June 27, 2022

You receive a medical bill in the mail weeks after an appointment. It’s unclear what you are being charged for and how much will be covered by insurance, and you are asked to send a check in the mail to settle the balance. Sound familiar?

We are pleased to announce that last week we led a $20.5 million Series B in Rivet, a company on a mission to solve the broken healthcare billing process. Rivet provides a healthcare billing platform that promotes transparency around pricing and financial responsibility across the key stakeholders in healthcare – patients, providers and payers. The company is led by a trio of first-time co-founders in Ted Ferrin, Andrew Harding and Paul Draper who possess a keen ability to identify an acute problem in the market, develop and launch a product and achieve product-market fit in rapid succession. Rivet has an ambitious team and is out to solve a massive problem, and we are thrilled to partner with them for the journey ahead.

So how is Rivet improving healthcare billing? First, it’s important to understand how incredibly complex and unwieldy payer (insurance) contracts are. These contracts are the basis for both payer and patient price responsibility, which breeds uncertainty around who is responsible for paying and exactly how much they need to pay. Rivet tackles this problem head-on by abstracting payer contracts into fee schedules that automatically calculate both patient and payer cost responsibility. With this information in hand, providers are able to hold payers accountable and offer greater transparency to patients.

There are some compelling tailwinds supporting patient estimates as well, including the advent of high-deductible health plans (HDHPs) and the No Surprises Act. HDHPs shift more of the financial responsibility to the patient, which has motivated patients to demand upfront cost estimates, and the No Surprises Act (which went into effect earlier this year) mandates that patients get access to cost estimates prior to their visits. Rivet helps providers meet this patient demand while remaining compliant with new regulations.

After services have been rendered, providers submit claims and collect reimbursement from payers based on the patients’ coverage. In the event that the payer provides some level of reimbursement, auditing that reimbursement is an incredibly manual process, and practices often lack the administrative resources to do so effectively, leading to missed underpayments. In the event a claim contains missing or inaccurate information, payers may outright deny claims that should otherwise be covered. Rivet’s Underpayments and Denials products automate the detection and remediation of these situations, reducing practices’ administrative burden and increasing provider collections.

For more than a decade, Catalyst has been investing in technology that drives operational efficiency in healthcare, which ultimately improves the patient experience as well as a practice’s bottom line. Our thesis was born out of our work with current and former portfolio companies such as Weave, Clinicient and Mindbody, and ultimately led to our most recent investment in Rivet.

When we initially came across Rivet back in 2019, we recognized a shared mission – building a future in which healthcare is more efficient and transparent. While the company was then still in its formative stages, we kept a close eye on its progress. Rivet’s accomplishments since then are nothing short of extraordinary, and when we finally had the opportunity to get involved earlier this year, we took it.