TriFetch founders Rosemary He (L) and Varuni Sarwal (R)
TriFetch
What if the biggest leak in healthcare is not clinical, but operational?
Every dollar a clinic cannot collect sits somewhere in a stack of unanswered phone calls, stalled prior authorizations, and referrals lost in a fax queue. Healthcare’s billing and payments crisis is not only a technology problem, but also an operations challenge. A new class of founders is betting the moment has arrived.
This week, TriFetch, an AI automation platform built for independent specialty clinics, is coming out of stealth with a $1.9 million pre-seed round led by Nexus Venture Partners, with angels from Google, Hippocratic AI, and Mercor. The founders, Varuni Sarwal and Rosemary He, are UCLA PhDs who spent years publishing machine learning research in Nature and ICML before turning their attention to a different kind of broken system: the back office of American healthcare.
Physicians and their staff spend an average of 13 hours per week on prior authorization requests alone, with 40% of practices employing staff whose entire job is managing that queue. One of TriFetch’s pilot clinics had two full-time staff members process up to 100 referrals a day. The company automates that workflow end to end, freeing roughly 16 hours of staff time daily and returning more than $200,000 annually to that clinic alone.
To understand the problem firsthand, the founders drove directly to the clinics themselves. “We spent a full day inside a practice with five physicians running three different EMRs,” He recalled. “The staff wasn’t inefficient. They were just absorbing friction that the system was never designed to eliminate.”
Sarwal puts it more bluntly: “The administrative burden and the revenue problem are the same problem. Clinics feel it as stress. It shows up on their books as lost revenue.”
The Same Problem, Different Angles
TriFetch is not the only company attacking this layer. A landmark JAMA study estimated that administrative complexity accounts for roughly $265 billion in annual waste across the US healthcare system, the single largest category of identifiable waste. Different companies are approaching that number from different ends of the care continuum.
For patients navigating public insurance, coverage gaps, or the ACA exchange, the same fragmented systems create a parallel problem: opaque denial letters, benefits they never knew they qualified for, and a process so confusing that many people opt out altogether. Kyndly is attacking that layer.
Co-founder Waleed Bahouth, who spent 15 years at Humana before launching the company, describes it without softening: “Health insurance sucks. It is needlessly complex, using coded language and jargon to confuse people. The last thing people want to consume is health care. Our focus is to remove the barriers to accessing care.” Kyndly’s platform helps people losing Medicaid coverage, gig economy workers, and small businesses navigate enrollment and find plans they can actually afford.
The pharmacy channel has its own version of the same problem. ScriptifyRx is building automation infrastructure for independent pharmacies, which absorb prior authorizations for specialty medications and claims adjudication workflows that most independent operators still manage manually. The independent pharmacy, like the independent specialty clinic, is absorbing friction designed for institutions with compliance departments and dedicated billing teams.
For a mid-size specialty practice, TriFetch estimates recovered costs and captured revenue in the range of $500,000 to $1.4 million annually. Dr. Shashi Ganti, Ophthalmologist at Cal Retina MD, speaks to the human side of that number: “Clinics up and down the US are facing the same administrative headache.” In her view, the promise of AI in clinical settings is less about the technology itself and more about whether it can be trusted to handle that burden safely and reliably.
The Infrastructure Beneath the Clinical Layer
What is emerging across TriFetch, Kyndly, and Scriptify Rx is the early architecture of something bigger. TriFetch slots directly into existing EMRs without disruption. Kyndly has cracked distribution by going through brokers rather than trying to displace them. ScriptifyRx is piloting with a customers the point where pharmacy administrative friction is most acute.
None of these companies are trying to rebuild American healthcare. They are trying to make the version that exists today stop bleeding money and time. The founders making real progress the ones willing to drive to the the clinics and figured out exactly where the friction lives.