For healthcare providers, RCM vendors, and digital health · Early-customer engagement

Healthcare back-office, run by operators who built it for travel-tech first.

We’ve spent years running multi-party, time-sensitive, high-volume B2C operations for travel-tech at scale. We’re applying that same operating model to healthcare RCM and patient-facing operations, and we’re taking one to two early customers in 2026.

370+ agents in active operations
Multi-party coordination experience
24/7 US-timezone coverage
90-day pilot start
Current travel-tech operations. Healthcare practice in development.
Before you read further

What you should know upfront.

Most BPO pages claim deep healthcare expertise with a logo wall of providers, made-up accuracy numbers, and a BAA on file from day one. We don’t have that, and we won’t pretend we do.

What we have is an operating model that runs the entire B2C function of a Trivago-owned OTA at scale. 100+ agents on that engagement alone. Tier 1 through Tier 3. Multi-party coordination across customers, suppliers, and partners. Time-sensitive escalations. Dispute and recovery work. Daily reconciliation across systems that don’t agree with each other.

If that operating reality sounds like healthcare back-office to you, it should. The lifecycle is similar. The failure modes are similar. The talent profile is similar. We’re now extending it into healthcare, and we want to do it with providers and RCM vendors who’d rather build the operation with us than wait for it off-the-shelf.

The transferable architecture

What we know about healthcare ops, before we’ve run them.

The operational shape of healthcare back-office is not new to us. Different vocabulary, same architecture.

Multi-party coordination

OTA: Customer → Platform → Supplier → Hotel
Healthcare: Patient → Provider → Payer → Pharmacy / Lab / Vendor

Same coordination problem. Same failure modes when one party drops the ball.

Time-sensitive escalation

OTA: A booking failure at check-in cascades into chargebacks, reviews, and lost lifetime value within 48 hours.
Healthcare: A failed eligibility check or denied claim cascades into rebilling cycles, AR aging, and patient dissatisfaction within 30 days.

Both businesses run on operational rhythm. Both pay heavily when it breaks.

Multi-system data integrity

OTA: PMS, booking platform, channel manager, supplier feed. Every record disagrees with every other record.
Healthcare: EHR, practice management, clearinghouse, payer portal, patient portal. Same problem at higher stakes, and with regulators watching.

We’ve spent years operating in the gap between systems that don’t agree. That’s a transferable skill.

What we’d run

Three pillars. Nine functions.

Each will run as its own discipline.

Early engagements start with one or two functions. Nobody buys the full stack on day one. The list below is what we’d build out together over a 90-day pilot.

01
Revenue Cycle (Front)

Where the dollars are earned or lost before any work is done.

Patient access and eligibility

Insurance verification, benefits checks, prior auth status, pre-service estimates. Run as a structured operational queue, not a per-call adventure. The single biggest source of preventable downstream rework.

Prior authorization operations

Submission, follow-up, peer-to-peer scheduling, status tracking. Owned end-to-end so your clinicians stop chasing paperwork.

Patient registration and intake

Demographic and insurance data capture, error-flagging against payer rules, document collection. Done right at intake, not patched at billing.

02
Revenue Cycle (Back)

Where the work converts into actual revenue, or doesn’t.

Medical coding support

Coder support, audit trail, edit-loop with providers. We’d staff certified coders into the pod and run the operational layer around them: queue management, follow-up, and turnaround SLAs.

Charge entry and claim submission

Charge capture review, claim scrubbing, clearinghouse submission, rejection management. Treated as a measured operation with daily metrics, not a black box.

Denials and appeals management

Denial intake, root-cause categorization, appeals authoring, payer follow-up. Treated as a P&L function, not a complaints inbox. The function most providers underinvest in and the one with the fastest payback.

03
Patient & Support Operations

The functions that touch the patient and the financial relationship.

Patient billing and collections

Statement cycles, payment plans, billing inquiries, hardship workflows. Empathy meets process discipline. Recover what’s recoverable, write off what isn’t, and stop spending CS hours on either question.

Patient customer service

Status calls, scheduling, billing questions, complaint routing. The volume function that eats most providers’ admin budget, and where FCR and AHT move dramatically with the right operating model.

Compliance and audit support (planned)

Audit response, regulatory correspondence, policy file maintenance. We’d build this with you in year two, after stabilizing day-to-day ops. Anyone promising you SOC 2 Type II and HITRUST on day one is lying, including us.

Compliance posture

Honest about HIPAA, BAA, and PHI.

Healthcare buyers ask three questions before any other: Do you have a BAA? Are you HIPAA-compliant? How do you handle PHI? Most BPO pages give you a yes on all three by default. We won’t.

We do not currently hold a BAA. We will execute one as part of the first healthcare engagement, with the customer as counterparty. We will not handle PHI under any circumstances until the BAA is signed and the operational controls are in place. Our infrastructure (Singapore HQ, Philippines delivery) supports HIPAA-aligned operations, but we will not claim formal HIPAA compliance audit until we have it.

What we will commit to in writing: BAA execution before any PHI touches the operation. Defined PHI handling policy reviewed by your compliance team. Access controls, audit logging, and breach notification procedures aligned to your standards. We staff to your compliance posture, not the other way around.

