{"id":93135,"title":"Avelis Health ⚔️ Preventing overpayments on medical claims","tagline":"We audit medical claims for self-insured employers and health plans","body":"TL;DR: We build AI agents to audit medical claims and identify errors due to coding, billing, and contract violations. Our voice agents automate the process of requesting medical records and recovering overpaid claims from providers.\n\nhttps://youtu.be/gL5IFvnwf6g\n\n**The Problem**\n\n* Self-insured employers and health plans lose $100B+ annually to overpayments on medical claims\n* Legacy audit systems only sample high-dollar claims, missing systematic errors\n* Patients pay the price with higher premiums, reduced coverage, and larger out-of-pocket expenses\n\n**The Solution**\n\n* Machine Learning: Our models review 100% of claims to identify errors and patterns over time\n* Voice AI: We automate the process of medical record retrieval with voice agents\n* Clinical validation with LLMs: Our AI agents review medical records to validate what was actually billed\n* Prevention \u0026 Recovery: We integrate into existing claim systems to prevent wrongful payments and recover funds already lost\n\n**Why we're building this**\\\nOver the past 9 years, Angel had three knee surgeries and fought down $250k in inflated hospital bills. We first built a consumer tool that saved $300k for 60 patients in a few months. Then we realized the bigger impact comes from fixing the problem at its source, before the bill ever reaches the patient.\n\n**Backgrounds:**\n\nAngel studied CS/Econ at Harvard and is a 3x founder. He scaled his first company to 60+ enterprise partnerships with financial institutions (Goldman Sachs, JPMorgan, Bank of America). In 2021, he and Ahmad founded Zuvy, a fintech company based in Nigeria, which was acquired by a PE firm in 2025. Earlier, Ahmad built healthcare data platforms for the Nigerian government, serving 20M+ people.\n\n**Get a risk-free claims audit at [avelishealth.com](http://avelishealth.com).**\n\n![uploaded image](/media/?type=post\u0026id=93135\u0026key=user_uploads/89898/2edb2c0f-4e8a-4e9b-bf8f-37918ec91b39)\n\n","slug":"OEB-avelis-health-preventing-overpayments-on-medical-claims","created_at":"2025-08-19T06:39:38.032Z","updated_at":"2026-05-25T04:31:54.967Z","total_vote_count":66,"url":"https://www.ycombinator.com/launches/OEB-avelis-health-preventing-overpayments-on-medical-claims","share_image_url":"https://www.ycombinator.com/media/?type=post\u0026id=93135\u0026key=user_uploads/89898/2edb2c0f-4e8a-4e9b-bf8f-37918ec91b39","company":{"id":30734,"name":"Avelis Health","slug":"avelis-health","url":"https://avelishealth.com","logo":"https://bookface-images.s3.amazonaws.com/small_logos/9759643303306b86f190396a0aa959a693947140.png","batch":"Summer 2025","industry":"Healthcare","tags":[],"search_path":"https://bookface.ycombinator.com/company/30734"}}