2026.10.09 | GP | Software | Forethought: AI Customer Support Customer View

Primary:

Forethought Technologies, Inc.

Associated:

Decagon AI, Inc.

Sierra Air Inc

Ada Support Inc.

Intercom Inc.

Zendesk, Inc.

CRM

NOW

Kore.ai, Inc.

NICE:TASE

Genesys Cloud Services, Inc.

Viewpoint:

Customer

Moderator: Pratiksha Kaval (PK)

Ajay Shukla (AS), Senior Sales Consultant for Energy and Sustainability Solutions - Honeywell International

SUMMARY

Overview

A seasoned healthcare revenue cycle management expert assessed Ventra Health across anesthesia, radiology, and hospital medicine. The company is gaining visibility and receiving more requests for proposals, but remains constrained by limited major customer references and a weaker market presence.

Its pricing, service delivery, and technology appear broadly comparable with competitors. The market currently has little meaningful differentiation, making sales execution, customer confidence, references, and implementation quality decisive.

Key Insights

Ventra’s largest weakness is not service capability but insufficient market visibility, field sales coverage, strategic partnerships, and referenceable accounts. AI strategy is becoming the most important purchasing consideration. Customers expect automation to lower collection costs, reduce staffing needs, improve accuracy, and prevent denials upstream. Hospitals increasingly prefer fewer vendors. Ventra’s narrower revenue-cycle scope can therefore disadvantage it against enterprise providers offering broader services. Ventra appears effective at managing implementation challenges and setting customer expectations, with no observed pattern of rapid customer losses after deployment. Recent acquired capabilities are becoming more integrated, although some legacy-business identity remains. The expert’s strongest conclusion was that Ventra’s outlook depends on two factors: a compelling AI roadmap and substantially stronger marketing and sales execution.

Competitive Landscape

Competitor type

Positioning versus Ventra

Key advantage or pressure

Large global RCM vendors

Broadly similar operating performance, with greater scale and experience

Larger references, wider services, and stronger enterprise relationships

Specialty billing firms

Compete directly in focused clinical specialties

Deep specialty expertise may strengthen credibility

In-house hospital teams

Remain an alternative for retained functions

Hospitals may preserve internal control while selectively outsourcing

Enterprise vendors

Favored when hospitals consolidate suppliers

Can cover more of the revenue cycle through one relationship

Ventra

Competitive in pricing, delivery, and core processes

Needs stronger references, denial prevention, and market presence

Ventra’s India and Philippines operations maintain cost and talent competitiveness but are not unique. The Philippines offers access

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to clinically trained staff who can support clinical-denial appeals.

Quantitative Insights

Metric

Expert commentary

AI impact horizon

Meaningful industry effects may emerge within 1–3 years

Example collection baselines

Performance may begin from 30 or 60 outstanding days

Improvement targets

Examples ranged from 10% to 80%, depending on the customer baseline

Traditional AR benchmark

A 45-day target is becoming less important than client-specific improvement

Outsourcing penetration

About 65% of the industry uses an external partner for at least some work

Selective outsourcing scope

Vendors may handle balances older than 180 days or zero-balance reviews

Early implementation period

Customer stability was assessed over approximately 90–180 days

Integration period

Full acquisition integration can require up to two years

Strategic outlook

Market positioning should be evaluated over the next 3–5 years

PK: Hello everyone, my name is Pratiksha Kaval and I am an analyst at Guidepoint Insight. Thank you for joining us today. In today's discussion, we will be focusing on Ventra Health with Ajay Shukla, who is a VP of Sales at GIPS Healthcare Solutions. So Ajay, before we start today's conference call, could you please provide me a brief overview of your background and responsibilities, particularly as it pertains to today's topic of discussion?

AS: Yes. My background is that I've been in health care for 35 years. I've been on the provider side or selling and providing tools to the provider side for that period of time, mostly focused on large health care systems and large physician practices. I've been specifically in the RCM space for about 16 years back with companies like nThrive, MedAssets, GIPS Healthcare, and so I've been providing the end-to-end services and competing in that side of the business for that period of time.

PK: That's really helpful, Ajay. So over the past 12 to 24 months, has Ventra appeared to gain or lose competitive momentum across anesthesia, radiology and hospital medicine? And where does it consistently win or lose against the major competitors such as GIPS, AGS, Coronis, specialty billing firms and in-house teams?

