The $92B Industry
That Needs Intelligence
Insurance companies use AI to deny and cut care. Cendri is the AI that fights for the independent facility — the facility's AI the behavioral health market has never had.
Traction
Why the Billing Revenue Leak Persists
The Appeal Outcome Gap
Denied claims frequently close with no recorded appeal outcome. That isn't proof nobody appealed — it's proof nobody can tell. A denial that closes without a recorded decision is where the money goes. The gap is pure operational friction: ASAM justification, level-of-care mapping, and payer-specific criteria mean generic appeal templates don't move the needle. Most facilities simply don't have the staff time.
The Clinical-RCM Disconnect
Kipu, Netsmart, and Qualifacts store documentation but do not generate auth letters. Eleos transcribes encounters but does not touch billing. No existing BH platform connects clinical documentation to billing outcomes — EHRs write notes, RCM tools track claims, and neither one sees both sides. Every prior auth is a one-shot with no reconciliation against what was actually paid.
Closed-Loop Authorization Learning (Patent-Pending)
Save → Outcome → Appeal → Payer Intelligence Loop
Every submission is recorded with payer, market, service level, and clinical scores. Payer intelligence draws on your facility's own authorizations from the last 180 days. 8 patent-pending claims, priority date locked April 2026.
Why now
Payers already use AI to decide authorizations. Independent behavioral health facilities answer with phone calls and paperwork. Kipu and Sunwave now open their data through APIs, so a facility-side AI can read the whole chart for the first time. And the facilities that need it most, 20\u201380 bed programs with no UR department, are the ones no enterprise vendor serves.
Key Market Drivers
AI Funding Surge
AI is the dominant funding theme in healthtech entering 2026. BH funding surged 38% in 2024 to $2.7B, with AI-focused deals leading growth (Rock Health Digital Health Funding Report, 2025).
EHR Modernization
ONC Cures Act mandates FHIR R4 interoperability. Every major EHR is now an integration target.
Clinician Shortage
Growing global shortage of BH professionals. Technology that reduces burnout becomes a retention tool — not just a cost center.
Built. Secured. In Pilot.
Three phases complete. One in pilot. Here's the full build and roadmap.
Phase 1: Platform Built
3 role-based portals. 23 AI endpoints. 20M+ scenarios across 112 clinical domains. Payer-specific requirements for 15+ payers in UR packages; 8 payer templates for prior-auth letters and appeals. AWS with signed BAA.
Phase 2: Security & Compliance
HIPAA-aligned on AWS. 42 CFR Part 2 consent-aware governance. Independent web application penetration test by Qualysec — 17 April 2026, retested 28 April 2026, all findings closed at retest. One finding regressed in July and was re-closed on 21 September. Continuous structural RLS policy auditing in production.
Phase 3: AI Enhancement & IP
Streaming responses and retrieval quality gates. The outcome loop is built; first measured outcomes come from the pilots. 8 patent-pending claims, priority date locked April 2026.
Phase 4: Pilot & Scale
Live EHR integration with behavioral health facilities on Kipu and Sunwave today. The outcome loop is built and running — first measured outcomes (authorized days per completed stay, denial mix, reviewer time) come from ongoing pilots, measured against each facility’s locked baseline. Onboarding a new Sunwave facility is configuration, not development.
How We Win the Days
The headline measure is authorized days per completed stay, compared with your locked baseline, by payer and level of care. Measured from your own EHR authorization records, frozen before Cendri goes live.
On every package Cendri drafts, we record what you requested and what the payer granted — by payer and level of care — and report the lift against your locked baseline. No baseline, no claim. We fight the payer's algorithm with yours.
Flat per-bed fee, plus a tiered share of results. The facility pays a predictable platform fee tied to capacity, and Cendri earns more only when it lifts authorized days above the locked baseline — so our incentive and the facility's are pointed the same way.
Why Cendri Is Hard to Replicate
An incumbent EHR could bolt on a scribe overnight. Replicating a 20M+ scenario behavioral-health corpus, a governed AI pipeline, payer intelligence built from real authorization outcomes, and 2+ years of clinical architecture takes considerably longer.
The incumbents aren't slow to this. They are structurally unable to build it.
Clinical Depth
112 clinical domains: PTSD, SUD, TBI, MST, eating disorders, faith-based, adolescent, elderly, oncology, cardiometabolic, and more.
Independently Security-Tested
Independent web application penetration test by Qualysec — 17 April 2026, retested 28 April 2026, all findings closed at retest. Continuous structural RLS policy auditing in production.
Whole-Person AI
Comorbidity bridges and faith integration are available in Cendri’s risk models.
Competitive Landscape
Why Cohere isn't a head-to-head competitor: Cohere Health builds AI for payers (Humana, Geisinger, Medica) to make prior-authorization decisions. Cendri builds AI for providers to optimize the prior-auth submissions those payers will receive. Different customer, opposite side of the table — Cendri serves the provider-side BH/SUD market Cohere doesn't touch.
Where Dazos fits: Dazos is a behavioral health CRM with an AI billing-analytics add-on (Dazos IQ) that flags revenue leaks and streamlines admissions. It is provider-side and BH-focused, but it tracks claims and admissions — it does not perform clinical-to-RCM reconciliation, draft authorization or appeal letters, or run a prior-auth outcome learning loop. Cendri competes on the UR and authorization fight Dazos doesn't enter.
BH EHRs are our distribution, not our competition.
Sunwave — now combined with Lightning Step — is one of the most widely used behavioral health EHRs. Cendri's Sunwave integration is live today, so onboarding another Sunwave facility is configuration, not development.
We compete in RCM. We win because of UR.
Generic RCM vendors cannot tell you why a claim was underpaid. The EHRs run the chart, not the fight for payment. Nobody has built this layer for providers.
| Capability | Cendri Health | Cohere Health | Kipu | Sunwave | Netsmart | Eleos | Dazos |
|---|---|---|---|---|---|---|---|
| Customer side | Provider | Payer | Provider | Provider | Provider | Provider | Provider |
| Behavioral health specialist | – (medical broad) | ||||||
| AI Governance Pipeline | Governed AI pipeline | Partial | |||||
| Clinical Retrieval Corpus | 20M+ BH scenarios | Internal payer rules | ~5 domains | ||||
| Documentation / UR Tools | UR packages, auth letters, appeals | Kipu Intelligence | MARA UR | Scribe | |||
| Prior-Auth Outcome Learning Loop | ✓ (Patent-pending) | Payer-side decisioning |
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Contains forward-looking illustrative projections based on the assumptions described herein; actual results may vary materially and are not guaranteed. Not an offer to sell or a solicitation of an offer to buy any security. © 2026 Cendri Health LLC.
