Spotlight: David Vakhtangishvili @ Andromeda Health

A spotlight is a short-form interview with a leader in health tech. In this spotlight, you'll hear from David Vakhtangishvili, founder and CEO of Andromeda Health.

What does Andromeda Health do?

Andromeda Health is the only all-in-one operating system / platform that unifies the four pillars of care (interoperability, pricing intelligence, AI automation, and the patient experience) into one AI-native infrastructure.

We have built a universal operating system for American healthcare – the only AI-native platform that unifies the four broken layers of care into one infrastructure: real-time interoperability (SWIFT-like system for healthcare), national pricing intelligence (Bloomberg-like platform for healthcare, covering 75% of US health plans), clinical AI automation in combination with unique data access (Palantir-like system for healthcare), and a patient Super App (Amazon-like app for healthcare).

Topped with a full business suite for small, mid-sized and large provider practices (Practice Management + EMR / EHR + Billing + Claims + Insurance Verification + CRM), Andromeda removes siloed / disconnected systems and intermediaries, covers all current technological gaps, cuts costs, and drives efficiency. For providers, we eliminate $30-$50 admission costs entirely, replace 5+ legacy tools with an all-in-one OS, lift patient throughput by 45% and reduce rejections by 50%.

For patients, we deliver true price transparency, instant booking, and one app for the entire care journey, reducing their costs and time spent on healthcare. For payers, we cut claims processing and administrative costs by 50% and compress paper workflows into minutes of work.

One platform. End-to-end. Already live. CMS-endorsed.

How did you end up working in health tech?

I got into health tech while serving in a leading role within a healthcare conglomerate, where I saw the daily operational and financial challenges affecting every part of the ecosystem - payers, providers, and patients.

Experiencing these fragmented workflows firsthand made me eager to help rebuild healthcare into a more connected, intelligent, and comprehensive ecosystem powered by technology. So, instead of drifting in, I decided to run it. For nearly a decade, I sat at the very top of one of the large integrated healthcare groups as a CFO, CIO and CRO, simultaneously. Hospitals, outpatient clinics, an insurance arm, and a pharmacy retail chain – all under one roof.

From that seat, I saw something no analyst report can teach you: every single dollar of waste in healthcare has the same root cause – fragmentation. Payers can't talk to providers. Providers can't talk to each other. Patients can't see prices and often cannot access service. Pharmacies live on a different island. Everyone is patching over the same broken plumbing with paper, phone calls, and 40-year-old EDI standards. I watched billions of dollars get incinerated by that gap – and watched patients pay the price in time, money, and worse outcomes. No wonder that out of the $5.0T annual healthcare spending, the US wastes $1.8T on administrative and support functions! 67% of patients (Harris Poll) are extremely dissatisfied with the quality of healthcare. Days and weeks are lost before patients get service only to receive a surprise bill in 2-3 months after the visit. The world's largest healthcare market is extremely inefficient.

So we built Andromeda Health to be the operating system I wish I had when I was running a healthcare group myself and to be the powerful all-in-one navigating tool I wish I had as a patient. A single AI-native, data-driven infrastructure with unique data access that finally connects payers, providers, pharmacies, and patients in real time. That's not a pivot. That's not a side bet. That's ten years of operating scars turned into a product.

How does your role intersect with revenue cycle management (RCM)?

RCM is one of the four pillars the entire platform was built on. We designed it that way deliberately, because in my prior life running a public healthcare group I watched RCM eat 4-9% of every dollar collected, and I knew the industry was solving the wrong problem. Legacy RCM tools – Waystar, TriZetto, Office Ally, Kareo – process claims after the fact. Andromeda prevents the denial before the claim is ever submitted. Here's how the stack actually works, end-to-end:

• Real-time eligibility & price estimation at point-of-care – 99% accurate, sub-second, across the top 8 US payers (75% of all health plans nationwide). The denial-prevention starts here, not at billing.

• AI-assisted coding & documentation – our Doctor AI and Claims AI agents catch coding errors before the claim leaves the building. They provide for a fully automated compilation of the Clinical Notes / SOAP Notes and the Claim, in a fraction of the time that human physicians and billing officers typically spend.

• Automated claim submission with cross-payer remittance prediction – we use our exclusive MRF data lake to predict what the payer will actually pay before we submit. No one else can do this.

• Real-time status tracking, ERAs, and final settlement – all in one workflow, plus up to 10 free re-submissions of the same claim.

• Claims audit & underpayment detection – we crosswalk transparency prices against actual remittance and flag pricing fraud and underpayments automatically.

The economics: flat $5 per claim, all-inclusive, no hidden fees – vs. the 4-9% of collections that legacy RCMs charge. For an average practice, that's a 50%-70% reduction in RCM cost and an 80% reduction in claim rejections that typically recovers 6-9% of annual revenue that was previously lost to denials and write-offs.

What do you think RCM will look like two years from now?

Two years from now, RCM as a job category will be half its current size, and twice as accurate. Claims won't be processed – they'll be predicted.

AI agents will negotiate with payer AI agents in machine-to-machine settlement, denials will collapse from 20% to under 5%, and the percentage-of-collections pricing model – the 4-9% tax that's defined RCM for 30 years – will be dead. RCM becomes a flat-fee utility, like Stripe for healthcare claims.

The big picture: RCM stops being a back-office function and becomes embedded infrastructure – invisible, autonomous, transactional. The companies that won the last decade by processing claims will not win the next decade. The companies that win the next decade will be the ones who own the cross-payer data and the agents that act on it. That's the race we're running.