AS: Yes, there does appear to be some increased momentum by Ventra. I do start to see them more. I think they're getting invited into more RFPs and there's a larger presence just in the marketplace where they're showing a presence and being available for clients to evaluate them. They do seem to be there, what appears to be. From my perspective, the reason they're not winning deals or some of the deals that they're pursuing, one is just the level of competition they're up against and the experience these companies have. But two is.

PK: Thank you for joining us.

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AS: Their lack of experience seems to be coming through or their lack of referenceable, significant referenceable accounts is what it appears that's affecting them. Their other tools, their pricing and their positioning seem to be fine, but it's that component of having enough references is what seems to be impacting them right now.

PK: That's really helpful. What measurable economic improvement must Ventra demonstrate to justify outsourcing and its middle of the market pricing? So it will be helpful to understand some directional benchmarks for improvement in cash collections, reduction in cost to collect and customer payback period.

AS: I'm sorry, would you repeat that one, please?

PK: Sure. What measurable economic improvement would you say must Ventra demonstrate to justify outsourcing and its middle-of-the-market pricing? I will repeat the second part of the question later, so maybe just the first part of the question, yeah.

AS: Yeah, okay. So we're ready to improve. The thing is, if every... The presentation and your availability of technology or your vision of technology is the biggest piece that clients are looking for right now. They want to see some demonstrable piece of technology currently, but they want to know that there's a vision and an action toward that because the technology component, and usually we're referring to AI, is going to be the 1 thing that really impacts our industry in 1 to 3 years to be able to start really reducing cost to collect and the number of people and the accuracy of collection. And it'll also focus towards more the front end issues too. So there'll be less denials, which impact collection also. So that's the number 1 thing I think is what you're looking at right now is where action needs to take place.

PK: Got it. So following up your point on the cost to collect, so want to understand some directional benchmarks for the improvement in cash collections, reduction in cost to collect and customer payback period.

AS: I'm having a little trouble following it. I'm sorry to keep asking to repeat that, but could you repeat that again, please?

PK: Sure. Can you provide some directional benchmarks for improvement in cash collection, reduction in cost to collect and customer payback period?

AS: Well, you know, right now it's being more measured in... You know, if you think about days to collect or amounts that are allowed and percentages, it's more looked at now as what is your baseline currently and what are you able to improve? So if your baseline is, you know, 30 days outstanding or 60 days outstanding, whatever it might be, then it's the improvement percentages that are really being looked at right now. So are you looking at 10%, 20%, 50% over the next year due to your technology improvements or, you know, what is the impact of your technology going to be? Hello? Yes, I'm here.

PK: I thought I lost you.

AS: No.

PK: So I couldn't hear the last sentence, actually.

AS: Oh, okay. I was just emphasizing that it's more baseline oriented right now to be able to say, okay, what is your baseline? What is your current collection measurements that you're following? And how much percentage increase or percentage improvements can be approached to those individual baselines that you have? So the old targets that you want to be at 45 days in AR and things of that nature, those are tending to lose some of their emphasis right now or have been losing some of their emphasis. And it's more on meeting the customer where they are today and then

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improving them past that point there. And whether the goals are 10%, 25%, or 80% improvement, whatever those goals are, it's being more measured against where your current state is at this point in time.

PK: Got it, that's really helpful to understand. For a mature anesthesia technology or hospital medicine client, how does Ventra compare with the leading competitors on first pass payment, initial denial, net collection rate, days in AR and receivable over 90 days? Like you just mentioned that there are 45 days in AR for example. So it will be helpful to understand how does Ventra compare with the leading competitors on these parameters.

AS: I don't see any real difference in their approach or their delivery than any other... all of the competitors out there. The parity is really... very difficult for companies right now because everything is pretty much at parity and waiting for this... incredible moment when AI steps in and starts to really take over. So there isn't... I think they're right in line with everyone as far as their collection days, their processes they're following, and how they're delivering. I think they're right there with the whole bulk of the group.

PK: Got it.

AS: You still there?

PK: Yeah, hello?

AS: Yeah.

PK: Hello?

AS: But yes, PK: Yeah, AS: I'm here.

PK: Can you hear me?

AS: Yes, I can hear you.

PK: So my next question would be, why does Ventra have difficulty competing against in-house billing and how does hospital's acquisition of a physician practice affect the likelihood that Ventra retains or wins the RCM relationship?

