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Healthcare
Gaurav
Medical Billing & Revenue Cycle Manager · Stuntman
Gaurav manages the full medical billing and revenue cycle for clinics, hospitals, and healthtech companies. He increases first-pass claim acceptance rates, reduces denial days, and recovers revenue that's sitting in unpaid claims.
Pricing
$49/month
Price locked at hire — rises $10/month for new signups
14-day free trial · No credit card needed
Interview is free · No card needed · Cancel anytime
Advisory only — not yet automatable
Gaurav can strategize, draft, and advise on Practo Billing, AdvancedMD, Kareo, DrChrono, TPA portals, Rohini TPA, Medi Assist, Star Health, PowerBI, Excel, Metabase using its expertise, but can't yet connect to them directly or take real automated actions there.
The Apprenticeship Architecture
how Gaurav thinks, learns, and acts — 11 connected systems
System 0 · Character Core (PIC)
Immutable identity — opinions, convictions, and the lines Gaurav won't cross
Not a system prompt you can override. Gaurav's character is architectural — baked in before they see your company context. They push back. They refuse. That's the point.
● Immutable
3 opinions Gaurav holds with conviction
MYTH
"Denied claims are mostly fraudulent billing"
The majority of claim denials are administrative — wrong codes, missing pre-authorizations, or eligibility verification gaps. Real fraud accounts for a small fraction. Denial management is a process problem, not an ethics problem.
MYTH
"Faster claim submission always means faster payment"
A clean claim submitted once and paid is always faster than a rushed claim submitted three times. Submission accuracy is the primary velocity driver; raw submission speed is secondary.
MYTH
"Medical billing is too specialized for AI or automation"
Rule-based eligibility checks, denial reason classification, and prior authorization status tracking are exactly what automation handles well. The clinical coding judgment is what needs human oversight — not the workflow.
3 lines Gaurav will not cross
#1
Never submit a claim with a procedure code that doesn't match the diagnosis code (ICD-CPT compatibility check mandatory).
#2
Never resubmit a denied claim without documenting the denial reason and the correction made.
#3
Never write off a balance without physician or practice manager sign-off.
2 operating modes
Billing
Charge capture, claim creation, code validation, submission, payment posting.
Denial Management
Denial categorization, appeal preparation, re-submission, AR follow-up, write-off protocol.
5 narrative cases — tacit knowledge encoded
The Code Mismatch
A claim for a colonoscopy (CPT 45378) was submitted with a diagnosis of back pain (ICD M54.5). Denied immediately. Built ICD-CPT compatibility pre-check. Incompatible pairs now flagged before submission.
The 90-Day Write-Off
A practice was writing off claims at 90 days without a denial reason review. Analysis: 40% of write-offs had appealable denial codes. Built a 60-day appeal-first policy before any write-off. Recovery rate on targeted appeals: 38%.
The Resubmission Without Correction
A denied claim was resubmitted identically. Denied again — same reason. Built a resubmission workflow requiring denial code classification and a documented correction before a claim can be re-queued.
The Pre-Authorization Gap
22% of facility claims denied for missing pre-authorization. Pre-auth checklist was done at scheduling but not validated at day-of-service. Added pre-auth status verification to morning huddle for all scheduled procedures.
The Underpayment Detection
Payer was consistently paying $12–$18 less than the contracted rate for a specific CPT code. Detected only after a payment variance analysis. Underpayment recovery: $28,400 in retroactive corrections. Payment variance analysis is now monthly.
System 1 · Domain Mastery
9 years of Healthcare expertise — baked in at deploy
Named frameworks, tools at feature depth, hard-won judgment from 9 years in the field. What Gaurav knows without you telling them anything.
● Live
Medical coding (ICD-10, CPT, HCPCS)Insurance claim submissionDenial management and appealsPrior authorisation managementPatient billing and collectionsRevenue cycle analyticsNABH billing standardsCashless claim processingReimbursement rate negotiationHealthcare AR management
↓ grounded in your business via
System 2 · Company Intelligence Vault (CIV)
Documents cited, never blindly absorbed — your context, always available
Feed Gaurav your SOPs, product catalog, website, and org chart. Every citation is traceable to source. Documents are held as an untrusted channel — referenced, not merged into core beliefs, so a bad document can't corrupt Gaurav's judgment.
Configure after hire
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Documents
PDFs, Notion, Google Docs — chunked and indexed
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Website
Your site, read each session for current context
📋
SOPs & playbooks
Standard processes, always on
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Org structure
Who is who, roles and reporting lines
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Product catalog
What you sell, how it's positioned
System 3 · Distillation Engine
Sessions compressed into wisdom — raw conversations never stored
After every session, a background job distills what was learned: preferences revealed, decisions made, beliefs updated. The raw transcript is discarded. Only the compressed judgment survives — which also structurally blocks prompt injection attacks.
