Commence

What Commence does

Commence is a Virginia Beach-based private healthcare technology company that delivers an AI-powered data platform and clinical services to federal health agencies, state and local governments, and commercial healthcare organizations. The company was formed in September 2025 through the combination of three legacy entities — DOMA Technologies (founded circa 2000), Livanta, and Advanta Government Services — under a unified Commence brand. It serves as a contracted operator for major federal health programs, including Centers for Medicare & Medicaid Services Quality Improvement Organization work (covering 60% of the Medicare population across 27 states), Veterans Affairs medical records retrieval, and Defense Health Agency TRICARE claims processing, alongside an emerging commercial health book.

The company's core technology is the DX Engage Platform, hosted on Amazon Web Services (US-East-1 and US-West-1) and certified under HITRUST r2, SOC 2 Type II, HIPAA, and ISO 18587. The platform supports a portfolio of solutions: AI-powered Fraud, Waste & Abuse detection (45% increase in flagged cases, 30% reduction in false positives), Independent Dispute Resolution under the No Surprises Act, Peer and Independent Reviews, Quality Improvement, Patient Advocacy, large-scale Data Transformation (2B+ documents, 820M+ records digitized, standardized to FHIR/HL7/JSON), and Fetch, a patent-pending AI-powered translation module for limited-English-proficiency patients integrated with Epic EHR. The platform is supported by a network of 500+ licensed clinicians across 54 specialties who perform federally-required clinical review and quality oversight.

Commence generates revenue primarily through long-term managed-services contracts with federal health agencies, supplemented by subscription and per-case commercial offerings. It employs 501-1,000 staff and serves 200+ clients. Go-to-market is enterprise field sales targeting federal procurement and commercial health systems, with distribution channels through Epic Showroom and a small business teaming network for federal set-aside contracts. The company is backed by Pleasant Land, a mission-driven private equity firm, and is led by a team with deep federal contracting, healthcare, and technology credentials.

Name

Commence

Legal name

Livanta LLC, Advanta Government Services, LLC, and DOMA Technologies LLC DBA Commence

Website

https://commence.ai

Company type

Private

Founded year

2025

Operating status

Operating

Headcount range

101–250 employees

Short description

Commence is a Virginia Beach-based private healthcare technology company that delivers an AI-powered data platform and clinical services — including fraud detection, data transformation, quality improvement, and patent-pending multilingual translation — to federal health agencies, state and local governments, and commercial healthcare organizations.

Ownership category

akta.pro rank

Product category

Healthcare Data Platform

NAICS

Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (51821), Computer Systems Design and Related Services (54151), Custom Computer Programming Services (541511), Computer Systems Design Services (541512)

SIC

Services-Prepackaged Software (7372), Services-Health Services (8000), Services-Computer Programming, Data Processing, Etc. (7370), Services-Computer Integrated Systems Design (7373)

akta.pro primary industry

Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment) (HLACABAK)

akta.pro secondary industries

HIE Platforms & Network Services (Community/Regional/National) (HLACABAB), Patient Engagement, Education & Messaging Platforms (portal/CRM integrated) (HLALABAJ), Care Navigation, Referral & Digital Front Door Platforms (HLALABAH)

Keywords

• Healthcare data platform
• Clinical review services
• Healthcare fraud detection
• Medical records transformation
• Healthcare interoperability

Headquarters

HQ city

Virginia Beach

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

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

Revenue model

1. Federal Health Program Contracts: Long-term government contracts with federal agencies including CMS Quality Improvement Organization (QIO) programs, VA medical records retrieval, DHA TRICARE claims processing. Contracts include regulatory compliance, clinical review, and data transformation services across Medicare, Medicaid, and military health programs.
2. State and Local Government Healthcare Programs: Contracts with state and local health agencies for data transformation, patient advocacy, and quality improvement services.
3. Commercial Healthcare Solutions: Enterprise solutions for commercial health systems including translation services (Fetch), fraud detection, and data transformation.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels4 records

Core offering

Commence delivers the DX Engage Platform, an AI-powered healthcare data technology hosted on AWS, combined with a network of 500+ licensed clinicians across 54 specialties. The platform powers healthcare data transformation, AI-powered fraud detection, clinical peer and quality reviews, independent dispute resolution, patient advocacy, and the patent-pending Fetch real-time translation solution integrated with Epic EHR. Services are delivered primarily through managed-services contracts to federal health agencies (CMS, VA, DHA), state and local government, and commercial healthcare organizations.

Product overview

Commence operates as a platform-plus-modules healthcare technology company, combining its core DX Engage Platform with specialized solution modules. The platform is a unified data-centered healthcare technology system that supports fraud detection, independent dispute resolution, peer and independent reviews, quality improvement, patient advocacy, and large-scale data transformation. Fetch, the company's patent-pending AI-powered translation module developed in partnership with The Language Group, integrates directly with Epic EHR systems via the Epic Showroom to deliver real-time multilingual patient discharge instructions. The company serves federal health agencies (CMS, VA, DHA), state and local government, and commercial health organizations, supporting over 200 clients and 60% of the Medicare population. Commence processes over 2 billion documents and 8 million pages daily across its platform, backed by 500+ licensed clinicians and 54 medical specialties.