Early customer terms

Why early matters.

Being early customer number one is different from being customer number fifty. The early engagement comes with things later customers don’t get.

01

Founder-led implementation

The first healthcare engagement is run by Arbitrail leadership, not handed to a project manager. You talk to the people who’ll architect the operation, not to a sales engineer.

02

Custom pod design

The pod is built around your workflow, not adapted from a generic RCM template. Your EHR, your payers, your specialties, your patient population. We’re learning healthcare from you, and we adjust the model to fit what you actually do.

03

Co-built playbook

Every workflow we build with you gets documented and refined. You get the playbook. We get the operational learning. Both sides win.

04

Preferential pricing through year one

Early customers price differently than year-three customers. We’ll lock in pricing that reflects the partnership, not the standard rate card.

05

Direct line to leadership

No account management layer between you and decision-makers. Issues escalate to founders in hours, not weeks.

Fit check

We’re not the right partner for every healthcare org.

We are the right partner for one or two specific kinds.

Good fit

  • Mid-size physician groups, ambulatory networks, or specialty practices with 50,000+ patient encounters per year
  • RCM vendors looking for an operations partner with quality discipline, not the cheapest seat rate
  • Digital health platforms with mixed in-house and outsourced ops who’ve been burned by quality issues
  • Operations leaders who’d rather build the model with us than wait for it off-the-shelf

Probably not the right fit

  • Large health systems needing instant 1,000-seat ramp on day one. We’ll get there, but not in 2026.
  • Pure clinical operations (nursing, MA, scribe). Our model is back-office and admin, not clinical.
  • Pricing-only conversations. If cost is the only lens, an established offshore BPO will beat us on rate card.
Engagement model

From first conversation to live ops.

STEP 01
Week 1 to 2

Discovery and scope

Founder-led conversation. We map your current operation to our operating model. We tell you what we’d commit to and what we wouldn’t.

STEP 02
Week 3 to 4

POC design and BAA

Scoped pilot. One function, one payer set, one specialty if applicable. BAA executed before any PHI access. Volumes, SLAs, and pricing agreed in writing.

STEP 03
Days 30 to 120

Live pilot

Dedicated pod stood up. Daily monitoring, weekly business reviews, monthly executive readouts. Real volume, real results, real numbers.

STEP 04
Day 120

Decision point

You decide. Continue and expand, continue at pilot scale, or end with a clean exit. Pilot pricing reflects the risk you’re taking on us, not the other way around.

You contract with one Arbitrail SG entity. One PM is accountable. One team delivers.

Common questions

What healthcare leaders ask us first.

You haven’t run healthcare back-office before. Why should we trust you?
We won’t ask you to. The pilot is structured so you carry minimal risk: 90 days, one function, scoped volume, pricing that reflects the early-customer terms. We earn the next phase by performing in the first one. If we don’t, you walk.
What healthcare experience does your team actually have?
Direct RCM experience: not yet. Operational experience: 370+ agents running multi-party, time-sensitive, high-volume operations every day, since 2021. We hire certified coders, billers, and patient access specialists into the pilot pod itself, and we partner with healthcare subject-matter advisors during the build phase. We’re transparent about what we’re building.
Do you have a BAA?
Not yet. We will execute one with you as part of the first healthcare engagement, before any PHI touches the operation. We will not handle PHI without an executed BAA in place. Anyone offering you a generic BAA on day one without scoping it to your specific PHI handling is glossing over the work that protects both sides.
Are you HIPAA-compliant?
We operate HIPAA-aligned. We have not yet completed a formal HIPAA compliance audit, and we will not claim that we have. Our infrastructure (Singapore HQ, Philippines delivery), access controls, and audit logging are designed to support HIPAA-aligned operations. As part of an engagement, we’ll align our controls to your specific compliance posture and audit standards.
Can you handle Medicare or Medicaid claims?
Not on day one. We’d start with commercial payers and self-pay, build operational competence and audit history, and add government payers in year two with appropriate certification. Anyone promising you full Medicare/Medicaid claims handling from a new offshore vendor on day one is overselling.
What’s the contract length and exit?
90-day pilot. After pilot, fixed-term engagement with 30 days’ notice to scale down, 90 days’ notice to end. No multi-year lock-ins. No early-termination fees. Pilot has a clean exit by design.
Where are your teams based and what about data residency?
Headquarters in Singapore, delivery hubs across the Philippines. PHI access controls, encryption-in-transit and at-rest, and data residency requirements are scoped as part of the BAA. We staff to your data handling requirements.
How is pricing structured?
Per-seat for staff augmentation, per-claim or per-transaction for high-volume functions, or hybrid by mutual agreement. Early customers get preferential pricing through year one. All-in pricing. No hidden charges for benefits, software, equipment, or compliance work.

Be early, or wait.

The model we built for travel-tech ops is going to translate into healthcare back-office. We’re certain of that operationally. We just need the first one or two providers or RCM vendors to prove it together. Late customers will buy a proven service at standard pricing. Early customers will build the proven service with us, at terms that reflect the partnership.

If you’re the kind of operations leader who’d rather shape what comes next than buy what already exists, we should talk.

Founder-led conversation. 30 minutes. No demo deck.
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