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ZeraRevenue AI · Specialty Medicine
Zera — Revenue AI for Specialty Medicine

Healthcare AI automated the doctor's note. Zera automates getting paid.

Zera is an autonomous revenue platform for specialty medical clinics. We replace fragmented human handoffs with a single AI engine.

Today — broken at every handoff
Consultation⋮Note⋮Coding⋮Invoice⋮Payment
Zera — one continuous AI workflow
Consultation→Note→Code→Claim→Payment
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ZeraRevenue AI · Specialty Medicine
02 — The Problem

Medical billing breaks at every human handoff.

In US healthcare, a documentation error instantly becomes lost income.

11.8%
First-time rejection rate. More than 1 in 10 insurance invoices gets rejected. (Kodiak Solutions, 2024)
$25–$118
Manual cost to fix a single rejected invoice. (MGMA · Change Healthcare)
65%
Abandonment rate. Most rejected invoices are never refiled; clinics simply lose that money.
In the US, private insurance pays the doctor — but only if the visit is translated into standardised codes. If the doctor's summary misses even tiny details, the insurance company rejects the bill. Clinics waste billions manually fixing these errors, and 65% of the time they give up and lose the money.
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ZeraRevenue AI · Specialty Medicine
03 — The Core Insight

Writing the note isn't the goal. Collecting the revenue is.

The clinical conversation is where the bill is born. The company that controls it controls everything downstream.

Traditional voice AI
Consultation→AI voice scribe→Summary noteStops here
Zera revenue AI
Consultation→Note→Auto-coding→Compliance→InvoiceRevenue collected
The company that controls the clinical conversation controls the downstream billing. That's a multi-billion-dollar platform opportunity, not a dictation tool.
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ZeraRevenue AI · Specialty Medicine
04 — The Product

Replacing scribes, coders, and billers with one engine.

One continuous AI workflow — from the live conversation to a claim-ready record.

01
Listen
Captures the live conversation ambiently.
02
Structure
Organises raw dialogue into a structured medical record.
03
Translate
Converts medical terms into official insurance billing codes.
04
Verify
Checks whether the doctor's record actually supports the bill.
05
Prepare
Produces a claim-ready record that carries its own documentation.
Clinical reasoning happens once, in real time — instead of being repeated by three separate human teams.
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ZeraRevenue AI · Specialty Medicine
05 — The Pre-Sign Gate

Don't discover errors weeks later. Fix them before sign-off.

While the chart is still open, Zera validates the record the way a billing expert would — and blocks sign-off when something is wrong, instead of just warning.

What it checks, before the doctor signs
01Right eye vs. left eye
02The conditions insurers pay more to manage
03Proof the doctor actually treated each condition
04Coded to the detail the insurer requires
05Drug billing matches the dose given
Old way
Send invoice → wait 6 weeks → rejected → pay to fix, or give up.
Zera way
AI blocks sign-off → names exactly what's wrong → doctor fixes it in seconds → the error never reaches the insurer.
$1,487.21
The drug for a single eye injection — priced to the exact dollar from official data. Never an estimate.
Zera doesn't warn — it refuses sign-off and states the reason, with the Medicare rule it checked against.
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ZeraRevenue AI · Specialty Medicine
06 — Traceable Truth

AI that proves its work.

Traceable Truth — every coding decision carries its source, back to the exact second of the audio transcript.

Billing codeJ0278
→
Audio transcript · 00:04:17
"…the patient received an intravitreal injection of 0.05 mL of Eylea in the right eye…"
Every code carries its source
Each item on the bill links to the moment in the recording it came from. Click the code, hear the doctor say it.
It abstains rather than guesses
If a detail wasn't documented, Zera doesn't invent it. It shows no code, no figure, and no confidence score it can't source.
The doctor stays in control
Zera drafts the bill; the physician approves it. Always.
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ZeraRevenue AI · Specialty Medicine
07 — Why Specialty Medicine

Generic AI fails in high-value specialty care.

We start with retina — one of the hardest specialties to code correctly, where a single missed detail destroys the margin on the visit.

