fixing healthcare @getlunabill
San Francisco, CA
- Tweets 936
- Following 748
- Followers 1,073
- Likes 19,228
biggest myth abt @ycombinator
we just sell to each other to make up for huge arr before demo day. total bs.
my 4th flight out of SFO this month.
in my batch, 60% of us have flown 2+ times in 4 weeks. some founders are legit eyeing airport-adjacent apts lol
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just realized we never lost our X virginity for ‘YC acceptance’
here it goes… @getlunabill is in F25
back to building 💻
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we have been locked-in for a year now
but nothing compares to the crucible that is the @ycombinator batch!
glad @hthieblot at @fdotinc kept challenging us to push the limits every single day
prolly the reason our average time-to-close for a healthcare system pilot ≈ 1 month
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just heard that the @fdotinc team had to wait for a team to turn 18
so they can open a bank account for the pre-seed lol
these founders are getting younger and younger
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we’ve built the most realistic AI caller for healthcare
- less than 2% detection as AI
- an 97.67% success rate across 30k+ calls
here’s how we achieved it:
ALT dashboard call result metrics across 30k+ calls
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1. over the last 30 days, we a/b tested 17 @elevenlabs voice models on 70,000+ outbound healthcare insurance calls for our clients. what we found surprised us...🧵
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not many people know this:
there are ~1M people employed in healthcare billing, serving US healthcare
every one of these healthcare billers lives with 2 screens and a phone
at @getlunabill, we automated 60K+ phone calls for them
we are making the phone invisible
…for now
ALT healthcare billing office in california
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just heard our ai voice agent tell a client it’s not a robot. now I’m wondering how long before luna negotiates for a raise
ALT call transcript
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i went to a hospital and got them $150million in unpaid insurance claims in 3 months
this covers 100k patients
and its how i plan to fix american healthcare:
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ever wanted to automate your craziest manual workflows? here’s a thread on every tool we tried and what we learned. 👇
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if you’re a founder in ur late 10s or early 20s
and need that extra edge to get into @ycombinator, email me
we will be hiring in december
at @getlunabill we aim to be a major talent pipeline for yc in the coming years
Startup culture feels very different these last few years.
This analysis of the 'new' Y Combinator under @garrytan's leadership highlights shifts:
• YC founders are younger, averaging ~26 years old
• More graduated from a top 20 university, now more than 50%
• Massive upswing in founders that previously worked at a YC-backed startup
• Nearly 85% of startups came from the Bay Area, up from 25-55%
(thanks for sharing, @jaredheyman)
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As a health-tech founder, I’ve deep-dived into different players in the ecosystem, and I’m blown away by this one company 🧵 (Hint: this one raised $75 million before the pivot!)
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for yc demo day
if you’re a vc fund and don’t have at least 1 yc alum in the team
you’re very late
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one of my favourite tech leaders is @vkhosla. i find myself rewatching his youtube lectures often. this one slide hit different.
AI has rewritten the rules. startups are doing series B moves in seed now.
we haven’t raised big yet, but if we do, it’ll be to mostly fuel growth. wild how fast things move with AI-native companies and people still think it’s a bubble.
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had to go find the team. it is @quolabsai built by @audrlo @notnamedkai @imjennywen
come watch them on demo day this friday @fdotinc
just heard that the @fdotinc team had to wait for a team to turn 18
so they can open a bank account for the pre-seed lol
these founders are getting younger and younger
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“fellas, is it gay to split a chatgpt subscription with your 3 best bros? 😏”
overheard at a tech bro party
peak modern masculine bonding
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in 2025, healthcare denials hit 1 in 5 Americans, costing lives!
we decided to use tech to end insurance nightmares: automating calls to fight denials, skyrocketing to 45k+ monthly.
proof 👇
but yesterday reminded me exactly why I’m building this
ALT Area chart showing outbound calls to insurers rising over 18 weeks
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only in sf 🌁: sim racing, fifa, and shipping AI to production — simultaneously
ALT founders, inc.
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as someone who ran ops for hospitals and clinics, i was horrified by the broken link between EMR softwares and its users. i spent months patching systems with extra staff simply to keep things together. full of frustration i decided to no longer build duct‑tape fixes and instead build for the future. i did not write single line of code until I had sat down with over 500 physicians and administrators to map every pain point. patients’ health and clinicians’ workflows are inseparable, and i am building with those insights guiding every decision
EMRs are billing programs that physicians are forced to use. There has never been any consideration of the user interface, as the physician isn't the purchaser of the program.
