after receiving care and is forced to navigate between the provider and the insurer to resolve the issue by themself.
Dekinsky also reminded the audience that the country spends about $950 billion a year on healthcare administration — a staggering inefficiency due in large part to an outdated administrative technology infrastructure
“The transactional chassis that we use to adjudicate healthcare in this country was chartered and created by the Balanced Budget Act of 1997, where we came live with a series of ANSI standard transactions for claims, eligibility, prior authorization and payment. And it is now 2025, and we’re running on the same transactions. They got upgraded once to accommodate ICD-10 codes. It’s absurd,” he explained.
On top of that, rising labor costs and the shift from traditional Medicare to Medicare Advantage — which pays less and is harder to bill — are eroding provider margins, Dekinsky added.
Additionally, denial rates have nearly doubled in the past five years as payers increasingly use AI to scrutinize claims, often asking providers to submit additional medical records to determine medical necessity, he stated. He noted that payers also “have a whole series of AI tools that have been deployed to claw back claims that have already been paid.”
Despite widespread adoption of EHRs over the past couple of decades, the infrastructure to support seamless data exchange is lacking, with delays and claim holds remaining all too common, Dekinsky said.
“When you add all that up, I can’t think of a better use case for the application of AI than the transactional bowels of U.S. healthcare,” he declared.
In his view, the U.S. doesn’t just need another healthcare revenue cycle management company — it needs one that is more cost-efficient. Most revenue cycle management vendors charge their providers a fee that represents 5–9% of collections — but Smarter Technologies aims for 1–1.5%, Dekinsky remarked.
The company is able to provide this affordable model due to its AI agents operating across payer portals and billing systems, as well as its low-cost, scalable offshore BPO, he said.
Dekinsky added that Smarter Technologies’ agents are trained not to make mistakes.
“[BPOs] say, we’ll do a 5% quality audit and we’ll guarantee you a 95% quality score. That means that an extraordinary number of mistakes are getting through, and those are [surprise] bills or authorizations that weren’t completed for a visit,” he explained.
He said Smarter Technologies’ agents don’t make those same mistakes because they follow strict procedures, reason when necessary and escalate edge cases to a human-in-the-loop team so they can be resolved appropriately.
Plenty of companies have promised to fix healthcare’s broken revenue cycle before — but Dekinsky believes Smarter Technologies will stand out by its ability to deliver on both accuracy and affordability.
The company currently serves more than 200 customers, including more than 60 health systems.
Photo: Nick Fanion, Breaking Media
