Company leader
Sameer Ather
Co-founder and CEO
XpertDox
Sameer Ather is the co-founder and chief executive of XpertDox, a Scottsdale, Arizona, company whose XpertCoding software codes and submits outpatient medical claims. He trained in cardiology and spent more than a decade in healthcare data analytics before he built the company.
From Molecular Biology to Statistical Genetics
In 2007 a mentor at Baylor College of Medicine urged him to move from molecular biology to statistical genetics, predicting that machines and AI would reshape clinical care. That advice led him to a PhD and more than ten years in healthcare data analytics. He came away convinced that "healthcare data was too unstructured, not connected".
Rare Diseases and the First XpertDox
During his cardiology fellowship he kept seeing patients with rare diseases struggle to find doctors who knew their condition. He reasoned that the right doctor would have published research, run trials and treated that disease. He left an academic career to build XpertDox around that idea.
Turning to Medical Coding
The company changed course during the pandemic, when clinics fell months behind on insurance claims and an urgent care chain asked for help with its backlog. XpertDox retooled its language engine to code and submit claims, and the return for that clinic showed a strong fit with the market. "We were more of an accidental fit, XpertDox and revenue cycle, not an intentional fit," he said.
Building Autonomous Coding
XpertCoding now assigns diagnosis and procedure codes, adds modifiers and units, and submits claims, while humans review the claims it flags. He points to first-pass denials as the problem worth solving: "30 to 40% of the claims get denied in the first pass". He credits his team for the company's growth, since "it takes a whole village to build something".