We are entering a $16B+ Total Addressable Market with a gaping $ 7.5B–$10B whitespace, targeting the highly underserved mid-market segment. Currently, 30–40% of denied medical claims go uncontested because practices lack the staff and capital to contest them. This systemic failure leaves between $50,000 and $300,000 in legally earned revenue permanently abandoned at each practice every year.
Reclaim AI resolves denied and aged claims end-to-end, embedding outcome-based contingency pricing—meaning practices pay zero upfront, and we only take a cut of the dollars we successfully recover, for our target ideal customer profile (practices with $80K+ in annual recoverable claims).
We didn’t just read market reports; we spent weeks interviewing billing managers, practice owners, revenue cycle leaders at health systems, and even digital operations leaders at major insurance companies. The dysfunction we uncovered is staggering, creating a massive opportunity for a disruptor:
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The pain is so severe, practices are building their own tech: The frustration of payer opacity is so deep that medical billers are hiring part-time software engineers to build in-house robotic process automation (RPA) scrapers just to check claim statuses.
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Massive, emotional write-offs: Staff carry immense guilt over these administrative losses. One small-practice assistant admitted, “I feel like we probably had to write off probably close to a million dollars” simply because they couldn’t keep up with the manual follow-ups.
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The “Payer-Side Inversion” Opportunity: We discovered that insurance companies are drowning in the exact same claims dysfunction they generate. One major payer we interviewed reported a backlog of 31,000 contested claims that consumed 80% of their staff’s operational capacity, forcing emergency hires just to manage the disputes.
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The Competition is Distracted: Well-funded Tier-1 competitors are charging $15K+ upfront licensing fees and fighting over enterprise health systems. The competitive window to capture the mid-market with a contingency-priced autonomous agent is wide open.
FutureSight is a leading venture builder that co-creates world-class software companies with values-driven entrepreneurs from inception to exit. We are a team of founders, operators and designers with experience successfully bringing software to market at scale.
You’ll co-create with a proven studio team, led by John Carbrey (4x entrepreneur, $100M ARR), Krista LaRiviere (3x exited, E&Y Top Women Entrepreneur), Alan Smith (Strategyzer co-founder, $120M in products built), Prathna Ramesh (former MD of Maple Leaf Angels, $275M in follow-on capital), and Johnny Tong (0-to-1 builder, acquired by SAP and Stripe) bring a rare combination of operator exits, institutional investing, and AI product depth.