Spotlight: Sam De Brouwer @ XY.AI Labs
A spotlight is a short-form interview with a leader in health tech. In this spotlight, you'll hear from Sam De Brouwer, co-founder and CEO of XY.AI Labs.
What does XY.AI Labs do?
At XY.AI, we're building a suite of AI agents that automate healthcare operations. Healthcare spends nearly $1.5 trillion every year on administrative work, like insurance verification, prior authorizations, claims processing, payment posting, and moving information between systems.
What makes XY.AI different is how comprehensive and composable our platform is. Our agents connect across the full stack—modern EHR APIs like Athena & AdvancedMD, payer portals like Availity, BCBS, and United, clearinghouses like Stedi, and legacy systems – giving organizations a single, unified automation layer across their entire revenue cycle. You don't need to stitch together a dozen point solutions to get the job done.
Our agents don't just assist people; they actually execute those workflows autonomously. The goal is simple: give healthcare teams back the gift of time so they can focus on caring for patients instead of paperwork.
How did you end up working in health tech?
I've spent most of my career building AI and tech companies, but healthcare became deeply personal because of my youngest son, now 27, who has had special needs since he was 5 years old because of a severe brain injury. In the last 15 years I have built applications and systems using AI in healthcare to impact outcomes and costs. With XY.AI I am addressing one of the biggest problems in healthcare, its operations.
We have extraordinary clinicians and dedicated healthcare workers across the front and back office, yet they're buried under administrative complexity. I became fascinated by the idea that AI could remove that burden and its frictions. If we can eliminate hours of repetitive work every day, we're not just making organizations more efficient—we're improving the experience for patients and the people who care for them.
How does your role intersect with revenue cycle management (RCM)?
Revenue cycle management is really the operational heartbeat of healthcare. If providers can't verify benefits, submit claims accurately, or get paid efficiently, the whole system struggles.
Our role is to automate those workflows end-to-end using AI agents, such as eligibility verification, prior authorizations, claim scrubbing, payment posting, ERA reconciliation, and EOB auditing. What makes this possible at scale is deep API and browser-based integrations: we connect natively with EHRs, payer networks, and clearinghouses like Stedi, so our agents can execute across the full revenue cycle as a single coordinated system, not a patchwork of disconnected tools.
The result is that we're helping organizations operate faster, more accurately, and with far less manual effort.
What do you think RCM will look like two years from now?
I think we'll stop talking about automation as individual tools and start thinking in terms of digital coworkers, and the organizations that get there first will have a structural cost and speed advantage.
Instead of staff logging into a dozen portals every morning, AI agents will be continuously working in the background, verifying benefits, submitting prior authorizations, following up on claims, reconciling payments, and escalating only the exceptions that require human judgment. We believe this because we're already measuring this with clients today—tracking metrics like 'zero-edit rate' (claims accepted with no human changes) and 'automation threshold' to show exactly what percentage of volume can run fully autonomously.
Humans won't disappear. Their role will shift from doing repetitive administrative work to supervising AI, making higher-value decisions, and focusing on patient relationships. That's where healthcare creates the most value.