AS: Well, one of the things is hospitals are looking more and more for less vendors and Ventra doesn't have a broad offering within all of revenue cycle. So if you go with Ventra, you've also got to have at least a couple of other vendors also to cover the rest of your revenue cycle. So when that happens, you've got to find very specific opportunities and pursue those, like their focus of anesthesia, radiology and things of that nature is a very good idea. But you've still got to be able to convince them to break off a piece of their revenue cycle instead of having a single vendor that may or may not take on more work. But if they do need them to, they're available to. And, you know, that's what hospitals are looking for right now is to narrow their vendor numbers, excuse me.

PK: Hello?

AS: I'm here. Hello?

PK: Hello? Yes.

AS: Hello. I can hear you fine.

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PK: Okay. So, directionally, what portion... I thought I lost you... directionally, what portion of an acquired practice's outsourced RCM scope is retained, brought in-house, or transferred to a large enterprise vendor?

AS: Yes, I have so much trouble here following. If you could, I'm sorry, but repeat that one again, please.

PK: Sure. So, directionally, what proportion would you say of an acquired practice's outsourced RCM scope is retained, brought in-house, or transferred to a large enterprise vendor?

AS: Right now, in the industry, we're approaching about... it is not all, it wouldn't be that 100% of something is outsourced, but at least portions of it. We're approaching 65% of the industry has now some outsourced partner to be able to accomplish some of these tasks. And it may be, and it's anywhere from a small amount where they're taking over maybe days over 180 or that is doing zero balance work, but they do have a vendor that they're participating with and they're not doing it 100% in-house.

PK: Got it. That's really helpful. Also, how differentiated are these... the launch by Ventra Health and AI-powered Revenue Intelligence Platform, Ventra's peer rate database and denial management capabilities... in actual competitive evaluation?

AS: Only through, I haven't actually seen their product, you know, that's one thing. So I've only going on what people are talking about and how they compare after a competitive event takes place or something of that nature. But they don't seem to be as robust in the denial area and have as much support to be able to prevent denials, or to avoid the denial. So they don't have the capabilities or not displaying the capabilities to do upstream changes that impact the back-end work that they're doing. And that's a big piece of it because if you can't stop what you're doing, you need to be in doing this type of work with denial, you should do it as you're working towards. Working yourself out of a job or working your company down to less work they're currently doing because you're not only going to collect what's needed and take care of what's needed, you're going to educate them on the front end so they can start to eliminate some of these denials.

PK: Got it. And you describe Ventra as particularly robust in denial management. So what specifically differentiates its capabilities and what direction improvement would you say it delivers in initial denial rates, recovery rates, days in AR, or cash collection versus the other competitors?

AS: Well... Again, it's difficult in our industry right now... there isn't real big distinct separations or competitive advantages. It's if you can get to the client and if you can move them toward confidence in your company and then establishing yourself within the client. The ability to have... There isn't a leader at this point in time or leaders that have specific unique differentiators, and I think Ventra fits right in with there. They can do the work. They can deliver the work. It's getting the message to the customer to educate them and then be able to get the individual deal. So part of the problem... I don't know if problem is the right word or not... but part of the situation they face, I don't think as much their technology or their capabilities, it's their presence in the marketplace and their team that's in the marketplace selling this and educating customers and approaching them and the messaging that they're getting out because there isn't... like I said... there isn't a big distinction between vendors right now and offerings from vendors. It's who's out there in the marketplace and doing better at the marketing component, the sales component, and then the overall delivery of what you said you would come forward with.

PK: Got it. That's really helpful. So talking about it, there's a footprint in India and Philippines. Does Ventra's captive delivery footprint in India and the Philippines create a meaningful advantage against the globally scaled competitors such as GIPS and AGS?

AS: So you're saying they're present in India and the Philippines, right? Is that what you're saying? Hello?

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PK: Hello?

AS: Elizabeth?

PK: Yeah, hello. Hi. I'm sorry, I think I dropped there; some network issues at my end, I guess. So yeah, we were talking about the footprint of the company in India and the Philippines. Should I repeat the question again?

AS: Yeah, please do.

PK: So does Ventra's captive delivery footprint in India and the Philippines create a meaningful advantage against the globally scaled competitors such as GIPS and AGS?

AS: So you're saying they have delivery capabilities in both India and the Philippines, you're saying, right?

PK: Yes.

AS: Is that correct?

PK: Yes.

AS: Okay, yes, it does. Well, most of the companies now do have India for sure. They've got... they're in India. And then a lot of them are in the Philippines or some other location. Having the Philippines is an advantage to be able to have in your offering. A lot of it because of the nursing capabilities that are in the Philippines. You can hire US registered nurses or Filipino registered nurses, which are very close in level of certification to US certified nurse, and you can have them to be able to support your work or help, and it's mostly applicable around clinical denials. When you're working with clinical denials, it's very helpful to have somebody with a clinical perspective that can write the denial and make the best case for reversing or changing the denial. So it doesn't really give them a competitive advantage being there because most of the companies are there in both locations, but it keeps them competitive and keeps them involved in the game because they are in those locations.

