He had paying customers before he even incorporated—then hit $1M ARR in a year and raised a $19M Series A. | Rahul Shivkumar, Co-Founder of Assured

Assured sells the credentialing step that makes doctors billable

Assured sells the unglamorous first step of getting a provider paid. After an offer letter a clinician must be credentialed and then paneled with each insurer, and until that finishes the practice cannot bill for their work. Assured runs it with AI agents, and customers committed before the company was incorporated.

Takeaways

• Provider credentialing is the front door to billing. Assured automates the work between an offer letter and a billable provider, using AI agents to verify information and follow up with payers until the provider is paneled. Rahul and Varun chose provider onboarding over the saturated core of revenue cycle management.
• Assured hit $1M ARR within a year. Assured raised a $19m Series A led by Insight in July, after reaching $1M ARR in about a year. Early growth came by word of mouth and a mention in a Y Combinator healthcare guide, though Assured was not a YC company.
• Cold calling still works in healthcare. Pickup rates near 8%, about four times what Rahul has heard elsewhere, and AI BDRs sounded robotic, so Assured kept humans. Six BDRs make 150 to 200 calls a day, book about two meetings each a week and convert roughly 10% of calls into demos.
• Discovery before the demo doubled close rates. Assured runs heavy discovery before showing anything, and demo-to-close rose from about 18% to about 40% last quarter. Deals are pushed with touch-point tracking, since a $200,000 deal over four months needs at least 16 touches.
• Two kinds of buyers, two different pitches. Where a provider bills $5,000 to $10,000 a day, 20 days of delay costs $50,000, and onboarding falls from about 90 days to 60 or 65. Another segment buys instead to avoid hiring four onboarding staff, at about a third of an FTE.
• Agents handle 60% of the work, then 90%. A first version of a workflow can run 60% on AI and 40% on people, then narrow toward 80/20 and 90/10 while keeping reliability high. A large engineering team keeps testing edge cases and evaluating what new models are good and bad at.

From Dawn Health to Assured

1. Rahul and Varun met in college and ran Dawn Health, a virtual sleep treatment center, where about 99% of revenue came from Medicare or commercial insurance.
2. Hiring and paneling providers there was painful, and the telehealth market turned as Teladoc rose in 2020 and 2021 and fell in 2023.
3. They sold Dawn Health in mid-2023 for an outcome Rahul calls between a big success and a tuck-in, then took three or four weeks off to decide whether to build again.
4. They listed what they knew that others might not, sized the market, and friends from Dawn Health building similar businesses became customers before Assured was incorporated.