Guardian is an AI platform to help healthcare providers (hospitals, MSOs, physician groups) fight denials and address unpaid claims. Providers deploy Guardian to:

1. Detect emerging patterns in payer reimbursements
2. Automate the diagnosis and resolution of unpaid claims and denials

Our founding team ran AI revenue cycle programs at Mount Sinai, NYC Health+Hospitals, and several other large health systems at Palantir, generating millions of dollars per hospital while eliminating hundreds of hours of work.
Helping healthcare providers fight insurance denials.
Title: Guardian AI: Helping healthcare providers fight insurance denials. | Y Combinator

URL Source: 

Markdown Content:


### Helping healthcare providers fight insurance denials.

Guardian is an AI platform to help healthcare providers (hospitals, MSOs, physician groups) fight denials and address unpaid claims. Providers deploy Guardian to: 1. Detect emerging patterns in payer reimbursements 2. Automate the diagnosis and resolution of unpaid claims and denials Our founding team ran AI revenue cycle programs at Mount Sinai, NYC Health+Hospitals, and several other large health systems at Palantir, generating millions of dollars per hospital while eliminating hundreds of hours of work.



Guardian AI

Founded:2024

Team Size:2

Location:New York

### Active Founders

### Mayank Jain, Founder

Guardian AI Co-founder, ex-Palantir, Microsoft, Jump. Before Guardian, Mayank was a lead on the Hospital's team at Palantir - overseeing product, sales, and implementation of our staffing & scheduling product. Born in India, grew up in Kuwait, studied CS + Business @ CMU '21



### Pranav Pillai, Founder

Before Guardian, Pranav was an Enterprise Lead on Palantir's Hospitals Team. He started and ran their Revenue Cycle Management vertical, doing $6M in sales in his first quarter on the job. Pranav graduated from the University of Pennsylvania's Jerome Fisher Program in Management & Technology (M&T) with an M.S. in Computer Science and dual Bachelors degrees in Computer Science and Finance.



### Company Launches

[### Guardian AI: Helping healthcare providers fight insurance claim denials](

🛎 **TL;DR**
------------

After helping hospitals implement AI workflows at Palantir, our team has built a product to help healthcare providers automate how they manage insurance claim denials. This is desperately needed by the 40% of hospitals in the US that have negative operating margins each year.

**Within a month of launching, Guardian has helped recoup \>$150,000 in claim value for providers.**

🏥🚨 **Hospitals are Dying**
----------------------------

While he was in college, the hospital where Pranav’s mom worked in Philadelphia went bankrupt - [**Bernie Sanders actually picketed outside in protest.**](

The last two years at Palantir, Mayank and Pranav have been working with some of the biggest health systems in the country who, despite their size, had hundreds of millions in unpaid claims and were shutting down hospitals.

Insurance companies are using AI to deny more claims. We’re on a mission to arm the providers and fix a system where 40% of hospitals are losing money.

🤖 **Fighting Denials with AI**
-------------------------------

Denial management is a manual and painstaking process. Healthcare providers have a long string of tasks to complete — (1) call payers, (2) write appeal letters, (3) scrape patient charts for missing diagnoses and authorizations, (4) check for clerical errors, (5) check clearinghouses for patient eligibility and provider enrollment – the list goes on. There are so many tasks and systems required to work a denial that **most healthcare providers end up writing off 5-20% of their accounts receivable.**

Our platform serves as a one-stop shop for denials management, where AI agents manage claims from end-to-end.



1.  **Data Model:** Guardian integrates with Clearinghouses, Payer Portals, and EHRs. Billing teams no longer have to switch between systems.
2.  **Claim Status & Denial Cohorts:** Looking at payer policies / contracts and trends in payer behavior, Guardian triages claims that are worth pursuing and determines a specific path to resolution.
3.  **Automating Denial Resolution:** Our growing denial resolution suite automates payer phone calls, claim corrections and re-submissions, and a dozen other rote tasks in a denied claim’s lifecycle.

👨‍💼👨‍💼 **The Team**
-----------------------



Mayank and Pranav were two of the first members of Palantir’s Commercial Healthcare Team. They’ve worked together to improve hospital operations at some of the largest health systems in the country.

After implementing AI programs at health systems the last several years, they look forward to democratizing AI across US healthcare and avoiding heartbreaking hospital and clinical practice closures.

🤝 **Our ask:** 💰 **Our Offer:**
---------------------------------

We do risk-free, rapid denials + AR age assessments for hospitals and medical practices. Give us your unpaid claims and we’ll run them through our software to find slam-dunk cases which payers have mis-processed - we’ve consistently found over $100K in low-hanging fruit when we’ve done this.

Reach out at [founders@withguardian.ai](mailto:founders@withguardian.ai) or grab time at [withguardian.ai.](
