Arbiter

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.

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

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

• Care orchestration platform
• Healthcare AI software
• Prior authorization automation
• Referral management system
• Site-of-care optimization

Headquarters

HQ city

New York

HQ country

United States

HQ region

North America

Offices4 records

Markets served

GTM type

B2B

Offering type

Software

Cost components

Personnel, Technology or R&D, Marketing or Sales, Operations, Infrastructure

Revenue model

1. 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

Go-to-market motion1 record

Distribution channels2 records

Marketing channels4 records

Core 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

Named customers2 records

Segments3 records

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability7 records

Feature4 records

Partnerships

Two partnerships are on record, tiered core.

• Leading National PayercoreStrategic or Co-development Partner · 1 November 2025Strategic 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 or Co-development Partner · 1 November 2025Strategic 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

Direct 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

• LinkedInlinkedin.com/company/arbiter-ai

Revenue estimate

Valuation estimate

Number of profiles

Profiles21 records

Funding overview

Funding rounds1 record

Investors4 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Arbiter