ExactRx

Exactrx develops artificial-intelligence software for revenue cycle management (RCM) at outpatient practices, surgery centers and multi-provider specialty groups. The product operates inside a provider's existing electronic medical record as an additional user: it ingests documentation such as operative notes, discharge summaries and SOAP notes, assigns CPT and diagnosis codes with modifiers, generates charges, assembles the claim package, writes codes and charges back to the EMR, and prepares the claim for submission. A tri-engine rules system scores each case against more than 80,000 payer-specific rules together with the provider's own managed care contract terms, which Exactrx converts into checkable logic, and a pattern-recognition layer trained on historical denials and payer behavior flags edge cases that rule checks miss. Dual-model verification has two independent systems check each other, and every action is logged to an audit trail with the EMR retained as the source of truth.

The company offers two operating models. Under Autonomous Revenue Cycle, Exactrx runs the cycle end to end and an Exactrx Expert reviews cases above a dollar or complexity threshold the customer sets, with the customer's central billing office handling post-submission rejection workflow and EOB review; under Automated Claims Preparation, the customer's own team stays in the review and submission path using the engine. Alongside claim preparation, Exactrx sells an analytics product covering denial tracking, payer contract analysis, underpayment recovery, charge capture and root-cause analysis of adjustments, plus AI-powered pre-operative checklists intended to surface payer requirements before surgery and reduce day-of cancellations. The company states it is HIPAA compliant, signs a BAA before deployment, and works with systems including Epic, HST, SIS and AthenaHealth.

Founding story

The founding team describes having worked on different sides of the reimbursement problem: an operator who had built and sold two healthcare businesses and observed denials undermining their finances, a clinician who contested denials at the point of care and saw patients abandon treatment during peer-to-peer delays, an academic researcher who had applied machine learning to biological data, and an engineer who had scaled healthcare technology through hypergrowth and an IPO. The company frames billing as clinical infrastructure and denials as a barrier to patient access to care.

Business model

Exactrx sells software plus human expert review as a service to healthcare providers, positioned as a revenue cycle partner rather than a seat-licensed tool. It states onboarding requires no IT integration project — the customer adds Exactrx as a user in its EHR — with go-live typically within 10 days.

Pricing is described as outcomes-based, tied to results rather than seat licenses, with a stated path to a fixed fee per case. The company says deployments typically return six times their cost in the first year.

Traction

The company reports a validation study of 3,145 cases reviewed by MDs, DOs, RNs and APPs at Weill Cornell Medicine and Northwestern Medicine, yielding 96% criterion-level accuracy, and cites a 99% first-pass approval rate. Third-party coverage reports roughly 85 qualified opportunities and seven pre-pilot commitments as of late 2025, with pilots slated to begin in the first quarter of 2026, and approximately 18 employees. An endorsement is published from the founder and CEO of Vertex Surgical Solutions.

Latest developments

In September 2026 the company reported winning the 3686 Pitch Competition, described as the top prize at Tennessee's largest entrepreneurship conference. Exactrx was featured at Governor Kathy Hochul's Empire AI roundtable hosted at Cornell Tech, appeared in Crain's Chicago Business coverage of the Northwestern-Techstars demo day, and was profiled on the Techstars blog. Athena Doshi was named to Inc.'s 2025 Female Founders 500, and the company was a Fast Company World Changing Ideas 2024 honoree.