Why retina
High-volume, high-cost procedures — a single injection can bill over $1,400 in drug alone — where one missed detail destroys the margin on the visit.
Beachhead
Retina specialists
~3,000 US physicians who bill eye-injection drugs
Expansion
Ophthalmology
~21,000 physicians
Expansion
Cardiology
~33,000 physicians
Destination
Full specialty medicine
One engine, specialty-specific workflows
An engine that survives retina generalises downward. One built for average office visits doesn't generalise up.
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ZeraRevenue AI · Specialty Medicine
08 — Why Now

Voice scribes are becoming commodities. Value is moving to revenue.

Value is moving downstream — from writing the note to acting on what the note means.

2023
Basic speech-to-text
2024–26
AI summaries (commoditising)
Next
Note → clinical intelligence
Zera
Clinical intelligence → revenue
The winner here isn't the software that writes notes. It's the software that collects the money.
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ZeraRevenue AI · Specialty Medicine
09 — Market Sizing & Economics

A $12K ACV wedge into a $273B market.

Pricing: $999 / doctor / month — about $12,000 annual contract value.

TAM
~$273B
US medical billing & documentation market, projected 2030.
SAM
~$680M
Ophthalmology + cardiology SaaS: ~57,000 physicians × $11,988.
SOM
~$36M
Initial retina beachhead; this round targets the first ~$0.5–0.7M ARR.
Illustrative, not projected — at $11,988 ACV: 500 doctors ≈ $6.0M ARR · 1,500 doctors ≈ $18.0M ARR.
TAM: industry reports. SAM/SOM: built bottom-up from physician counts × ACV.
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ZeraRevenue AI · Specialty Medicine
10 — Competitive Advantage

Replacing a fragmented ~$1,900/mo software stack.

Today's fragmented stackMonthly cost
Voice scribe software$250–400
Coding & compliance tools$200–500
Billing & claims software$300–700
Integration overhead$100–300
Total~$850–1,900/mo
Zera — one platform
$999 / doctor / month
One continuous platform
Catches errors before filing
Works across record systems
Priced inside that range — and it stops the revenue leak.
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ZeraRevenue AI · Specialty Medicine
11 — Business Model Expansion

Land with software. Expand into revenue.

Phase 1 — the platform
$999 / month / provider
~$12K ACV on annual contracts.
A flat $5K 90-day pilot converts on a measured outcome.
Phase 2 — the expansion path
Claim transmission→Denials→Collections→Insurer rules→Automated billing
Software fees → workflow fees → a share of the billing itself. Every step is a larger contract with the same customer.
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ZeraRevenue AI · Specialty Medicine
12 — Real Production Traction

Built on production discipline, not a slide pitch.

The same team already runs a healthcare-AI platform in live production.

25+ years
Founder expertise in clinical coding and billing.
2,000+ min/day
Clinical audio processed in live production through Audryl, our documentation platform.
99.5%
Audited accuracy in Audryl’s live production operation with over 70,000 doctors’ notes processed so far.
Live app
Zera is built and demoable at app.zera.health.
To be clear — the 2,000 minutes a day and the 99.5% are Audryl, the platform we already run in production. Zera itself is built and demoable, and has no paying customers yet. That's exactly what this round funds.
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ZeraRevenue AI · Specialty Medicine
13 — Executive Leadership

Industry veterans who understand where billing breaks.

We aren't entering healthcare to learn the workflow. We've spent years inside it.

AM
Arvind Manohar
Founder & CEO
25+ years in clinical documentation, coding & billing. Built the entire Zera platform solo, in under 5 months. Founder & CEO, NuScript Group
DW
Doug Wolfgram
Chief Technology Officer · joining at close
Former CTO, CareSpan Health (telehealth records & billing). Former CTO, BodiMetrics (led FDA clearance). Ex-VP Tech, LendingTree.
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ZeraRevenue AI · Specialty Medicine
14 — The Ask & Use of Funds

Raising $1.5M pre-seed.

StructurePost-money SAFEFirst close$500KRunway~18 months
~50%
Team
CTO full-time, engineering, clinical & coding advisor
~25%
Product
Claim transmission, first EHR integration, SOC 2 Type II
~20%
Go-to-market
Founder-led, retina beachhead, pilot motion
~5%
Operations
Legal, insurance, compliance infrastructure
At the next round
10 practices → 40–60 doctors → $500–700K ARR → claims live end to end
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ZeraRevenue AI · Specialty Medicine
Revenue AI · Specialty Medicine

Note. Code. Claim.
The revenue intelligence layer for specialty medicine.

Note→Code→Claim→Revenue
arvind@nuscript.ai
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