Arbiter
Arbiter is an AI-powered care orchestration platform that connects patients, providers, and payers to automate referrals, prior authorizations, and care coordination. Its Record-Action-Alignment model unifies clinical, financial, and policy data to reduce U.S. healthcare fragmentation.
- Company typePrivate
- Founded2025
- HeadquartersNew York, United States
- Headcount11–50
- GTM typeB2B
- OfferingSoftware
What Arbiter does
Arbiter AI, LLC is a New York-based healthcare technology company founded in 2025 that has built an AI-powered care orchestration platform connecting patients, payers, and providers. The company targets the nearly $1 trillion in annual U.S. healthcare waste caused by fragmented data, technology, and incentives, positioning itself as a "conductor" between payers and providers rather than another point-solution tool. Its platform is powered by a proprietary Record-Action-Alignment model in which the Record layer unifies clinical, financial, and policy data into a longitudinal patient record, the Action layer deploys agentic AI to recommend and automate next-best steps in real time, and the Alignment layer continuously monitors outcomes and updates the system.
The platform's modular products include Gap Detection & Clinical Triggers (surfacing referral opportunities from quality gaps and risk-adjustment data in the EMR), a Provider Graph & Routing Engine (matching patients to optimal providers on cost, quality, and availability), Automated Prior Authorizations (structuring payer criteria and codifying policy documents), and Patient Engagement & Scheduling (multi-channel outreach, real-time scheduling, reminders, and follow-up). The initial commercial application is real-time site-of-care optimization, with stated plans to extend into predictive healthcare management and disease prediction. Arbiter has reported onboarding 1,000+ clinicians within six months of launch.
The business model is a B2B enterprise SaaS play, with quote-based annual subscription pricing to payers, providers, and health systems, distributed through direct enterprise sales and an operator-backed cap table (TriEdge Investments, MFO Ventures, WindRose Health Investors, TPG, Summit Partners) whose members own or operate provider organizations, specialty groups, health plans, and MSOs. The company is deploying through strategic partnerships with a leading national payer and major provider networks, and it maintains offices in New York, San Francisco, and Boca Raton. The founding team and board combine operators from UnitedHealth, Cigna, VillageMD, Eli Lilly, One Medical, Oscar, Mount Sinai, and Kaiser Permanente with technologists from Meta, Apple, and Google.
Arbiter firmographics
Firmographics- Name
- Arbiter
- Legal name
- Arbiter AI, LLC
- Website
- https://arbiter.ai
- Company type
- Private
- Founded year
- 2025
- Operating status
- Operating
- Headcount range
- 11–50 employees
- Short description
- Arbiter is an AI-powered care orchestration platform that connects patients, providers, and payers to automate referrals, prior authorizations, and care coordination. Its Record-Action-Alignment model unifies clinical, financial, and policy data to reduce U.S. healthcare fragmentation.
- Ownership category
- akta.pro rank
Arbiter industry classification
Industry- Product category
- Healthcare Care Orchestration Software
- NAICS
- Software Publishers (5132)
- SIC
- Services-Prepackaged Software (7372)
- akta.pro primary industry
- Adherence, Reminders & Engagement Automation (Medication/Follow-up) (HLACAEAJ)
- akta.pro secondary industries
- End-to-End Enterprise AI Platforms (MLOps & Model Lifecycle Management) (HDAEANAA), Document, Workflow & Policy Servicing Automation (RPA/No-Code) (FSAGAGAK)
Keywords
Where Arbiter is headquartered
LocationHeadquarters
- HQ city
- New York
- HQ country
- United States
- HQ region
- North America
Offices4 records
Markets served
Arbiter business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Personnel, Technology or R&D, Marketing or Sales, Operations, Infrastructure
Revenue model
- Platform Licensing/Subscription: B2B healthcare technology platform licensed to payers, providers, and health systems. The platform unifies patients, payers, and providers on an intelligent platform to orchestrate care coordination, authorizations, and optimization.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Annual | Enterprise platform licensing for payers and providers |
Go-to-market motion1 record
Distribution channels2 records
Marketing channels4 records
Arbiter product offering
Product offeringCore offering
Arbiter sells an AI-powered care orchestration platform that unifies patients, payers, and providers on a single system to orchestrate and automate referrals, prior authorizations, and care optimization at scale. The platform is built on a Record-Action-Alignment model that integrates clinical, financial, and policy data, recommends and executes the next best action via agentic AI, and continuously monitors and aligns outcomes. Its first deployed application is real-time site-of-care optimization, and it is licensed to enterprise healthcare payers, providers, and health systems.
Product overview
Arbiter offers a modular AI-powered care orchestration platform that unifies patients, payers, and providers on one intelligent system. The platform is built on the Record-Action-Alignment model, which integrates clinical, financial, and policy data into a longitudinal patient record, then uses AI to automate actions and keep stakeholders synchronized. Key modules include: Gap Detection & Clinical Triggers (detects care opportunities in real-time), Provider Graph & Routing Engine (matches patients to optimal providers), Automated Prior Authorizations (streamlines approval workflows), and Patient Engagement & Scheduling (multi-channel outreach and appointment coordination). The initial application is real-time site-of-care optimization, with plans to expand toward predictive healthcare management.
