Wedge

What do they actually do

Wedge builds, installs, and runs AI agents inside hospitals and health systems. It combines a managed platform with forward‑deployed engineers who develop custom agents, integrate them into EHR, billing, and phone/scheduling systems, and then operate them with ongoing monitoring and governance through Wedge’s platform Wedge site, YC company page.

Primary users are operations managers, revenue‑cycle teams, records teams, and IT/security. Wedge shadows staff to map processes, defines ROI targets for each agent (revenue recapture, hours saved), and deploys department‑by‑department with auditability and controls Wedge site.

In production or offered today: payment reconciliation, records retrieval with audit trails, claims submission/denials follow‑up, medical coding, an AI receptionist for routine scheduling/calls, and an AI governance agent that monitors other AI products Wedge site. Their launch materials describe moving quickly into pilots across health systems (they report “60+ locations”) YC company page, Fondo launch post.

Who are their target customer(s)

• Revenue cycle manager: Manual claims/denials workflows and payment posting consume staff time and delay cash; Wedge’s agents submit/track claims and post remittances into billing systems to reduce this workload Wedge site.
• Health information management (records) director: Pulling charts, responding to records requests, and maintaining audit trails are repetitive and error‑prone; Wedge offers agents that retrieve charts and create auditable logs to standardize the process Wedge site.
• Operations / front‑desk manager: High call volume, no‑shows, and receptionist turnover hurt scheduling and patient experience; Wedge provides an AI receptionist and routine scheduling automations to handle common requests Wedge site.
• IT / security / compliance officer: Concerns about AI touching PHI without controls, fragmented vendor tools, and lack of consistent logging; Wedge positions continuous AI governance and monitoring to provide auditability and policy enforcement Wedge site, YC company page.
• CFO / VP of finance: Needs near‑term, measurable ROI and predictable cost reduction; Wedge ties deployments to defined ROI metrics and starts with pilots that prove outcomes before expanding Wedge site, YC company page.

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

• First 10: Run tightly scoped department pilots (RCM, records, front desk) with clear ROI metrics, embed an engineer to integrate into EHR/billing/phones, and deliver an audit‑ready deployment plus a referenceable results deck Wedge site, YC company page.
• First 50: Productize repeatable agents and deployment playbooks from early pilots; sell fixed‑scope bundles to similar sites with standardized security/compliance and ROI templates to minimize bespoke work Wedge site, YC company page.
• First 100: Scale via EHR integrators, RCM vendors, and consultancies; offer a self‑service agent catalog and shift to multi‑year managed‑service contracts with published outcomes and automated monitoring to reduce on‑site engineering Wedge site, YC company page.

What is the rough total addressable market

Top-down context:

The near‑term U.S. hospital TAM aligns with the U.S. Revenue Cycle Management market at about $58.5B (2024), plus smaller adjacent categories (records/document retrieval, front‑desk automation, agentic AI/governance), yielding roughly $55–65B today Precedence Research, Market size summaries, Grand View Research – Agentic AI. Longer‑term upside across broader providers and AI automation reaches into the low hundreds of billions per industry forecasts Grand View AI in healthcare.

Bottom-up calculation:

There are ~6,093 U.S. hospitals; dividing the $58.5B U.S. RCM market by this count implies ≈$9.6M per hospital per year across RCM vendors, consistent with a $55–65B TAM when adding adjacent back‑office automation and governance AHA, Precedence Research.

Assumptions:

• RCM spend is the primary proxy for near‑term budgets Wedge can target; adjacent categories add a few billion today.
• Hospitals will reallocate a portion of RCM/automation budgets to AI agent platforms over time.
• Estimates focus on U.S. hospitals; broader provider types and geographies expand TAM materially.

Who are some of their notable competitors

• Notable: Healthcare automation platform that uses AI/RPA to automate EHR workflows (intake, scheduling, RCM tasks); overlaps with Wedge’s back‑office automations Notable.
• AKASA: AI‑driven automation for revenue cycle operations (eligibility, prior auth, claims/denials); directly competes for RCM automation budgets AKASA.
• Waystar: Large RCM software platform (claims, denials, payments) that controls key workflows and spend in hospitals Waystar.
• R1 RCM: Managed RCM services provider for health systems that increasingly incorporates automation; competes for the same operational dollars R1 RCM.
• Syllable: AI voice assistants and call‑center automation for healthcare front doors (scheduling, patient communications); overlaps with Wedge’s AI receptionist use case Syllable.