The Revenue Execution Gap

Millions in EBITDA stuck in unworked denials,
underpayments, and aging AR.

End-to-end revenue cycle execution for PE portfolios. Denials managed. Underpayments recovered. AR optimized. No new hires. Outcome-based pricing.

ANKA inverts the traditional model. Deploy it across your portfolio for standardized revenue cycle execution. Every dollar of margin improvement lands in EBITDA.

30–60%

McKinsey Q1 2026: Agentic AI reduces RCM cost-to-collect. The linear FTE model no longer works.

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HIPAA Compliant SOC 2 Certified Outcome-based pricing

Portfolio EBITDA Impact

Revenue leakage before & after ANKA · Per portfolio company

$6M

$2M

Co. 1
Cardiology

$5M

$1.5M

Co. 2
Anesthesia

$8M

$2.5M

Co. 3
Pain Mgmt

$4M

$1M

Co. 4
Radiology

$7M

$2M

Co. 5
Urology

Leakage without ANKA

Residual with ANKA

$2–5M EBITDA lift across the portfolio From execution, not headcount

The Operating Model

The linear FTE model is dead.
Here’s what replaces it.

Old Model — Add FTEs Per Acquisition

5 acquisitions. $800K in new overhead. Zero margin improvement.

Acquisition Year 1 $150M practice. 2 RCM staff. $240K/year. You hit baseline — not growth.

Year 2 staffing 3–4 staff needed. $400K/year (salary + benefits + turnover). You’ve added $160K in permanent overhead with no collections improvement.

At 5 acquisitions +$800K in annual RCM costs. No margin improvement. Just wage scale. Every exit story weakened.

+$800K overhead · No EBITDA improvement

New Model — Agentic Execution Across the Portfolio

5 acquisitions. One playbook. $600K–$1.2M in margin improvement.

Deployment (Weeks 1–4) ANKA connects to each portfolio company. Single integration per EHR type. One playbook. Replicated across every company.

Execution (Month 1+) Every denial worked. Every underpayment recovered. Cost per appeal: $15–20 vs. $180–250 with an FTE. 30–50% cost-to-collect reduction.

At 5 acquisitions $600K–$1.2M in margin improvement from same staff. More revenue. Lower operational costs. Clean EBITDA story for exit.

$600K–$1.2M margin improvement · No new hires

McKinsey (Jan 2026): “Agentic AI cuts RCM cost-to-collect by 30–60%. The operating leverage is now in execution, not headcount.”

Deployment Timeline

Your post-acquisition playbook

Four phases. 90 days from contract to stable execution across every portfolio company.

Day 1–30

Assess

Claims volume. Denial rate. Underpayment exposure. Aged AR. Current RCM cost structure. Staffing gaps identified. Recovery opportunity quantified.

What’s broken + what’s recoverable

Day 30–60

Connect

EHR integration. Denial feeds configured. AR data flowing. Payer contracts uploaded. Automation workflows tested. Your team trained. Exceptions defined.

Systems live. Zero manual work needed.

Day 60–90

Execute

ANKA goes live. Denials flowing to resolution. Appeals written and submitted. Underpayments recovered. Follow-ups automated. Team handles exceptions only.

First revenue improvements visible

Day 90+

Measure & Optimize

Denial rate trending down. AR days improving. Collection rate climbing. Outcome SLAs measured weekly. Adjustments made automatically.

30–50% cost-to-collect reduction

Portfolio Metrics

What this means for your portfolio

30–50%

Reduction in cost-to-collect

Across all portfolio companies. Without adding staff.

20–35%

Collections improvement

From unworked denials and underpayment recovery. Flows to EBITDA.

4 weeks

Time to deploy

One playbook. Multiple companies. Parallel deployment.

Upfront cost (contingency option)

Recover underpayments first. Pay from what you find.

Example portfolio calculation

5 healthcare companies · $750M combined revenue · Average 4% baseline collection leakage (standard for mid-market). Total leakage: $30M per year. ANKA’s 30–50% cost-to-collect reduction + collections improvement = $2–5M in annual EBITDA lift. From execution, not headcount.

Why We’re Different

What $852M in failed healthcare AI teaches us

The Olive AI Model

Olive AI

Raised $852M · Went bankrupt 2024

✗Promised to do “all back-office work”

✗Built dashboards. Sent alerts. Showed insights.

✗Required people to execute — you still needed staff

✗Never delivered execution. Only reporting.

✗Went bankrupt in 2024

AI that tells you what to do. Your team still does it.

The ANKA Model

ANKA

Outcomes guaranteed in the contract

✓Does the work. Not the reporting.

✓Appeal gets submitted. Not recommended for submission.

✓Underpayment gets recovered. Not flagged for recovery.

✓Your team handles exceptions only (the 10% needing judgment)

✓Outcomes guaranteed in the contract. Teeth on the guarantee.

AI that does the work. You pay only when results improve.

“The difference between AI that helps you do work and AI that does the work is everything.” One model went bankrupt on $852M. The other guarantees outcomes in the contract.

FAQs

PE-Backed

Yes. We’ve done it. The deployment is parallel, not sequential. Week 1–2: Assessment across all companies (concurrent). Week 2–3: EHR integration (one per EHR type, then replicated). Week 4: Execution live across the entire portfolio. One playbook. Repeatable setup.

Standard. Most of our PE portfolios run 3–5 different systems. We integrate once per EHR type, then replicate the integration to every company using that system. No extra work. No extra cost. Deployment timeline doesn’t extend.

No minimum. We work with individual PE-backed companies (same model) and with portfolios of 10+. The playbook scales. Your operational leverage scales with it.

Exits: ANKA’s data and outcome history stay with you for valuation and due diligence. New acquisitions: ANKA’s already deployed at your other companies — you can add the new company to the same system in 2–3 weeks (assessment + integration + execution).

Millions in EBITDA stuck in unworked denials,underpayments, and aging AR.

The linear FTE model is dead.Here’s what replaces it.