Emergency injuries should be handled in an ER, where patient care comes first. They won’t bother trying to get your insurance information until after you’ve been treated and stabilised.
As far as specialists go… when I go to a specialist, they key in my insurance card and have an approval within seconds. Of course with a serious injury I’d be at an ER not sitting around a specialist’s waiting room.
My biggest concern, though, is this will be used to replace back office staff and serious mistakes will get made, patients will be the ones stuck with figuring out insurance nightmares - there won’t be any back office staff left to help, and providers will be given heavier workloads with less assistance. And no, I don’t trust LLMs to make medical decisions.
1oooqooq 3 days ago [-]
> in an ER, where patient care comes first. They won’t bother trying to get your insurance information until after you’ve been treated and stabilised
speaking from 1st hand experience, you are wrong.
> this will be used to replace back office staff and serious mistakes will get made, patients will be the ones stuck with figuring out insurance nightmares
on this you're spot on!
trollbridge 19 hours ago [-]
Registration should have zero to do with providing patient care; if it does, you’ve got a great grounds for a lawsuit if anything goes wrong, and it’s also blatantly illegal for an ER to do that.
Last few times I’ve been in the ER, the registration guy didn’t come around until we were already in an ER hospital bed and waiting around after being triaged.
There may be really terribly run hospitals who risk lawsuits (or have already been sued for millions) - I would avoid such places.
prawn 4 days ago [-]
In the screenshot on your site alongside the "No more typos" feature, you have a typo: "United Helathcare". Also an error in the 'extraction' of the phone number ("-55-").
ansong99 3 days ago [-]
Thx for pointing these out !
mexicocitinluez 3 days ago [-]
Do you not see the irony in that?
xenospn 4 days ago [-]
Good luck getting into brick and mortar clinics (I really mean it!). It is so incredibly hard to get established, small businesses to do anything regarding IT or tech. They are all incredibly overworked and the last thing they want to deal with is tech or learning how to use a new platform.
ansong99 4 days ago [-]
Yeah some of our first customers have been smaller/brick and mortar clinics! We find getting in-person time with these owners and personally offering to train staff goes a long way in ensuring trust and confidence in using our product. On that note we have found conferences and meet-ups super helpful.
trollbridge 3 days ago [-]
Is part of your value proposition that your product will replace some of the staff?
taikon 4 days ago [-]
What if it fails to mention a critically important piece of info? Would your company be liable or would I as a physician have be liable for its mistake?
ansong99 4 days ago [-]
Great question. Our software is designed to assist, not replace, the physician’s role in making clinical decisions. It accelerates the time between an inbound referral and patient care by extracting and organizing information, but the final review always remains with the physician.
To minimize risk, we implement safeguards to prevent hallucinations, and our system is built to flag potential missing or unclear information rather than override clinical judgment.
taikon 3 days ago [-]
So I'd still need to do a full chart review? I'm not sure it would save me any significant amount of time.
reureu 4 days ago [-]
When you say you integrate with EHRs using RPA or API, are you using FHIR for the API connection? Or what interop standards are you using?
ansong99 4 days ago [-]
We're doing both RPA and API integrations now - depending on what works best for any given EHR/clinic. FHIR connections are on the way.
tyre 3 days ago [-]
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Onavo 4 days ago [-]
There are so many companies in the transcription -> EMR -> insurance automation space. What differentiates you?
the_sleaze_ 4 days ago [-]
In fairness, I think of EMR/EHRs as thin wrappers over insurance automation to begin with.
mexicocitinluez 3 days ago [-]
Most of them sell to the C-suite first (money, reports, and compliance) and due to that those areas often get the most focus. I believe it's why a large portion of EMR's suck balls.
So yea, teh central question in most systems isn't "Is this patient getting better" it's "Can I bill this visit?"
ansong99 4 days ago [-]
I’d actually love to hear more—can you expand on this point here?
trollbridge 3 days ago [-]
Not sure if you are familiar with payor systems or not, but an EMR/EHR basically gathers all the information sent to a payor system and prepares it in the format the payor wants.
A good EMR/EHR does the same thing with referrals and authorisations, and bigger hospitals will have direct real time links to insurers to approve those referrals. Most of them happen instantly. The ones that aren’t require manual review from a medical practitioner who workers for the insurer.
