Exactrx (Techstars 2025) is a Tennessee-based healthcare technology company that reduces denials and delays to care through proprietary AI powering autonomous, embedded checklists. By ensuring that cases align with payer policy and guidelines, the platform prevents claim denials and delays to care.

Emilie Vallauri, Global Program Manager at Techstars, spoke with Athena Doshi, CEO and co-founder, about her journey building at the intersection of technology and medicine, and how her team is refactoring healthcare operations for a more efficient future.

Emilie Vallauri: Could you start by introducing yourself and sharing how you became an entrepreneur?

Athena Doshi: My background is in physiology and neuroscience with a specialization in human interaction design from UC San Diego. I actually started my first company in college: a public health SaaS platform which templated public health solutions and allowed grassroots organisations in Tanzania and India to launch and scale their own public health programs. From there, I went deep into digital health, scaling products at Omada Health ahead of their IPO and publishing clinical research with the American College of Cardiology during my time at Heartbeat Health. Those experiences gave me a ground-level view of how healthcare actually operates, where the inefficiencies live, and what it takes to build something that clinicians and operators will actually use. I was originally studying to be a doctor, but ultimately changed my path after falling in love with the intersection of healthcare and technology. I've always been drawn to large-scale problems, and the revenue cycle felt like one of the most consequential and underloved ones in the industry.

Emilie: Who are the other members of your founding team, and how did you all meet?

Athena: Our core team is a lean group of four subject matter experts: repeat entrepreneurs with exits who have built digital health products for companies valued at $1B+ and pioneered AI/ML in medicine at leading clinical institutions.

Ellard Li, our co-founder and CTO, was the engineering manager of my product team at Omada Health. He has 15+ years of experience in full-stack software development, with a specialty in API development, within some of the most regulated industries like financial services and healthcare. 

Dr. Jan Krumsiek, PhD, leads AI/ML development at Exactrx. He is a 2x founder, pioneer in AI, NLP, and large language models, and professor at Weill Cornell Medicine of AI and Computational Biology. 

Finally, Dr. Gina Cocos, PharmD, a fellow UC San Diego graduate, is a cofounder and clinical expert with a doctorate in pharmacy from UCSF. She holds a deep understanding of clinical guidelines and payer policy, and how they intersect with revenue cycle and practice management.

We're also backed by a strong advisor bench including surgeons, cardiologists, anesthesiologists, and senior commercial leaders from Johnson & Johnson and Novo Nordisk, giving us both clinical depth and enterprise go-to-market experience.

Emilie: How did the idea for Exactrx start? What problem did you set out to solve?

Athena: We initially started building a precision medicine platform. However, while attending conferences and speaking with medical device companies, we discovered a deeper "house on fire" problem: the immense difficulty of operating healthcare as a profitable business. We realized that outpatient organizations were hemorrhaging revenue due to manual, repetitive revenue cycle and practice management tasks. We pivoted to build "autonomous checklists" that generate submission-ready claims, turning staff into reviewers rather than manual laborers.

Emilie: In simple terms, what does Exactrx do, and why is it important?

Athena: To understand what we've built, it helps to understand what agentic AI actually means. Unlike a chatbot that responds to questions, an agentic AI system acts autonomously, reasoning through a problem, breaks it into steps, executes each one using available tools, and delivers an output, all with minimal human involvement. That's exactly what ExactRx does for healthcare billing. When a surgical case is completed, our platform takes over: it pulls documentation from your EMR, validates every code against payer-specific rules, identifies what's missing and routes requests to the right people, and generates a fully submission-ready claim, all before your team touches it. We prepare your claims. You review and submit. 

This is critical because administrative costs currently cost the healthcare industry nearly $166 billion annually, yet over 30% of cases are still delayed or denied. We ensure patients get timely care without the back-and-forth cycle of justifying medical decisions to insurance companies.