PK: That is actually helpful. How will this Ventra execute implementations, educate, and retain customers based on competitive transition, customer feedback and renewal activity which you have observed?

AS: So are you asking how well are they doing their implementations? Is that the question?

PK: Yes. Implementation, retaining customers based on competitive transition, customer feedback and renewal activity that you have observed. Okay.

AS: Okay. Well, what I have seen is they haven't immediately come in in the first 90 to 180 days or something that lost a customer because of their implementation. So whether or not their implementation is extremely effective or if they're able to just get through the bumps and valleys that happen when you're doing these types of implementations. These are implementations for RCM are always, especially if it's a first-time outsourcing or a first- time going global, they're always a little bumpy. And how well you address those and how well you communicate with the client and build a relationship to be able to get through the bumps and pre-educate them, they do seem to be doing a good job there. So they must be doing well in informing their customers. You know, we will experience things that happen. We can't identify everything that's going to happen, but we're going to be there quickly to help you solve the problem and redirect the efforts if necessary.

PK: Credit will definitely help us. And has adding Advocate RCM and their partnership in 2024 strengthened execution and the multi-specialty proposition or does Ventra still appear to operate as a separate legacy business?

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AS: They do still show their legacy businesses, but I do believe they've made really good strides in bringing them together as a single offering and incorporating the companies together. And it takes time for those to take place, sometimes up to even 2 years to be able to really integrate another company when that takes place. So I think they're moving it in the right direction and it seems to be they're taking it out of the silos and becoming a single presence, a single discussion when they're talking about the company and the total offering that they have.

PK: Got it. That's really helpful. Almost reaching the time limit here, but before we wrap up, just 1 or 2 more last questions. How important are payer contracting, underpayment recovery and No Surprises Act dispute resolution capabilities to Ventra's customer proposition?

AS: How important are... Say again for me, please.

PK: Yes. How important are payer contracting, underpayment recovery and No Surprises Act dispute resolution capabilities to Ventra's customer proposition?

AS: Well, understanding the payer contracts and having them available to you for that specific client are critical. So in order to be able to process why they wouldn't have paid you, you have to know their rules and the regulations they put in their own contracts. So the contract component and being able to process, read and digest that into your system for validation is a critical component of, you know, working denials work. So, yes. That is, they do need to do that or they do seem to be doing it fairly well in the marketplace right now.

PK: Got it. So looking over the next 3 to 5 years, what will you say is the strongest bull case and bear case for Ventra and which 2 operating indicators would most quickly confirm either outcome?

AS: Their market presence has to be increased and their physical—and what I mean by that is their physical presence of marketing information, people in the field, strategic partners that may help them deliver it, consulting groups that can recommend and bring them in. All of those pieces need to come together very tightly at this point to be able to have a successful 3 to 5 years going forward. And that's what... if they can't get that type of stronghold, even with the best technology and the best delivery and everything else that they might have or do have, it won't be recognized because they're not telling the story strong enough in the marketplace and being aggressive enough with their effort toward reaching out to the market.

PK: Got it, Ajay. I think we have covered most of the agenda here. Is there anything else that you would like to highlight for Ventra as a company for someone doing diligence on Ventra and which we haven't discussed during the call?

AS: And I think we've covered quite a bit. The main thing with it isn't their offering. Right now, it's how much are you investing in technology? How much vision do you have towards an AI improvement? And that's what the clients are really looking for, whether or not... we don't know, nobody has a crystal ball to know that that's what's going to happen and it's going to actually occur. But right now, the clients are so enthused about AI. It's those 2 pieces. How strong is your marketing plan, including sales in the field, and how strong is your AI story?

PK: Yes, definitely, Ajay. Thank you so much for your time today. It was a really insightful call and we will definitely follow up if we do more work here. Thank you again.

AS: Very good. Thank you.

PK: Thank you. Bye-bye. Take care.

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DISCLAIMER: The statements or opinions expressed today are those of the Advisor and not Guidepoint, who disclaims all liability for the content provided. The Advisor may not disclose material nonpublic or confidential information or any information that would cause the Advisor to breach any duty or obligations. Guidepoint is not a registered investment advisor and the information provided is not intended to constitute investment advice.

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