Healthcare AI company Commure built out a platform to automate end-to-end referral management and patient intake.
The company designed its platform, called Commure Orchestrator, to close the gap between referrals sent and patients seen by eliminating fax-based workflows, reducing referral leakage and cutting pre-visit administrative burden.
Industry data and studies show that a large percentage of medical referrals—from 35% to 50%—never get completed or lead to an appointment with a specialist. And the ones that do take 31 days on average, often routed through fax machines, authorization holds and manual hand-offs. These bottlenecks lead to referral leakage, which means lost revenue for providers and patients not getting the care they need.
“Every referral that doesn't convert is a patient who fell through the cracks and revenue that never shows up in the books,” Dan Warner, president of Commure, said in a statement. "Orchestrator automates the entire pre-visit workflow so neither of those things has to happen."
Commure offers AI tools and agents that embed in the workflow of health systems and providers. Its tech is largely focused on simplifying administrative work, which Commure said consumes about $1 trillion each year across the country.
The new referral management and patient intake solution streamlines the full pre-visit workflow. It ingests any unstructured data source, extracts structured clinical and payer data, validates against an organization's business rules, coordinates across teams in a unified dashboard queue and writes accepted referrals directly back to the electronic health record system.
Commure Orchestrator is designed to operate across care settings, including inpatient, outpatient, post-acute, home health, hospice and specialty care. The platform is already live with home health and ambulatory health systems, processing hundreds of thousands of tasks fully autonomously, according to the company.
Commure can also close the loop, creating a seamless referral-to-patient visit hand-off through AI agents. Once the referral is accepted and the patient is scheduled, digital intake agents guide patients through consent, pre-visit forms and insurance collection.
Orchestrator runs on Commure's unified data model and connects downstream to ambient AI for clinical workflows and RCM for revenue cycle, executives said.
The company says the platform addresses key operational bottlenecks. Real-time referral queues connected with automated outreach help prevent patient drop-off, and real-time referral triage and provider matching enable faster response times, higher referral acceptance and improved patient experience.
Automated payer verification and prior authorization tracking eliminate manual portal checks and last-minute appointment cancellations. There's less intake friction as pre-visit intake flows directly into the EHR as structured data, not a PDF attachment, according to the company. And, Commure's single platform replaces a disconnected mix of fax workflows, intake tools and referral management software.
In May, Commure banked $70 million in fresh funding, reaching a $7 billion valuation, with plans to scale its platform and continue building out its technology. At the time, Commure said it planned to grow its revenue cycle and practice management tools to specialty practices, hospitals and integrated delivery networks. A year ago, the company raised $200 million.
Commure was hatched by General Catalyst in 2017 and launched in 2020. In October 2023, the company merged with Athelas, a provider of healthcare workflow automation software, to grab a bigger piece of the health system market. Nine months later, in July 2024, Commure acquired healthcare AI company Augmedix for $139 million, giving it a foothold in the AI medical scribe market. In December 2024, the company acquired Memora Health, a digital care navigation platform launched out of Harvard Innovation Labs.
The company has been steadily building out its technology stack to service healthcare organizations with AI-powered solutions for clinical documentation, revenue cycle management and practice management operations. A year ago, Commure launched a suite of AI agents designed to automate complex tasks and tackle front-office functions, along with patient navigation, care management and revenue cycle.