I do not understand how a cobbled-together LLM based system will do this better than the existing EMRs.
ansong99 4 days ago [-]
For sure. At Cenote, we’re obsessed with ensuring our software delivers real value to clinics, rather than just adding another point solution—or worse, overwhelming them with multiple fragmented tools. As mentioned in another thread, many of these clinics aren’t the most tech-forward, and we've found that in-person discussions often reshape our bundle (e.g., prioritizing referral intake over insurance verification). This tailored approach ironically simplifies integration and maximizes ROI for our customers.
redeux 4 days ago [-]
> rather than just adding another point solution—or worse, overwhelming them with multiple fragmented tools ...
> This tailored approach
It really is AI slop all the way down now isn't it?
6stringmerc 4 days ago [-]
Thanks for clarifying that you have little to no interest in enhancing the quality of outcomes or success of treatment or quality of life for patients! Very telling!
ansong99 4 days ago [-]
Not our intention at all. Let me know what gave you that impression? We generally see the incentives of the owners we work with as very aligned with providing the best quality of care to their patients, and see our software as accelerating delivery of that care
achillesheels 4 days ago [-]
Good luck with HIPAA! Maybe, unsolicited advice and all, target patient recruitment CROs first? They seem to be “edgier” than big hospicorp…peace
potatoman22 4 days ago [-]
> The OCR returns confidence intervals. If the LLM reasons over OCR that it is not confident about, we flag this in the UI to the end user and ask a human to review before moving forward.
This seems helpful, but what if the flagging system misses an error? Do you measure the accuracy of your various systems on your customer data? These are typically the more challenging aspects of integrating ML in healthcare.
4 days ago [-]
HPMOR 4 days ago [-]
This seems really interesting. I'm curious how this compares to fully automated EHRs similar to what Modernizing Medicine has built for Dermatology practices. Also there's a startup called DayDental which does RCM, for dental practices. Additionally, are you planning on integrating with large EHRs like Epic/Cerner, or is this for smaller EHRs like SimplePractice?
ansong99 4 days ago [-]
I appreciate the interest! We love the efforts at the federal level and by other tech companies to modernize healthcare. We see AI agents as the next step in this evolution—where nearly all back-office needs can be productized into AI, enabling Cenote to provide every clinic with a best-in-class back-office team.
To your latter question, we’ve spoken with many hospital networks using Epic that would benefit significantly from our software. However, integrating with larger EHRs is notoriously labor-intensive, so for now, we’re prioritizing more accessible clinics.
trollbridge 3 days ago [-]
Large hospital systems with EPIC can often get near-instant insurance approvals. Interestingly, they’ve done this without using AI.
A few examples are Cleveland Clinic which has instant approvals for a wide variety of specialties with most of the insurances they’re panelled on. For another example, OhioHealth had both instant approvals and instant copayment/deductible estimates at the point of service back in… 2013 (at least with Medical Mutual).
Back office workers are skilled workers who often know how to do things like navigate an insurer who denies things they shouldn’t be denying. How is an automated system going to do that?
jermaustin1 3 days ago [-]
Same with my doctor/hospital system as well. They use Epic. I will request an appointment, and I know within a minute of clicking accept that insurance has accepted the appointment, and how much I will owe.
Only once did I not get approved (for a sleep study), so I called the doctor's office, and they got me approved within a couple more minutes after pushing something else, and I got a new estimate in my portal and via text letting me know it was covered.
If the insurance kicked back that appointment and some AI was responsible for getting it approved on the doctor end (AI is definitely used on the insurance end), who do I call?
I'm all for AI helping you out, possibly extracting useful information from paper forms, but we haven't used paper forms in a LONG time.
I'm not a doctor, but my wife is a Licensed Marriage and Family Therapist, and she's tried at my insistence to use some of the AI software for her practice, and it all falls flat to the point she will not try anymore and has sworn off AI completely. She doesn't use Siri, her browser blocks the google AI results, and most of her research is in her medical books anyway.
AI is the future, but today is the present.
quinnjh 3 days ago [-]
Super cool !