Differentiator

Problem solved

Functional benefit

Products and services

• DX Engage Platform Core technology platform underlying Commence's healthcare solutions, enabling automation, clinical oversight, and large-scale data processing across federal, state, and commercial health programs. Supports fraud detection, medical record retrieval, claims processing, and AI-powered clinical review at scale.
• Fetch (On Demand Translation) Patent-pending AI-powered, human-reviewed real-time translation solution integrated with Epic and other EHR systems to deliver multilingual patient discharge instructions within clinical workflows. Targets Limited English Proficiency patients and ensures compliance with Section 1557, Title VI, and CLAS standards.
• Fraud, Waste & Abuse Prevention AI-powered analytics solution that detects and prevents healthcare fraud using real-time alerts and clinical review integration. Increases flagged fraud cases by 45%, reduces false positives by 30%, and supports oversight across Medicare, Medicaid, and commercial plans.
• Independent Dispute Resolution (IDR) Certified Independent Dispute Resolution entity under the No Surprises Act, delivering timely impartial decisions for medical payment disputes between payers and providers.
• Peer & Independent Reviews Data-driven peer review solution led by clinical experts that evaluates provider performance and patient outcomes, applying evidence-based assessments and written determinations following established clinical guidelines.
• Quality Improvement Clinical quality improvement solution leveraging data-driven benchmarks and licensed clinician expertise to help agencies improve care quality and safety, meet regulatory standards, and lead across Medicare and Medicaid programs.
• Patient Advocacy Patient support solution connecting patients to care through real-time guidance, multilingual outreach, and compassionate advocacy. Includes Fetch translation integration for LEP patients and automated care coordination across 15+ healthcare facilities.
• Data Transformation Large-scale data transformation solution that digitizes, standardizes, and activates massive volumes of healthcare data, processing 2B+ documents, 820M+ records, and 8M+ pages daily, converting unstructured data to FHIR, JSON, and HL7 formats.

Quantifiable outcome

• 45% increase in fraud detection, 30% reduction in false positives
• +7 more outcomes

Named customers5 records

Segments3 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration3 records

AI capability7 records

Feature4 records

Partnerships

Three partnerships are on record, tiered core and minor.

• The Language Group (TLG)coreStrategic or Co-development Partner · 18 September 2025Strategic partnership to co-develop and launch Fetch, a patent-pending AI-powered real-time translation solution for healthcare. TLG provides professional language solutions with ISO 17100 and ISO 18587 certifications, while Commence provides the technology platform and healthcare integration. Solution is Epic Showroom approved and serves limited English proficiency patients.
• EpiccoreTechnology or IntegrationFetch translation solution is integrated with Epic EHR systems and approved in the Epic Showroom marketplace, enabling distribution to Epic's healthcare system customer base.
• U.S. Department of Defense SBIR/STTR ProgramminorOthersSmall Business Innovation Research and Small Business Technology Transfer programs providing resources and platforms to support small business growth in federal contracting.

Scale indicators12 records

Recent moves7 records

Expansion highlights6 records

Direct peers

• Linguava (and CyraCom/Language Line): Healthcare-focused language access and translation providers that compete directly with Commence's Fetch solution in serving Limited English Proficiency patients under Section 1557 — typically entrenched in non-Epic health system relationships.
• Booz Allen Hamilton: Major federal health IT and consulting contractor that competes with Commence for VA, DHA, and CMS modernization work, including data transformation and clinical analytics engagements.
• Maximus: Federal health services contractor that competes directly with Commence on CMS Quality Improvement Organization (QIO) contracts and large-scale federal health program operations; both serve Medicare/Medicaid beneficiaries under multi-year federal contracts.
• Health Catalyst: Healthcare data and analytics platform company serving health systems with interoperability, quality improvement, and population health analytics — overlapping with Commence's Data Transformation and Quality Improvement modules on the commercial side.
• NTT DATA Federal Services (formerly Cognosante): Federal health IT contractor with deep CMS, VA, and DHA relationships offering data interoperability and program integrity services — overlapping with Commence's federal health data transformation and quality improvement contracts.

Emerging players

• Persivia: Healthcare AI and analytics company delivering clinical decision support and population health on a platform that processes clinical data — directly comparable to Commence's DX Engage platform in terms of clinical data activation and AI-driven workflows.
• Datavant: Healthcare data interoperability company focused on connecting health data across payers, providers, and life sciences — comparable to Commence's FHIR/HL7 data transformation work, though more focused on de-identification and data exchange than full clinical workflows.

Broad incumbents

• Optum (UnitedHealth Group): Largest healthcare data, analytics, and services platform in the US; overlaps with Commence on payer-provider data exchange, fraud detection, and clinical analytics, but operates at vastly greater scale across both commercial and federal markets.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks5 records

Key highlights6 records

Customer concentration

• Xx.com/Commence_AI
• LinkedInlinkedin.com/company/commence-ai

Compliance4 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles13 records

Funding overview

Funding rounds

Investors

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 Commence