Insurance operations platform for care companies. Rent, then own.
The five workstreams in one place: payer contracting, credentialing, RCM, eligibility, and compliance. Anvil runs them first under our entity so you can launch, then under yours so you own the contracts.
Updated November 2, 2026
Anvil is an insurance operations platform for care companies. The five workstreams are payer contracting, credentialing, RCM, eligibility, and compliance. We run them first under our entity so you can launch, then under yours so you keep the asset.
Payer contracting, credentialing, RCM, eligibility, and compliance
What you would have to hire for each workstream, and what Anvil runs instead.
What hiring for each one costs is in the five workstreams of insurance operations.
| Workstream | Build it yourself | With Anvil |
|---|---|---|
| Payer contracting | Contracting lead with payer relationships in each state, plus counsel for contract review. | Rent: you bill under our existing contracts. Own: we contract your entity with commercial, Medicaid, and MA payers, and you see the rate ladder. Psychiatry, therapy, and ABA groups start with behavioral health payer contracting. |
| Credentialing | One credentialing specialist per 30-40 clinicians, a CAQH process, and someone chasing payer portals every week. | Roster-adds under our PC in weeks. Full credentialing files under your entity, largely automated, tracked in one place. |
| RCM | Certified coders, a billing team, AR specialists, and charting standards that survive an audit. | Coding, claims, denial management, and AR. Clean-claim rate reported monthly. Claims risk on us during rental. Coding, claims, and denials are telehealth revenue cycle management. |
| Eligibility | A clearinghouse contract, an engineer to integrate 270/271, and ops to handle the payer outages. | One API and a hosted widget. Soft check at booking, copay estimate, outage detection built in. |
| Compliance | Healthcare counsel for AKS and each state CPOM analysis, plus a security program. | Rental structured for the AKS personal services safe harbor. Your PC structured for CPOM by state. HIPAA in place; SOC 2 Type II in progress. See whether to rent a PC or own one and how corporate practice of medicine for telehealth applies. |
Which workstream first?
- Eligibility: eligibility verification at booking.
- Credentialing: roster-adds under our PC in weeks.
- Payer contracting: commercial contracts for a new PC commonly land in 4 to 8 months.
- RCM: clean-claim rate reported monthly, with claims risk on Anvil during rental.
- Compliance: rental structured for the AKS personal services safe harbor, and your PC structured for CPOM by state.
Two entities. Volume moves from ours to yours.
This is the diagram to send your co-founder.
The second entity is the point: it is how you own your payer contracts instead of renting them, and it is papered under the MSO-PC structure for telehealth. Already on another vendor? See switching from a network rental vendor.
Comparing vendors? Read the Bridge alternative fact table.
Rent, then own: the timeline
The Anvil PC bills on day 30. Your PC forms in week 1. Contracts are in your name by month 6. Claims risk is on Anvil during rental, and the clean-claim rate is reported monthly.
Fits the stack you already have
EHRs and scheduling
Eligibility at booking works with your own booking flow through the API or the hosted widget. Charting standards are documented per EHR. Ask about yours.
Clearinghouses and payments
Claims go through our clearinghouse under either entity. Patient responsibility can be collected through your existing payment processor, Stripe included.
Reporting
Collections by entity, payer, state, and clinician. Contracted rate and platform fee as separate lines. Exports and a reporting API.
Built for a regulated business
What is in place
- HIPAA program, BAA available on request
- Encryption in transit and at rest, role-based access, audit logging
- No PHI collected on this marketing site
What is in progress
- SOC 2 Type II, with a public trust center on completion
- Published sub-processor list
Dated roadmap: CPOM, AKS, and security compliance.
Questions, answered
What is an insurance operations platform for care companies?
The five workstreams in one place: payer contracting, credentialing, RCM, eligibility, and compliance. Anvil runs them first under our entity so you can launch, then under yours so you own the contracts.
Should I rent a PC or build my own professional corporation?
Do both, in order. Renting a PC gets you billing in weeks because the payer contracts already exist. Building your own PC is how you end up owning the contracts, but new commercial contracts commonly take 4 to 8 months. Anvil launches you on our PC and forms yours in parallel, so building never delays revenue.
What is an MSO-PC structure and does my telehealth startup need one?
An MSO-PC structure splits a care company into a physician-owned professional corporation that delivers and bills care and a management services organization that founders and investors own. Many states' corporate practice of medicine rules require it when non-physicians own the business. Anvil structures your PC for each state's rules, with counsel reviewing every structure.
How do I switch from a network rental vendor to my own payer contracts without losing revenue?
Keep billing through your current vendor until each of your own contracts is effective, so there is no revenue gap. Form your professional corporation, file contract applications in your name, and move volume payer by payer as each contract is effective, then give notice. Remaining payers can run through Anvil's rented PC.
See the five workstreams on your own numbers.
Run the calculator, then talk to us about the tier that fits.