What OCR are you using for confidence ? Tesseract? Curious how you flag for Humam in the loop.
maz1b 4 days ago [-]
As a full stack engineer + doctor, always good to see innovation and ideas in this space. Best of luck.
ansong99 4 days ago [-]
Thanks, we appreciate the support :)
aitchnyu 3 days ago [-]
Umm, how did you learn each profession and how many hours per week do you spend on each?
maz1b 4 hours ago [-]
Been hacking away on projects and programming since I was 7 years old (covering engineering side). Medical school came later as a backup and also a passion, but also because my vision to impact a billion people seems most attainable through the combination of innovation in tech+healthcare.
cfu28 2 days ago [-]
Can't speak for them, but its not super common so they're isn't going to be one answer that represents all doctors in this niche.
For me: Got CS degree in undergrad, worked as a SWE full time for for 2 years, did OSS and some consulting work in med school (0-20hrs/week). Now my work is primarily clinical as a resident ~65 hrs/week, with just 5-10hrs/week on programming.
MisterKent 4 days ago [-]
Maybe I'm alone in this, especially on this site.
I'm beginning to become disillusioned with these things. We're replacing like 1000s of jobs with a system that will almost certainly do a worse job than before. And the money is split between hospital shareholders and VC.
I get that there's an efficiency (market) gain here. But these AI startups that target existing sector automations seem like they're most just attempting to drive wealth inequality in a period of already terrible westh inequality.
ansong99 4 days ago [-]
These are topics that we at Cenote also mull over. Right now how we see things are:
1. If we perform worse, we won't deliver any value to the owner and we'll soon be out of a business
2. It's our bet that AI agents can actually perform these monotonous, detailed tasks very well and that this will free up humans to take on higher value work.
3. That higher value work being: calling patients, educating them, helping facilitate patient care. This is ultimately the work the owners we talk to are excited for their teams to take on!
harvey9 3 days ago [-]
Depends on how you perform worse (if you do so). It takes a while for medical errors to occur (in human or automated systems ) and then there is a lag before consequences for the patient, and not all negative outcomes lead to complaints or lawsuits.
choilive 4 days ago [-]
Is a world where nobody needs to work a utopia or dystopia?
daveguy 4 days ago [-]
At this point a world where no one needs to work would be dystopian. Are we going to rely on the benevolence of our increasingly for-profit government. On the benevolence of our oligarchs to allow us the labor the robots aren't capable of doing yet? I see the promise of post-scarcity, but I haven't seen anything close to the technology it would require. Just greed. Corner cutting and rent collection for profit. I'd rather not see our medical back offices enshittified.
choilive 3 days ago [-]
The insurance companies have already enshittified the medical back office to levels beyond comprehension.
daveguy 3 days ago [-]
Yeah, but why "extract value" out of every note? Seems like a better application for open source and non profits.
mexicocitinluez 3 days ago [-]
You're not alone.
I work in healthcare and it's a sea of bullshit all the way down.
And most of the time they're being started by kids right out of school with ZERO clinical experience.
ilrwbwrkhv 3 days ago [-]
Put your seat belt on fellas. The future is coming when your stomach cancer will go unnoticed since AI is doing the work. A correction will happen and then these will get banned.
3 days ago [-]
fdsfad 4 days ago [-]
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fdasdffda 4 days ago [-]
[dead]
browningstreet 4 days ago [-]
Cenote?
C Note?
$100?
Really?
ciguy 4 days ago [-]
A cenote is an inland tidal pool connected to the ocean. Mostly found along the Riviera Maya in Mexico.
ansong99 4 days ago [-]
Aha yes we were inspired by this latter definition, which explains the turquoise branding on our site.
Mesmoria 4 days ago [-]
And at least in my mind associated with Maya rituals.
ciguy 4 days ago [-]
Yes some of them are sacred sites for the Mayan peoples.
User23 3 days ago [-]
I'm thinking GP is saying that maybe human sacrifice rituals aren't the best look for a medical tech startup?
bshacklett 2 days ago [-]
Perhaps not a good look, but oddly fitting given the current state of affairs.
vladsanchez 3 days ago [-]
Still have to change WebFlow's Entropy Site Template Title ;)
Rendered at 14:37:07 GMT+0000 (UTC) with Wasmer Edge.
