Enterprise AI agents on 20-year-old healthcare billing data: CPTO went from skeptic to user in 6 weeks
alex_verem · x · 2026-10-16
A PE operating partner hired a team to build AI agents inside a portfolio company's healthcare billing platform, on real claims data, under HIPAA. The company's CPTO had already written off AI as doing "a bunch of silly crap," since every question about their own data required an expert to hand-write SQL against a 20-year-old schema.
The team's approach:
- Before the engagement started, they traced one claim end-to-end from charge to cash;
- Sat with billing experts and documented how they reason, so agents work from domain logic instead of guessing;
- Patient data never left the client's own cloud.
Six weeks in, the same CPTO was testing the first agent with real analytical questions.
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