Cenote

What do they actually do

Cenote builds software to automate back‑office work for medical clinics. The product reads incoming referrals and faxed documents, extracts the key data, checks insurance eligibility, prepares or submits prior authorizations, and follows up on incomplete online intakes to move patients toward scheduling and treatment YC page Launch HN Website.

They focus on specialist outpatient clinics first, with applicability to specialty pharmacies and digital/telehealth clinics that handle high referral or intake volumes. The goal is to shorten referral‑to‑treatment delays and reduce manual administrative work that causes patient drop‑off and revenue lag YC page TechTimes.

Who are their target customer(s)

• Specialist outpatient clinics (sleep centers, orthopedics, dermatology): Staff manually read and transcribe referral faxes, extract missing data, and verify information before scheduling, creating multi‑day delays and patient drop‑off YC page Launch HN.
• Specialty pharmacies and medical‑supply practices: Teams spend significant time confirming insurance coverage and completing prior authorizations, which holds up treatments or shipments until payers respond YC page.
• Digital and telehealth clinics reliant on online intake: Many signups stop partway or go cold; generic slow follow‑up leads to low conversion from half‑filled forms YC page Website.
• Small practices with minimal administrative staff: A few employees juggle referral/fax processing and chasing missing information, forcing hiring decisions or acceptance of lost patients and revenue YC page.
• Clinic operations or revenue managers: Referral‑to‑treatment times are slow and drop‑off rates are high; improving them usually means costly headcount or accepting billing and revenue delays YC page TechTimes.

How would they acquire their first 10, 50, and 100 customers

• First 10: Founder‑led, high‑touch pilots with nearby specialist clinics, using targeted outreach and hands‑on onboarding/integrations to show immediate reductions in referral processing delays on real workflows YC page Launch HN.
• First 50: Turn 2–3 successful pilots into case studies and run segmented outbound to similar clinics; add a seller/implementer and a standard onboarding playbook to convert pilots into paid contracts, leveraging early press and proof points TechTimes YC page.
• First 100: Layer on partnerships with select EHR/referral vendors and specialty pharmacies, plus focused presence at a few specialty conferences; publish concise ops playbooks and use YC/press credibility to shorten sales cycles TechTimes YC page.

What is the rough total addressable market

Top-down context:

Administrative automation tied to referrals, intake, and prior authorization sits inside a >$1T ambulatory care revenue pool in the U.S. and includes a directly comparable electronic prior‑authorization market estimated around $3.2B, with broader RCM software much larger Statista MarketIntelo Fortune Business Insights.

Bottom-up calculation:

There are on the order of hundreds of thousands of practices with tens of thousands of single‑specialty outpatient clinics; using ~213k private practices (2020) and the share that are single‑specialty implies ~70–80k specialty clinics to prioritize, plus specialty pharmacies and digital clinics PMC analysis AMA.

Assumptions:

• A meaningful subset of single‑specialty outpatient clinics have sufficient referral/prior‑auth volume to justify automation spend.
• Average annual software spend per target site on these workflows is in the low‑thousands to tens‑of‑thousands of dollars, consistent with e‑prior auth/RCM benchmarks.
• Cenote can access these buyers via direct sales and select channel partners (EHR/referral/ pharmacy), yielding practical penetration of the tens‑of‑thousands customer base.

Who are some of their notable competitors

• Olive: Enterprise automation vendor that built prior authorization, patient access, and revenue‑cycle tools for hospitals/health systems; overlaps on prior‑auth and insurance workflows but focuses on large enterprise deals. Its prior‑auth business was acquired by Availity FierceHealthcare.
• CoverMyMeds (McKesson): Widely used prior‑authorization workflow for medications and specialty drugs; strong pharmacy/EHR integrations. Overlaps where clinics or specialty pharmacies need drug PA workflows.
• Phreesia: Patient intake and registration platform to capture demographics, insurance, and forms pre‑visit; overlaps on reducing abandoned intake but focuses on front‑end intake rather than parsing referrals or handling complex prior auth.
• Luma Health: Patient communication and outreach tool for reminders, two‑way messaging, and re‑engagement; overlaps with follow‑up on incomplete signups, but is centered on messaging/scheduling rather than insurer checks or data extraction from referrals.
• ReferralMD: Referral‑management and routing system to track inbound referrals and standardize forms; directly addresses referral intake/triage but is built around referral routing workflows more than end‑to‑end insurance or prior‑auth automation.