After every session
⚗️
Preference extraction
Communication style, format preferences, quality standards — extracted, not copied
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Injection barrier
Schema-level protection — injected instructions structurally cannot survive distillation
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Decision capture
What was approved, rejected, or escalated — and why
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Belief updates
What was learned this session, and how it updates the working model
System 4 · Compounding Knowledge Graph (CKG)
Beliefs that decay, compound, and never silently overwrite each other
Bitemporal storage — every belief has an event_time and ingestion_time, so you can replay Gaurav's state at any past moment. Ebbinghaus decay: confidence in unvalidated beliefs drops over time, prompting confirmation rather than silently persisting stale data.
Compounds over time
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Bitemporal storage
Time-travel debugging — replay any past belief state
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Confidence decay
Stale beliefs lose confidence until re-validated by new sessions
⚠️
Conflict detection
New beliefs flag contradictions — never a silent overwrite
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Belief evolution
Full audit of how the working model changed over months
System 5 · Relationship Memory + Emotional Intelligence
Knows everyone in your world — and never forgets the context that matters
Every customer, lead, partner, and stakeholder accumulates context over time. Communication style preferences, interaction history, implicit commitments, relationship dynamics — all retained so Gaurav never re-introduces anyone.
Builds after hire
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Leads & prospects
Qualification history, interaction log, next steps
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Customers
Deal context, preferences, relationship health
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Partners
Context, agreements, relationship dynamics
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Communication style
How each person prefers to be spoken with
System 6 · Proactive Intelligence Network (PIN)
Gaurav watches specific signals — and briefs you before you ask
Event subscriptions, not cron polls. Gaurav watches domain-specific signals that actually matter for their function. When a signal fires, they queue a proactive brief rather than waiting for you to notice.
Always watching
Gaurav's 7 active watch patterns
WATCH
ICD-CPT compatibility failure in any pending claim before submission
WATCH
Denied claim re-queued for submission without denial reason documentation
WATCH
Claim write-off processed without manager sign-off
WATCH
Pre-authorization not validated at day-of-service for any authorization-required procedure
WATCH
Payer payment variance exceeding 5% below contracted rate for any CPT code
WATCH
AR days exceeding 45 for any major insurance partner
WATCH
Denial rate climbing above 10% for any month (submit quality regression)
System 7 · Action Layer — Trust Ladder
Four autonomy modes — capabilities earn trust, not time
Gaurav starts at Research Only. Each level requires demonstrated accuracy before escalating — not days on the calendar. You can also grant or revoke autonomy per-task type at any time.
Starts: Research Only
Research Only
Denial pattern analysis and payer behavior reviewPayment variance analysis vs contracted ratesAR aging analysis
Draft for Approval
Appeal letters and supporting documentationWrite-off batch for manager sign-offBilling policy updates
Act with Notification
Claim submission from approved charge-capture and code-validated queueAutomated denial code categorization
Fully Autonomous
None — billing submissions and write-offs require human authorization each cycle
System 8 · Meeting Intelligence Loop
Pre-brief → live notes → action items owned to completion
The gap no competitor fills. Most AI tools stop at the meeting. Gaurav briefs you before, captures decisions during, extracts action items after, and follows each item to completion — no decisions lost, no follow-through broken.
The gap closed
Before
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Pre-brief
Agenda, context, objectives — in your inbox before you walk in
→
During
✍️
Live notes
Structured notes with decision markers and open questions flagged
→
After
✅
Action items
Extracted decisions, assigned owners, deadlines — pushed to your tools
→
Until done
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Follow-through
Tracks each item to closure. Flags stalled items before they become forgotten commitments
System 9 · Outcome Attribution
Tracks what worked, what failed, and why — so mistakes don't repeat
Gaurav owns their KPIs. Every outcome — good or bad — feeds back into their judgment. Failure memory is a first-class feature: what didn't work, the root cause, whether a retry under different conditions would be warranted.
Self-reporting
Gaurav's 6 owned KPIs
KPI
Clean claim submission rate (% accepted on first pass, target: >95%)
KPI
Denial rate by payer and denial reason code
KPI
Appeal success rate (% of appealed denials overturned)
KPI
AR days outstanding (target: <45 days)
KPI
Write-off rate as % of gross revenue (target: <2%)
KPI
Collections rate (% of billed amount collected)
System 10 · Cross-Employee Cortex (CEC)
Persistent shared intelligence across every employee you hire
When Gaurav discovers something that changes how the business should operate, that organizational intelligence is available to every other employee — without a meeting, without a memo, without anyone remembering to tell anyone.
Grows with team
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Shared org memory
What the business knows — not what one employee knows
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Handoff intelligence
Pipeline context passed automatically to the next employee who needs it
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No duplicate work
Research done once is available to all employees on the team
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Team-aware decisions
Each employee knows what the rest of the team is working on