The HITECH Act was a gift to a donor and has cost billions of dollars, and has led to physician burnout, a lack of patient privacy, and hundreds of millions of patients' records ending up on the dark web.
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our cofounder chatroom, this wknd. our friend’s dad passed away from a preventable disease. in that moment, it became painfully clear - this is why we have to build in healthcare. no family should ever have to go through this
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first time in Minneapolis to see a client and this happens next door
when ppl told me i will see real america outside the ‘sf bubble’, i thought diners and farmer’s market…not this
stay safe everyone
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made my first angel investment in sf. one of those stacks. diamond hands @jmdagdelen
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building in healthcare had me question all assumptions. take practice management systems - biggest misnomer ever. they are anything but practice management lol. i’m amazed doctors have tolerated this trash for so long. they got to go ngl. they are awful
Sometimes founders don't realize that coming into a market with fresh eyes can be your greatest advantage.
When building Mercury, I found that people who knew too much about fintech were less likely to invest.
I've experienced this from both sides. As an investor, when I see fintech companies, it's hard not to immediately see all the problems they'll face. You try to be optimistic, but if you know too much, it's definitely harder to see past the obstacles.
This pattern extends beyond fintech. A successful hedge fund manager recently shared that he was excited about a startup trying to disrupt hedge funds precisely because "they know nothing about hedge funds." Otherwise, they'd just apply the conventional approaches.
Sometimes the most transformative products come from founders who aren't constrained by industry assumptions about what's possible or "how things are done."
Our latest Founders In Arms episode explores this paradox of expertise - how knowing "too much" can blind us to the very opportunities that outsiders can see with perfect clarity.
Link to full episode in bio.
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Slept at 4a, woke up at 8a, and just had my breakfast at 5p, @ionkarbatra made it. It’s been like this since I moved to the valley in May, nonstop hustle building my startup
If ur an early stage foundr in health-tech and not in SF, I won’t even include u on my competition slide
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point #2 is so solid. i think healthcare is the only industry where u sell a product (care) and then spend 3-4 months proving to the buyer (insurance) that the product purchased was good and they should pay. somehow this is normal lol.
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at depths of >10km, earth’s crust holds 100x more energy than all fossil fuels reserves together rn. check out #MazamaEnergy
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my friends called me too-obsessed, but this paid off big time! 🧵
here is our decision-maker’s persona: 50yo revenue-cycle leader, 8-10yrs healthcare finance, data-driven, eyeing a VP role. but i went further and researched her public socials, turns out she is a spa lover! 1/4
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yesterday, a physician friend whispered, “I don’t get how we’re not protesting every day.”
fun fact: for every 1 doctor, there are 35 admins, none of whom ever interact with a single patient. can u imagine?
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Just realized my @WHOOP has been DEAD for 6 DAYS 💀
already paid a FULL YEAR subscription FML! robbery lol!
i understand why folks use apple watch now.
should i switch ?
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2. male-coded ai voices winning.
here’s how some of them did:
➡️cade-ronan: 99% clarity on 3k calls
➡️jack-riven and jace-marlowe: 92% completion on 3.5k calls
➡️beck-wilde & luca-thorn: 85%+ success at scale
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4. honestly, i’m amazed at how good these voice models are getting. the next 6 months are gonna be nuts - i’m pumped to see where it goes. ⏱️
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sf fam: thanksgiving vibes, but we’re still grinding in full selling mode. everyone’s off work - it’s brutal. how do you balance the hustle this week? 🙏
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at @fdotinc we normalized saying ‘i’m building’ to ‘what’re u upto tomorrow?’
you don’t ask @Cristiano if he’s working tomorrow, you ask if he’s training
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knew a few folks back in 2013 btc era who stored their seed phrases in rfid/nfc implants..still think thats a more valuable hack lol
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so i went old school, took a chance and sent a $100 spa gift card to her houston office. it was a small gesture, but i betted on personalization. 2/4
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but here’s the catch: managing those disputes spiked labor costs by 30%.
that’s when we are stepping in with our AI voice caller - automating all the insurance communications.
- flag claims eligible for the No Surprises Act
- AI‑voice calls to insurers, verify eligibility and claim statuses
- bundle EOBs, notes and other claim docs for dispute
Now, their revenue teams work smarter, not harder.
