Avelis Health
Avelis Health is an AI-powered medical claims audit platform that uses machine learning, clinician review, and voice AI agents to identify and recover billing, coding, and contract errors for TPAs and self-insured employer health plans on an outcome-based pricing model.
- Company typePrivate
- Founded2025
- HeadquartersSan Francisco, United States
- Headcount1–10
- GTM typeB2B
- OfferingSoftware
What Avelis Health does
Avelis Health is an early-stage healthcare technology company that has built an AI-powered payment integrity platform for medical claims auditing. The company's core product, Payment Integrity, applies machine learning models combined with clinician-in-the-loop review to audit 100% of medical claims—rather than sampling high-dollar claims only—and to identify hidden billing, coding, and contract errors. The platform is paired with an AI Call Center sub-product that deploys proprietary voice AI agents to autonomously conduct provider outreach, navigate disputes, negotiate recoveries, and reconcile payments without human-initiated calls. The company's stated AI capabilities span anomaly detection on structured claims data, parsing of unstructured clinical notes, speech-driven autonomous agent workflows, and end-to-end process automation of the post-pay recovery cycle.
Avelis sells to Third Party Administrators (TPAs) and self-insured employer health plans, addressing pain points such as manual claims review, $2-to-recover-$1 cost ratios, and provider abrasion. The company uses an outcome-based pricing model—it charges only on actual savings recovered, with no implementation fees, no subscription, and no per-seat costs—and ingests claims in standard formats (CSV, 837/835). Go-to-market is enterprise direct sales supported by a content and podcast-led inbound motion, with demo booking as the primary conversion mechanism.
The company was founded in 2025, is headquartered in San Francisco, operates as Avelis, Inc., and employs 1–10 people. It is HIPAA-compliant as a Business Associate, holds Privacy and Security Policies, and processes Protected Health Information with encryption in transit and at rest. Avelis raised a $500,000 pre-seed round in June 2025 led by Y Combinator, with participation from Rebel Fund and ZAKA VC. Co-founders Angel Onuoha (CEO) and Ahmad Shehu (CTO) lead the company.
Avelis Health firmographics
Firmographics- Name
- Avelis Health
- Legal name
- Avelis, Inc.
- Website
- https://avelishealth.com
- Company type
- Private
- Founded year
- 2025
- Operating status
- Operating
- Headcount range
- 1–10 employees
- Short description
- Avelis Health is an AI-powered medical claims audit platform that uses machine learning, clinician review, and voice AI agents to identify and recover billing, coding, and contract errors for TPAs and self-insured employer health plans on an outcome-based pricing model.
- Ownership category
- akta.pro rank
Avelis Health industry classification
Industry- Product category
- Healthcare Payment Integrity
- NAICS
- Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (518), Financial Transactions Processing, Reserve, and Clearinghouse Activities (52232)
- SIC
- Services-Prepackaged Software (7372), Services-Computer Integrated Systems Design (7373)
- akta.pro primary industry
- Accounts Receivable (A/R) & Collections Management (HLACACAJ)
- akta.pro secondary industry
- Denials Management & Appeals (HLACACAH)
Keywords
Where Avelis Health is headquartered
LocationHeadquarters
- HQ city
- San Francisco
- HQ country
- United States
- HQ region
- North America
Markets served
Avelis Health business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Technology or R&D, Personnel, Infrastructure, Operations, Marketing or Sales
Revenue model
- Outcome-Based Savings Recovery: Avelis charges only for actual savings recovered. No implementation fees, no setup costs. The company earns a percentage or fixed fee contingent on successful recovery of overpayments from medical claims. This aligns incentives with customers and reduces upfront risk.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Outcome Based/ Performance | Pay-as-you-go | Outcome-based pricing with zero upfront costs |
Distribution channels1 record
Marketing channels3 records
Avelis Health product offering
Product offeringCore offering
Avelis Health provides an AI-powered payment integrity platform that audits 100% of medical claims using machine learning combined with clinician review to identify billing, coding, and contract errors. The platform deploys proprietary voice AI agents to autonomously conduct post-payment recovery outreach to healthcare providers, negotiating and resolving claim disputes at scale for Third Party Administrators (TPAs) and self-insured employer health plans.
Product overview
Avelis Health operates as a unified AI-powered platform for medical claims payment integrity. The core product, Payment Integrity, combines machine learning and clinician review to audit 100% of claims and recover hidden billing, coding, and contract errors. This platform is paired with a built-in AI Call Center module that deploys voice AI agents to autonomously negotiate and resolve post-payment recoveries with providers. The offering is designed for TPAs and self-insured employer health plans, with no implementation fees and a performance-based pricing model where the company charges only for actual savings recovered.
Differentiator
Problem solved
Functional benefit
Products and services
- Payment Integrity AI-powered claims auditing platform that reviews 100% of medical claims with machine learning and clinician oversight to identify and recover hidden billing, coding, and contract errors for TPAs and self-insured employer health plans.