Emilie: Who is benefiting from this solution, and how does it interact with other players like insurance companies?

Athena: Our primary clients are management service organizations that support provider groups and procedural sites like ambulatory surgery centers. While we don't interface directly with insurance companies, we use their clear guidelines to ensure clinics submit documentation in the right format the first time.

Emilie: What were the largest challenges you faced while building the product?

Athena: Payer rules change constantly, so staying subscribed to those updates and negotiated rates is an intricate challenge. Additionally, documentation often lives across multiple disconnected EMRs. To solve this, our team actually shadowed providers for days and even took medical billing courses to build genuine subject matter expertise.

Emilie: What sets Exactrx apart from competitors in the space?

Athena: Accuracy and speed. Many generalized AI models produce variable outputs every time you run them. Our proprietary architecture parses complex medical data into discrete tasks, which eliminates hallucinations. We’ve achieved a 96% criterion-level accuracy across complex medical cases, meaning clinicians approve nearly all of our automated recommendations. Additionally, customers can simply add us as a user in their system without going through complex integration cycles, which allows us to go live faster than our competitors and with less overhead for our customers.

Emilie: What have been your proudest recent milestones?

Athena: Honestly, the thing I'm most proud of is that we're delivering real outcomes for customers. Seeing the platform actually work in production: reducing denials, shortening AR cycles, giving teams back their time. That's what makes everything feel worth it. Beyond that, we've grown very fast, and our approach to marketing has been pretty unconventional — we’ve used tools like TikTok, newsletters, Reddit, and more — and there’s still so much more to come.

Everything has come through founder-led sales with essentially no traditional marketing spend, which I think says a lot about the strength of the product and the problem we're solving. The team is also starting to get the recognition it deserves, and on a personal note, I was honored to be named one of the Inc. 500 Female Founders of 2025.

Emilie: That’s amazing! And what are the next steps for the company in 2026?

Athena: This is our execution year. We are moving from working with design partners to a broader commercialization phase, making the platform accessible to more healthcare organizations. We want to give outpatient clinics "tech-like margins." We are also considering a fundraising round this year to scale our go-to-market efforts.

Emilie: Being a founder is hard… What motivates you to keep going on the hard days?

Athena: Honestly, some days are really hard. There are moments where you question everything. I was on the path to becoming a doctor myself. I had been accepted to my dream medical school and turned it down. That's not a small thing to sit with. But I made that choice because I believed there was a way to have a bigger impact from the outside, by building the infrastructure that makes the whole system work better. And I have to keep believing that. I think about the clinicians who went into medicine to help people and spend half their day on paperwork instead. I think about patients who delay care because a billing process broke down somewhere and nobody caught it. That shouldn't happen. It doesn't have to. My sister is in medical school right now, and I think about her a lot. I want her to start her practice with tools that actually work, so she can just focus on her patients. On a personal level, I genuinely couldn't do this without my partner. There have been long drives to client meetings where he's just waited in the car for hours. That kind of support means more than I can say.

Emilie: What advice would you give to aspiring founders?

Athena: Take all advice with a grain of salt. I was 19 when I started my first company, and very susceptible to influence, but you have to trust your own unique experience. Also, don't compare your growth to others; a B2B company has a different journey than a consumer platform. Focus on building a profitable business rather than chasing generic press or titles.

Emilie: Why did you decide to join Techstars, and how did the Northwestern Medicine partnership help?

Athena: Northwestern Medicine was a massive draw for us, not because health systems are our target market, but because getting close to a clinical institution of that scale gives you an incredibly rigorous environment to pressure-test your product. The complexity of their workflows, their standards for documentation, and their expectations around compliance. All of that makes us sharper as we go deeper into ambulatory surgery centers and MSOs, which is where we're focused. They've been incredible mentors and design partners for that reason. Between that and the support from Brad Schnitzer, Techstars has been a critical part of how we've built the credibility and rigor that our actual customers expect.

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