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ai voice tech is wild! if you’re testing it out, drop your use case below. i’d be happy to share which voices really worked for us. #AIVoice
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go apply to @join_savant! super ambitious folks
10 days left to apply for @join_savant epoch 1.
we’ve accepted 10 teams so far, including
> repeat bio founder building affordable biochemical tests for diagnosing genetic diseases
> ex-apple building cleaning robots
> rocket scientist building oss stack for aerospace
1/9 🧵
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beautifully put. to me urgency is a startup’s engine: non-negotiable goals that force decisions every day. this kills distractions and the ‘remote work ting’. if nothing seems urgent you may be doing it all wrong
1/ Why would a startup ever move slowly?
It's far from obvious, especially given that startup founders are amongst the most hard-working, resilient, driven, gritty (and insane) people in the world
There is more below but the leading cause is simply indecisiveness and hedging 👇
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overheard at a healthcare conference:
“choosing between @HeyEpic and @OracleHealth is like picking @Ferrari vs. @Ford - why settle for ford?”
FYI, epic was the ferrari 🙃
they’re not ready for what's coming lol
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3. the crazy part? in just one month, this saved 38k+ staffing hours for our healthcare clients. it’s wild to see ai voice actually change things like that.
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how does @iamwilliamwang manage to look good everywhere!! 🤯
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just realized from our clients: whatsapp + ms teams are the duct tape of their business comms. old-school industries use it for everything - chats, time sheets… but it’s clunky af.
why hasn’t anyone built ‘discord for low-tech industries’?
lmk if someone’s on it
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a week later, she called to thank me personally, scheduled a demo. even better, we signed them last month! 3/4
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great point! sf based health-tech founder here: imo to build any great product, it requires finding your team’s core strengths: often marrying ur deep domain experience with the tech ur team knows best. our team previously built asia’s top ai scribe, now we are using ai voice to obliterate a critical workflow bottleneck. this approach helped us execute with relentless speed. and also have since landed major clients from the east coast.
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we are building ai voice agents to replace callers to insurance companies in a specific vertical. it is a whole job…the task would’ve been to put together an excel sheet of all the claims you needed to reach out about and wait for the human to dial.
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1) high concurrency process lines. insurances only open from 9 am to 5 pm. we have burst usage within the timeframe.
2) we A/B tested >45 voice models and then used EQ audio to simulate bad call conditions. result? < 2% detection as AI!
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founders: test your pitch deck after 24 hours with zero sleep. if it still fires you up, you’ve got something special 🫡
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3) we test our AI with counterfactual simulations in a sandbox, learning from every failed call to improve continuously. it’s like having a crystal ball for better outcomes.
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if you’re in founder mode, you need to see this. @Emmie and the team have been shipping non-stop for the past month at @fdotinc - results speak for themselves!
Introducing @yuzu_labs: Cursor for Videos.
The average founder spends 8 hours a week making content.
A single agency video takes 5-7 rounds of feedback and 3-5 business days per round. That's 35 days before you ship PLUS the filming and editing time.
Now you can create unlimited inbound marketing videos in minutes with no agency needed.
Just your AI working 24/7 while you run your business.
We're innovating on the corporate stack so you can do more with less.
See it in action 👇
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healthcare practice management systems are a masterclass in inefficiency
- needs an entire army overseas to do what 1 button could do
- runs on fax-era logic
- costs more in human labor than gdp of small nations
meanwhile healthcare:
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@Stedi started in 2017 as an EDI platform for sectors like transportation and healthcare, helping organizations automate data exchanges. By 2024, they expanded with more dev tools for seamless integrations
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4) IVR/conversation separation: a single prompt can’t handle the phone menu and the conversation right after. we split both into specialized agents for peak performance. this made our AI sharper and more responsive.
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ship small, solve one thing in best way possible, become irreplaceable. then chip away at other things until you run the whole system
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booked a 30 min 7am zoom with a customer, morphed into a 3 hour session. its the 5th time this past week. is this founder mode or did i just become my clients’ unofficial therapist?
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@vela_gao just shared this treasure with me. i think it’ll help ;)
anirudhkamath.notion.site/An…
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Then in 2024, something huge went down that most don’t know about. Change Healthcare, which handles 40% of U.S. healthcare claims, was hacked
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everyone is scared of getting a hospital bill that’s 10x what you expected
that’s the nightmare millions of patients face every year
however not many know that hospitals can use #NoSurprisesAct (NSA) to protect you from those shock bills for emergency or in-network care.
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