As far as specialists go… when I go to a specialist, they key in my insurance card and have an approval within seconds. Of course with a serious injury I’d be at an ER not sitting around a specialist’s waiting room.
My biggest concern, though, is this will be used to replace back office staff and serious mistakes will get made, patients will be the ones stuck with figuring out insurance nightmares - there won’t be any back office staff left to help, and providers will be given heavier workloads with less assistance. And no, I don’t trust LLMs to make medical decisions.
speaking from 1st hand experience, you are wrong.
> this will be used to replace back office staff and serious mistakes will get made, patients will be the ones stuck with figuring out insurance nightmares
on this you're spot on!
Last few times I’ve been in the ER, the registration guy didn’t come around until we were already in an ER hospital bed and waiting around after being triaged.
There may be really terribly run hospitals who risk lawsuits (or have already been sued for millions) - I would avoid such places.
To minimize risk, we implement safeguards to prevent hallucinations, and our system is built to flag potential missing or unclear information rather than override clinical judgment.
So yea, teh central question in most systems isn't "Is this patient getting better" it's "Can I bill this visit?"
A good EMR/EHR does the same thing with referrals and authorisations, and bigger hospitals will have direct real time links to insurers to approve those referrals. Most of them happen instantly. The ones that aren’t require manual review from a medical practitioner who workers for the insurer.
I do not understand how a cobbled-together LLM based system will do this better than the existing EMRs.
> This tailored approach
It really is AI slop all the way down now isn't it?
This seems helpful, but what if the flagging system misses an error? Do you measure the accuracy of your various systems on your customer data? These are typically the more challenging aspects of integrating ML in healthcare.
To your latter question, we’ve spoken with many hospital networks using Epic that would benefit significantly from our software. However, integrating with larger EHRs is notoriously labor-intensive, so for now, we’re prioritizing more accessible clinics.
A few examples are Cleveland Clinic which has instant approvals for a wide variety of specialties with most of the insurances they’re panelled on. For another example, OhioHealth had both instant approvals and instant copayment/deductible estimates at the point of service back in… 2013 (at least with Medical Mutual).
Back office workers are skilled workers who often know how to do things like navigate an insurer who denies things they shouldn’t be denying. How is an automated system going to do that?
Only once did I not get approved (for a sleep study), so I called the doctor's office, and they got me approved within a couple more minutes after pushing something else, and I got a new estimate in my portal and via text letting me know it was covered.
If the insurance kicked back that appointment and some AI was responsible for getting it approved on the doctor end (AI is definitely used on the insurance end), who do I call?
I'm all for AI helping you out, possibly extracting useful information from paper forms, but we haven't used paper forms in a LONG time.
I'm not a doctor, but my wife is a Licensed Marriage and Family Therapist, and she's tried at my insistence to use some of the AI software for her practice, and it all falls flat to the point she will not try anymore and has sworn off AI completely. She doesn't use Siri, her browser blocks the google AI results, and most of her research is in her medical books anyway.
AI is the future, but today is the present.
For me: Got CS degree in undergrad, worked as a SWE full time for for 2 years, did OSS and some consulting work in med school (0-20hrs/week). Now my work is primarily clinical as a resident ~65 hrs/week, with just 5-10hrs/week on programming.
I'm beginning to become disillusioned with these things. We're replacing like 1000s of jobs with a system that will almost certainly do a worse job than before. And the money is split between hospital shareholders and VC.
I get that there's an efficiency (market) gain here. But these AI startups that target existing sector automations seem like they're most just attempting to drive wealth inequality in a period of already terrible westh inequality.
1. If we perform worse, we won't deliver any value to the owner and we'll soon be out of a business
2. It's our bet that AI agents can actually perform these monotonous, detailed tasks very well and that this will free up humans to take on higher value work.
3. That higher value work being: calling patients, educating them, helping facilitate patient care. This is ultimately the work the owners we talk to are excited for their teams to take on!
I work in healthcare and it's a sea of bullshit all the way down.
And most of the time they're being started by kids right out of school with ZERO clinical experience.
C Note?
$100?
Really?