Angle: The Clearing House

Status: Noodling Date: Feb 13, 2026

The Thesis

Healthcare authorization is a two-sided transaction that nobody is clearing efficiently. Providers submit requests, payers adjudicate them. Both sides are now arming up with AI — providers automating appeals, payers automating denials. Mello calls it an "arms race." Dan calls it "clearing a financial transaction." Both are right.

Someone needs to build the thing in the middle.

Dan is building provider-side tools (appeal letter generation with Coral Health/Stochastic). DaisyAI is building payer-side tools (auto-auth, appeals defense at Premera). The end state is obvious: if both sides are on the same platform, you clear the transaction instead of fighting over it. Like financial markets — you take both sides of the spread.

Why Us

Who better to build the neutral middle than someone who isn't tied to all the old power networks?

Every incumbent in this space has baggage:

MCG/InterQual — owned by payers, serve payer interests, providers hate them
Epic — provider-side, building appeals tools, no payer trust
Optum — literally owned by UnitedHealth. Nobody on the other side trusts them
The Big Consultancies — tied to legacy systems and relationships, no AI-native capability

The old guard can't build the middle because they ARE one of the sides. Their relationships, economics, and reputation are locked in. A neutral clearing house has to come from someone without that baggage.

DaisyAI is two founders with no legacy allegiances, building from first principles, with relationships on both sides (Premera on payer, Dan/Stochastic on provider). Young enough to be trusted by both. Technical enough to build it. Naive enough to try.

The Progression

Now: Win on one side (payer — Premera). Learn the systems, the data, the decision-making.
Next: Dan's Stochastic work builds the provider-side equivalent. Knowledge flows between us.
Then: Connect the two. Shared data standards, shared decision frameworks, transactions that clear instead of fight.
End state: Authorization as a cleared transaction. Both sides pay for efficiency. Margin comes from the spread.

This is Dan's vision from the Feb 13 call: "Think of it as financial transactions — if both sides are on the same toolset, for the love of God, can we just clear the transaction more efficiently?"

What Mello's Article Validates

Her vendor landscape (Health Affairs, Jan 2026) shows the market split cleanly into insurer tools and provider tools. Only TWO companies sit in the "collaborative platforms" category: XSOLIS Dragonfly and Rhyme. That's a nearly empty category in a market where 84% of insurers are already using AI.

Her core concern — the arms race — is the problem this angle solves. If you stop the arms race by building the clearing house, you're the hero of her story.

Why This Is Hard

Dan learned at Moxe: "You can't build end-to-end and expect both sides to adopt together." Each side has to be valuable independently first.
Trust from both sides is the moat — and it's fragile. One perceived betrayal and you're dead.
Business model is tricky: who pays? Both sides? Transaction fee? Subscription?
Regulatory complexity: different rules for payer tools vs. provider tools vs. neutral platforms.
You have to win at one side first before anyone believes you can bridge.

How It Connects

Vibe Coder Army angle = the workforce that builds and deploys this
Dan's NewCo concept = the organizational structure that could house this (DaisyAI + Stochastic + FDE services)
Team of 5 = the legacy system integration expertise needed to actually connect to payer/provider backends
Premera engagement = the payer-side learning ground
Dan at Summa = the provider-side learning ground (via Percepta/GC)

The Line

"Both sides of healthcare authorization are arming up with AI. Someone needs to build the middle. The incumbents can't — they ARE the sides. We can."

Open Questions

Is this a 2-year story or a 5-year story? Does it matter for fundraising?
Does Dan need to be formally involved for this to be credible, or is the informal knowledge-sharing enough?
How do you pitch "clearing house" without sounding like you're building a marketplace (which VCs are tired of)?
Is the right analogy financial clearing, or is it more like SWIFT / payment rails?
Does Mello's "collaborative platforms" framing help or hurt? (Only 2 companies there — is that validation or a warning?)