Spotlight: Robert Del Grande @ Valian Systems

A spotlight is a short-form interview with a leader in health tech. In this spotlight, you'll hear from Robert Del Grande, founder and CEO of Valian Systems.

What does Valian Systems do?

Valian runs a practice operationally. Three things. Patient communication, so the phone gets answered, appointments get booked and the reminders go out. Insurance verification, so a patient's benefits are confirmed before they walk in, not while somebody sits on hold with a carrier. And revenue cycle management, the claims and the collections on the back end.

The reason we do all three is that they aren't really three things. The call that books the appointment, the verification that runs before it and the claim that goes out after it are all the same patient. When a practice buys those from three different vendors, nobody owns the handoff between them, and the office eats whatever falls in the gap. That gap is where the denials and the write-offs live.

Most offices are paying four or five vendors for this, and the front desk is still drowning. We'd rather be the one shop that runs all of it.

How did you end up working in health tech?

I didn't come from healthcare. I ran an Amazon wholesale business from 2017 to 2024 and got it to eight figures a year. Sourcing, a warehouse, offshore teams. What I actually spent my days on was operations, and the thing I learned is that most of what a business pays for is people doing the same repeatable work over and over. For years the answer to that was hiring it out somewhere cheaper. I ran that playbook for seven years.

In 2024 I pivoted into AI agents because that playbook was finished. Dental was the first place I looked where the back office had that exact shape. Somebody is on hold with a carrier for twenty minutes to find out whether one plan is active, then they do it again for the next patient, and the same kind of thing happens again at the collections end. It's the operational problem I'd already spent years on, just in a different industry and with a lot more money falling through the cracks.

The other reason I stayed is that I can build it myself now. Valian is bootstrapped and I build the product. So when a carrier does something strange on a Tuesday, it gets fixed Tuesday, not in somebody else's next sprint.

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

It's the whole cycle, front to back. Verification is the front of it, and that's where the money actually gets decided even though it doesn't get collected until much later. If the benefits are wrong on the day of the appointment then everything after it is wrong too. The claim gets denied, the patient gets a bill they weren't expecting, and somebody spends the next week cleaning it up. Collections is the other end of that same problem, and a lot of what lands there traces straight back to a bad check at the front.

So my job is making sure that first check is right, making it happen without a person doing it, and then carrying it through to what actually gets paid.

The part nobody tells you is that the software is the easy half. The hard half is carrier behavior. We're early, we went live June 1, and a lot of my week is still spent on the cases where a payer doesn't answer the way the documentation says it will. That matters more than it sounds like it should, because a front desk stops trusting the whole system the second one check doesn't come back.

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

I think the verification and the phone call stop being jobs. Not the people, the tasks. There's no reason a human should be on hold to find out if a plan is active, and no reason collections should depend on somebody remembering to follow up. Those hours go back to the practice.

The harder part is trust, and I think that's what actually decides who wins. A front desk stops trusting a system the second a check doesn't come back. So whoever takes this has to be boringly reliable before they get clever. Reliability is the moat, not the model.

I also think the point solutions get squeezed. Owning one slice of the cycle stops being enough, because the value compounds when the same system sees the call, the eligibility and the claim on the same patient.

We started in dental on purpose. You prove the concept in one niche, get it right, then move outward into the other medical verticals. That's what we're doing over the coming months and years, and I think it's how the whole industry goes.