Quantifiable outcome
- Save 2-7% on plan spend annually
- +1 more outcomes
Companies that use Avelis Health
Customer profileSegments2 records
Ideal customer profiles2 records
Avelis Health technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
AI capability8 records
Feature5 records
Avelis Health partnerships and signals
Strategic signalScale indicators2 records
Recent moves4 records
Expansion highlights4 records
Avelis Health competitors and assessment
Company assessmentDirect peers
- SmarterDx: AI platform that audits clinical documentation and hospital billing to capture missed revenue and ensure coding accuracy. Closely comparable to Avelis because both apply AI plus clinical review to identify errors that traditional sampling misses, though SmarterDx is hospital-side and Avelis is payer/TPA-side.
- AKASA: Applies AI and automation to the healthcare revenue cycle for providers and payers. Comparable to Avelis because both target revenue cycle workflows with AI-led automation and pitch automation as a path to lower-cost, higher-accuracy operations.
- Anterior: AI platform used by payers to automate prior authorization and utilization management decisions. Comparable to Avelis because both sell AI-native tools to payers/TPAs to replace manual clinical and administrative review at scale.
Emerging players
- Cohere Health: AI-driven prior authorization and utilization management platform serving health plans. Comparable to Avelis because both target payer-side clinical decision workflows with AI to reduce cost and turnaround time.
- Tennr: AI platform automating healthcare administrative workflows such as patient intake, referrals, and document processing. Comparable to Avelis because both apply AI to manual healthcare back-office processes to reduce cost and turnaround time.
- Clarify: Healthcare analytics and AI platform serving payers and providers with insights on cost, utilization, and quality. Comparable to Avelis because both sell AI-driven analytics to payers and TPAs to identify savings opportunities in claims and care delivery.
Broad incumbents
- Cotiviti: Established payment integrity and claim accuracy vendor serving payers and TPAs. Most direct incumbent comparable to Avelis — both focus on identifying and recovering overpayments, but Cotiviti operates at far greater scale with sampling- and rules-based methodologies.
- Optum (UnitedHealth Group): Diversified healthcare services and RCM/payment integrity arm of UnitedHealth Group, including the former Change Healthcare. Comparable to Avelis because Optum offers payment integrity, claims editing, and recovery at massive scale — the primary competitive backdrop for any payer-side AI startup.
- MultiPlan: Public cost-containment and payment integrity company serving payers, TPAs, and self-funded employers. Comparable to Avelis because both target overpayment recovery on behalf of health plans and self-insured employers, though MultiPlan is the established scaled incumbent.
- Zelis: Healthcare payments optimization and cost containment vendor serving payers, providers, and employers. Comparable to Avelis because Zelis addresses payment integrity, repricing, and recovery workflows that overlap with Avelis's core product.
Market position
Strengths4 records
Weaknesses4 records
Competitive moat3 records
Key risks5 records
Key highlights6 records
Customer concentration
Avelis Health social profiles
Digital presenceAvelis Health compliance and trust
Trust signalCompliance1 record
Avelis Health financial estimates
Financial estimateRevenue estimate
Valuation estimate
Avelis Health leadership team
Management profileNumber of profiles
Profiles2 records
Avelis Health funding detail
Funding detailFunding overview
Funding rounds1 record
Investors4 records
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Avelis Health M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Avelis Health
What does Avelis Health do?
Avelis Health provides an AI-powered payment integrity platform that audits 100% of medical claims using machine learning combined with clinician review to identify billing, coding, and contract errors. The platform deploys proprietary voice AI agents to autonomously conduct post-payment recovery outreach to healthcare providers, negotiating and resolving claim disputes at scale for Third Party Administrators (TPAs) and self-insured employer health plans.
Is Avelis Health a public or private company?
Avelis Health is a private company. It is classified as venture growth investor backed and is currently operating.
When was Avelis Health founded?
Avelis Health was founded in 2025. It employs 1 to 10 people.
Where is Avelis Health based?
Avelis Health is headquartered in San Francisco, United States, in the North America region.
How does Avelis Health make money?
One revenue line is on record: outcome-Based Savings Recovery.
Who are Avelis Health's main competitors?
Direct peers on record are SmarterDx, AKASA and Anterior. Emerging players are Cohere Health, Tennr and Clarify. Broad incumbents are Cotiviti, Optum (UnitedHealth Group), MultiPlan and Zelis.
Does Avelis Health have an API?
No public API is recorded for Avelis Health.
What industry is Avelis Health in?
Avelis Health's product category is Healthcare Payment Integrity. Its primary akta.pro industry code is HLACACAJ, Accounts Receivable (A/R) & Collections Management, with a secondary code of HLACACAH, Denials Management & Appeals. Its NAICS code is 518 and its SIC code is 7372.