The Problem

In the United States, 15-25% of every healthcare dollar goes toward administrative tasks. This hidden tax drives up the cost of care, overburdens clinicians, and ultimately keeps best-in-class treatments out of reach for many. Complex, high-variance processes—slowed by policy decisions and fragmented technology—have built a system where automation has struggled to make real headway.

Our Perspective

I. Complexity

From prior authorization and coding to billing and payment, healthcare administration involves multiple steps demanding human-level reasoning. Technology often solves one piece of the puzzle, but fails to navigate the entire process seamlessly.

II. High Variance

The U.S. has thousands of insurers, each with its own requirements and communication standards. This variance forces providers to juggle an ever-changing set of rules, forms, and portals—making automation a perpetual challenge.

III. Viscosity

Healthcare's internal friction—like fragmented data standards and reliance on non-digital channels (fax, phone)—slows the adoption of new tech. Even when a portion of the workflow is digital, the rest still demands manual intervention.

Our Vision

We believe modern AI can finally tackle these structural problems. Advances in natural language understanding and multi-modal capabilities empower machines to process complex data, handle different platforms, and adapt to each provider's unique processes. Rather than replacing existing systems, AI can act as digital staff, blending into your workflows the same way a human would.

Our Solution

We're building Akomi to automate administrative operations for healthcare providers, starting with prior authorization—a notoriously manual, high-cost process.

I. Auto-piloting Existing Systems

Akomi's AI agents navigate payer portals and handle phone, fax, or digital standards like X-12. Providers don't have to reconfigure their current workflows—Akomi works alongside them.

II. Learning Your Trade-Craft

Every organization develops its own playbook. Akomi adapts to your unique processes, ingesting clinic-specific rules, best practices, and insurer guidelines to maximize claim approvals.

III. Being Factually Grounded

Akomi references insurance policies, ICD/CPT code definitions, and patient records with superhuman accuracy. We ensure every PA submission is backed by the exact documentation required.

Why Prior Authorization?

I. Highest Cost, Lowest Automation

This process has the greatest potential for cost savings and efficiency gains.

II. Domain-Specific Complexity

It requires medical know-how and multiple interactions (payer portals, EHRs, forms). A successful AI solution here paves the way for broader automation.

III. Clinician Burnout

Nearly all physicians say PAs contribute to their burnout. Eliminating this hassle directly impacts care quality and staff well-being.

The Road Ahead

We're starting with Prior Authorization, but our vision encompasses the entire revenue cycle management (RCM) workflow, from eligibility checks and claim submissions to final reimbursement. By deploying AI agents to handle these repetitive and error-prone tasks, we will give clinicians the freedom to concentrate on what they do best: caring for patients.

- Akomi Team