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!
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.
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.
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.
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.
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?
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.
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.
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!
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
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.
