Addressing revenue cycle's root problem, data fragmentation | Eliana Berger (Joyful Health)
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概要
Eliana Berger, CEO and co-founder of Joyful Health, joins Kevin and Martin following the company's recent $17M Series A. Eliana walks through what she observed spending two years inside provider practices as a fractional CFO, the data fragmentation that sits underneath revenue cycle, and how she thinks about the distinction between AI services and AI agents in denials work.
Topics discussed:
- What Eliana found working inside practices as a fractional CFO, and why finance kept surfacing as the hair-on-fire problem
- Addressing revenue cycle's root problem: the lack of a financial source of truth across EHRs, billing systems, clearinghouses, payer portals, and bank accounts
- Why Joyful shifted from selling software to owning the outcome end-to-end
- The distinction between AI services and AI agents, and where rules-based automation works versus where expertise is required
- The mechanics of working a denial, including ERAs, vague denial codes like CO-16, and the cross-system "detective work" involved
- The payer-provider dynamic and how AI is showing up on both sides
- Joyful's system-agnostic go-to-market and four-to-eight week implementation timeline
- The longer-term vision of integrating from payer contracts through to the bank account
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