Why we exist
Systems of record ran the last era of surgery centers. Systems of work will run the next.
Every year, more surgery moves out of hospitals and into ambulatory surgery centers — over 22 million procedures, a $60 billion market, growing on every structural tailwind healthcare has. And every one of those cases is still pushed from order to payment by hand.
What your systems recorded · feed
- PM14:02 · case 0412 completed · OR 2
- EHR14:19 · chart closed
- 83516:40 · remit posted · Payer B
What Perivanta did about it
- Implant charge reconstructed before the claim went out
- Payer B short-pay caught — recovery packet filed
- Friday’s opening filled with a cleared waitlist case
The work nobody owns
Walk into a well-run ASC and watch a single case try to happen. The referral arrives by fax. Someone re-keys it, someone calls the payer, someone chases the H&P, someone submits the auth and sticky-notes the follow-up, someone calls the patient about money, someone reconciles the op note, and someone — months later — notices the payer paid short. Ten owners. No owner.
Every system in the building records its piece: the PM system has the booking, the EHR has the chart, the clearinghouse has the claim. None of them knows what the case needs next, and none of them does anything about it. So the connective work lands on people, and the failures land where they’re most expensive — on the morning of surgery, and on the remit.
Point solutions keep optimizing single departments. But the value isn’t in any one step — it’s in the continuity between steps: the auth that matches the scheduled procedure, the estimate built from current benefits, the appeal that cites the case’s own record. That continuity is the product nobody has built for ASCs.
What we believe
01The ASC is the future of surgery.
Payers want it, patients prefer it, and clinical innovation keeps expanding what’s safe outside the hospital. More than half of eligible procedures already happen in ambulatory settings, and policy is accelerating the shift. The question isn’t whether surgery moves to ASCs — it’s whether the administrative model underneath can carry the volume.
02Recording is not doing.
Legacy ASC platforms are essential systems of record — scheduling, documentation, billing. But between the records sits the actual work: verifying, requesting, chasing, reconciling, filing, appealing. Software has never done that work. People have, one phone call and portal check at a time.
03The case is the unit of work.
Departmental queues lose the thread that matters: this patient, this procedure, this payer, this date. A case should carry its own state, evidence, and dependencies — so a changed CPT or a moved date triggers exactly the re-work it requires, and nothing rides quietly toward a denial.
04Automation must earn its authority.
A system that acts needs a higher bar than a system that reports. Autonomy should expand action by action — observe, draft, approve, autopilot — with the evidence visible at every step and consequential decisions always in human hands.
05Hospital software scaled down is not the answer.
Revenue-cycle and OR tools built for hospitals assume analysts, IT departments, and hospital economics. ASCs run lean administrative teams against high case volume — usually with no back office at all. They need software built for that reality from the first line of code.
06The operators should build it with us.
The most credible ASC platform won’t be designed in a conference room. It will be shaped case by case with the administrators, coordinators, and physician-owners who live the work. That’s why our first customers are design partners, not logos.
Where we are
Perivanta is early. We’re assembling a small group of founding centers to shape the platform against real referrals, real payer behavior, real patients, and real schedules.
The industry math, design principles, and automation model are on this site so operators can decide whether the design partner program is worth their time.
Design partner program
Help build the system that does the work
We are selecting a small group of founding centers to shape the platform. Design partners get early access, direct input on the roadmap, and founding-partner terms.