Differentiator
Problem solved
Functional benefit
Products and services
- AI-Powered Care Orchestration Platform Enterprise software platform that unifies patients, payers, and providers on a single system to orchestrate and automate referrals, prior authorizations, and care optimization at scale. Built on the Record-Action-Alignment model that integrates clinical, financial, and policy data, uses agentic AI to recommend and execute next best actions, and continuously monitors outcomes. Licensed to enterprise healthcare payers, providers, and health systems on an annual subscription basis.
Quantifiable outcome
- Nearly $1 trillion in annual healthcare waste addressed through reduced fragmentation
- +4 more outcomes
Companies that use Arbiter
Customer profileNamed customers2 records
Segments3 records
Ideal customer profiles2 records
Arbiter technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
AI capability7 records
Feature4 records
Arbiter partnerships and signals
Strategic signalPartnerships
Two partnerships are on record, tiered core.
- Leading National PayercoreStrategic partnership for real-time site-of-care optimization. Arbiter's platform is delivered in partnership with this leading national payer and major provider networks, matching referrals to best-fit providers and automating authorizations.
- Major Provider NetworkscoreStrategic partnership for real-time site-of-care optimization. Arbiter's platform is delivered in partnership with a leading national payer and these major provider networks, enabling care coordination across the ecosystem.
Scale indicators8 records
Recent moves7 records
Expansion highlights6 records
Arbiter competitors and assessment
Company assessmentDirect peers
- Cohere Health: AI-powered prior authorization and utilization management platform serving payers and providers. Most direct competitor to Arbiter's Automated Prior Authorizations and care orchestration modules.
- Bamboo Health: Real-time care coordination network connecting behavioral health, acute, and post-acute providers via care notifications, referrals, and analytics. Overlaps with Arbiter's referral management and patient engagement capabilities.
- Phreesia: Patient intake, scheduling, and engagement platform for ambulatory care and health systems. Overlaps with Arbiter's Patient Engagement & Scheduling module and care-gap closure workflows.
- Evolent Health: Value-based care platform that orchestrates specialty care management, provider enablement, and payer-provider alignment. Competes with Arbiter in care coordination and site-of-care optimization for health plans.
- Health Catalyst: Data and analytics platform for healthcare systems that supports care management, population health, and operational improvement. Comparable to Arbiter's longitudinal Record layer and outcome alignment.
- Kyruus Health: Provider directory, search, and scheduling platform powering patient-provider matching and online scheduling for health systems. Directly comparable to Arbiter's Provider Graph & Routing Engine and scheduling modules.
Emerging players
- Luma Health: Patient engagement platform focused on scheduling, referrals, and automated outreach for provider organizations. Adjacent competitor in patient-side workflows of the care orchestration stack.
- Olive AI: Healthcare automation AI platform targeting revenue cycle, supply chain, and prior authorization workflows for hospitals. Closest historic analog of an AI-native healthcare orchestrator — cautionary tale on enterprise scaling in this space.
Broad incumbents
- R1 RCM: Revenue cycle management and patient access platform serving health systems, with workflow automation spanning scheduling, prior auth, and financial clearance. Adjacent competitor in care orchestration and prior auth.
- Optum (UnitedHealth Group): Largest healthcare services and innovation platform, offering prior authorization, care navigation, analytics, and provider enablement. Represents the dominant incumbent Arbiter must displace or integrate with.
Market position
Strengths4 records
Weaknesses4 records
Competitive moat5 records
Key risks6 records
Key highlights6 records
Customer concentration
Arbiter social profiles
Digital presenceArbiter financial estimates
Financial estimateRevenue estimate
Valuation estimate
Arbiter leadership team
Management profileNumber of profiles
Profiles21 records
Arbiter funding detail
Funding detailFunding overview
Funding rounds1 record
Investors4 records
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Arbiter 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 Arbiter
What does Arbiter do?
Arbiter sells an AI-powered care orchestration platform that unifies patients, payers, and providers on a single system to orchestrate and automate referrals, prior authorizations, and care optimization at scale. The platform is built on a Record-Action-Alignment model that integrates clinical, financial, and policy data, recommends and executes the next best action via agentic AI, and continuously monitors and aligns outcomes. Its first deployed application is real-time site-of-care optimization, and it is licensed to enterprise healthcare payers, providers, and health systems.
Is Arbiter a public or private company?
Arbiter is a private company. It is classified as venture growth investor backed and is currently operating.
When was Arbiter founded?
Arbiter was founded in 2025. It employs 11 to 50 people.
Where is Arbiter based?
Arbiter is headquartered in New York, United States, in the North America region.
How does Arbiter make money?
One revenue line is on record: platform Licensing/Subscription.
Who are Arbiter's main competitors?
Direct peers on record are Cohere Health, Bamboo Health, Phreesia, Evolent Health, Health Catalyst and Kyruus Health. Emerging players are Luma Health and Olive AI. Broad incumbents are R1 RCM and Optum (UnitedHealth Group).
Does Arbiter have an API?
No public API is recorded for Arbiter.
What industry is Arbiter in?
Arbiter's product category is Healthcare Care Orchestration Software. Its primary akta.pro industry code is HLACAEAJ, Adherence, Reminders & Engagement Automation (Medication/Follow-up), with a secondary code of HDAEANAA, End-to-End Enterprise AI Platforms (MLOps & Model Lifecycle Management). Its NAICS code is 5132 and its SIC code is 7372.