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Why We Started Fuse: Fixing US Healthcare's Opacity
The Problem
When a patient walks into a US healthcare clinic today, they typically have no idea what they're going to pay. Unlike buying groceries, booking a hotel, or purchasing anything else in the modern economy, healthcare remains a financial black box. You receive treatment first, then wait weeks for a bill that often comes as a complete surprise.
This isn't just inconvenient—it's a significant financial risk for patients, and a symptom of a broken system. Only one in six patients know what their care will cost before treatment, despite the fact that twenty cents of every dollar healthcare providers spend goes to financial administration—not patient care, not medical equipment, but paperwork, phone calls, and bureaucracy.
The situation is increasingly unsustainable. Patients are walking into medical appointments with no idea what they'll owe, while healthcare costs continue rising at unsustainable rates. Meanwhile, providers lose up to 10% of their revenue to billing errors and underpayments.
Our Solution
We started Fuse because AI and other technologies can now automate many of the manual tasks that previously made accurate patient cost estimates nearly impossible to create efficiently.
Before, provider admin teams had to manually read insurance card details, contact patients for missing information, upload this data to payer websites, note patient benefits, call payers for additional details, read their contracts, calculate bills, explain bills to patients, before finally billing a patient. This process was slow, error-prone, and expensive.
Fuse is now automating these steps:
- Patient intake and data capture - automatically extracting and organizing insurance information
- Real-time insurance verification - conducting CPT-code level benefits checks without manual payer portal navigation
- Contract analysis and payment benchmarking - determining accurate allowed amounts and patient responsibility
- Automated cost estimation - generating precise patient estimates before treatment
- Streamlined billing and collections - handling the entire billing workflow
The results: We've already reduced insurance verification administration by over 95% while eliminating eligibility-related denials for our partners.
Our Vision
Every patient should know the accurate cost of their care before treatment—just like shopping for products anywhere else. This should be the norm, not the exception.
Patients should expect price transparency from their healthcare providers. Healthcare providers shouldn't have to spend hours determining the cost of care for each patient. When you buy anything else, you see the price upfront. Healthcare should work the same way.
We're building the infrastructure to make this vision reality. A healthcare system where financial transparency is standard, where patients can make informed decisions about their care, and where providers can focus on healing instead of endless administrative tasks.
As repeat entrepreneurs focused on financial inclusion, we're excited to be backed by leading investors like Y Combinator to make this vision a reality.
The Problem
When a patient walks into a US healthcare clinic today, they typically have no idea what they're going to pay. Unlike buying groceries, booking a hotel, or purchasing anything else in the modern economy, healthcare remains a financial black box. You receive treatment first, then wait weeks for a bill that often comes as a complete surprise.
This isn't just inconvenient—it's a significant financial risk for patients, and a symptom of a broken system. Only one in six patients know what their care will cost before treatment, despite the fact that twenty cents of every dollar healthcare providers spend goes to financial administration—not patient care, not medical equipment, but paperwork, phone calls, and bureaucracy.
The situation is increasingly unsustainable. Patients are walking into medical appointments with no idea what they'll owe, while healthcare costs continue rising at unsustainable rates. Meanwhile, providers lose up to 10% of their revenue to billing errors and underpayments.
Our Solution
We started Fuse because AI and other technologies can now automate many of the manual tasks that previously made accurate patient cost estimates nearly impossible to create efficiently.
Before, provider admin teams had to manually read insurance card details, contact patients for missing information, upload this data to payer websites, note patient benefits, call payers for additional details, read their contracts, calculate bills, explain bills to patients, before finally billing a patient. This process was slow, error-prone, and expensive.
Fuse is now automating these steps:
- Patient intake and data capture - automatically extracting and organizing insurance information
- Real-time insurance verification - conducting CPT-code level benefits checks without manual payer portal navigation
- Contract analysis and payment benchmarking - determining accurate allowed amounts and patient responsibility
- Automated cost estimation - generating precise patient estimates before treatment
- Streamlined billing and collections - handling the entire billing workflow
The results: We've already reduced insurance verification administration by over 95% while eliminating eligibility-related denials for our partners.
Our Vision
Every patient should know the accurate cost of their care before treatment—just like shopping for products anywhere else. This should be the norm, not the exception.
Patients should expect price transparency from their healthcare providers. Healthcare providers shouldn't have to spend hours determining the cost of care for each patient. When you buy anything else, you see the price upfront. Healthcare should work the same way.
We're building the infrastructure to make this vision reality. A healthcare system where financial transparency is standard, where patients can make informed decisions about their care, and where providers can focus on healing instead of endless administrative tasks.
As repeat entrepreneurs focused on financial inclusion, we're excited to be backed by leading investors like Y Combinator to make this vision a reality.
FAQs
Questions?
