Procode AI Raises $4M And Acquires The Auctus Group To Build AI-Powered RCM For Surgeons
Procode, an AI revenue cycle management company focused on private practice surgeons, has launched from stealth with $4 million in funding and the acquisition of The Auctus Group. The round was led by Story Ventures with participation from CHAP Health Ventures, Progression Fund, and Dmitry Shevelenko (Chief Business Officer at Perplexity). The company was founded in 2024 by Jeff Cripe, Kameron Rezzadeh, M.D., and James Baez-Silva.
The move pairs Auctus' established billing operations in plastic surgery and dermatology with Procode's AI infrastructure. For practice leaders, the signal is clear: automation is moving from pilot projects to full-stack billing operations, with real revenue impact.
What Procode AI Offers
- Coding Copilot: Translates operative reports into billing and diagnostic codes so coders can work faster and with greater accuracy. The company reports up to 90% faster coding.
- Claims and Reimbursement Automation: Streamlines submission workflows and reduces coding-related denials.
- AR and Denials Management Engine: Uses AI to prioritize follow-up, payment posting, charge posting, and decisioning to accelerate collections and improve reliability.
- Auctus Provider App: Real-time financial and claims data for surgeons, increasing visibility into performance and revenue flow.
Traction And Scale
Within five months of acquiring The Auctus Group, Procode added $2 million in annual recurring revenue. Management attributes the lift to fewer coding denials, fewer accounts receivable days, and improved reimbursement rates.
Founded in 2012, The Auctus Group continues to operate under CEO John Gwin, who remains at the helm of the RCM business. Procode AI currently serves more than 300 plastic surgery and dermatology providers.
Leadership And Investors
Founders: Jeff Cripe, Kameron Rezzadeh, M.D., and James Baez-Silva. Investors include Story Ventures (lead), CHAP Health Ventures, Progression Fund, and Dmitry Shevelenko.
What Practice Leaders Should Evaluate
- Business case: Baseline your denial rate, AR days, first-pass acceptance rate, net collection rate, and coder throughput. Define targets and a 90-120 day ROI checkpoint.
- Workflow fit: How does Coding Copilot integrate with your EHR/PM and document templates? Clarify intake-to-charge capture-to-claims handoffs.
- Accuracy and oversight: Coding audit process, confidence scoring, human-in-the-loop checkpoints, and payer-specific rule handling.
- Denials playbook: Root-cause analytics, automated appeals, underpayment detection, and escalation rules by payer.
- Data and security: PHI handling, encryption, audit logs, access controls, BAA terms, and model/data segregation.
- Change management: Training plan for coders and billers, surgeon education, and KPI dashboards for daily/weekly review.
- Contracts: Pricing tied to outcomes where possible, SLAs for clean claim rate and response times, and exit/data portability.
Key Quotes
"Our cofounder is a surgeon. Our mission is personal and singular: create the first, best, and largest AI-powered revenue cycle management company for surgeons in private practice. The Auctus Group is a tech-forward, missionary team who want to build the next generation biller with us." - Jeff Cripe, Co-Founder of Procode Inc.
"As a surgeon, choosing a medical biller means trusting all of your insurance-based income to one company. At Procode, we're building technology that ensures that providers are reimbursed fairly for procedures that they perform, and that they are reimbursed faster than ever before." - Kameron Rezzadeh, M.D., Co-Founder of Procode Inc.
"Most RCM AI products are vaporware. As CEO of The Auctus Group and a longtime HBMA leader, I've searched for AI technology that can better equip our team to deliver better billing outcomes for clients and, in Procode, we finally found that." - John Gwin, CEO of The Auctus Group
Metrics To Monitor Post-Implementation
- First-pass claim acceptance rate and average days to submit charges
- Denial rate by payer and denial reason; appeal win rate
- Days in AR (overall and by payer/age bucket)
- Net collection rate and payer underpayment detection/recoupments
- Coding turnaround time and coder productivity per case
- Cash acceleration: variance vs. baseline monthly cash
Integration And Compliance Notes
- Confirm interfaces with your EHR/PM, clearinghouse, and patient payment tools; support for HL7/FHIR or vendor APIs.
- Validate claim and remittance formats (837/835), payer rule updates, and ongoing maintenance responsibilities.
- Require full audit trails, versioning of code suggestions, and clear override controls for staff.
- Ensure signed BAA, documented incident response, and periodic security reviews.
Why This Matters For Management
RCM margins are being squeezed by payer friction and staffing costs. Teams that combine established billing operations with targeted AI can reclaim denial-prone dollars and shorten AR without adding headcount.
The Auctus acquisition gives Procode immediate operating scale while its AI aims to compress cycle times. If you lead a surgical practice, this is the moment to test AI-driven coding and denials workflows under tight metrics and clear SLAs.
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