Payment Infrastructure Modernization for Healthcare
The U.S. healthcare system wastes $200–350 billion annually on administrative friction—billing complexity, payment delays, prior authorization bureaucracy, and claims rework.
PIM Health replaces decades-old batch processing with near-real-time payment infrastructure. Providers get paid in days, not months. Patients know what they owe before they leave.
No new programs. No statutory overhaul. Just modern infrastructure.
Get the WhitepaperHealthcare payment infrastructure hasn't meaningfully evolved since the 1980s. While every other industry processes transactions in real time, healthcare still runs on batch processing, sequential payer interaction, and manual reconciliation.
Providers
Wait 45–90 days to get paid
Patients
Don't know costs until bills arrive weeks later
Physicians
Spend more time on paperwork than patients
Employers
Absorb administrative waste in every premium dollar
This isn't a coverage problem. It's an infrastructure problem. And infrastructure problems have infrastructure solutions.
PIM doesn't replace insurance. It modernizes the pipes.
Real-time eligibility
Know coverage before the visit
Provider attestation
Physicians certify necessity; no clerk gatekeeping
Instant adjudication
Claims process in minutes, not weeks
Immediate payment
Providers paid in 24–72 hours
Post-payment validation
Oversight through analysis, not prior auth
Today, you don't know what you owe until weeks after your visit—if then. Surprise bills aren't a bug; they're a feature of a system built on delayed coordination.
Know your cost at checkout
Near-real-time out-of-pocket determination means no more guessing. Your share is calculated before you leave the exam room.
No more surprise bills
Coordination of benefits happens in minutes, not months. All payers—primary, secondary, HSA—are queried simultaneously.
Faster access to care
Streamlined prior authorization removes administrative barriers that delay treatment when you need it most.
0
Surprise bills
72h
Payment, not 90 days
The average practice waits 45–60 days to get paid. 10–15% of claims require rework. Physicians spend 14+ hours weekly on prior authorization. This isn't healthcare—it's paperwork.
Payment in 72 hours, not 90 days
Real-time adjudication means real-time cash flow. Stop financing your payers' float.
60–80% reduction in cost-to-collect
Cleaner claims, fewer denials, less rework. Your billing staff can focus on exceptions, not everything.
Your clinical judgment, restored
Provider attestation replaces insurance clerk gatekeeping. You certify medical necessity; validation happens post-payment through peer review.
PIM was designed by Don Peterson, founder of IVX Health—a specialty infusion network that grew to 120+ locations before acquisition in 2024. He built this because he lived the dysfunction firsthand.
Administrative costs consume 15–25% of U.S. healthcare spending—double the international benchmark. PIM provides infrastructure-level savings without requiring benefit changes or new mandates.
$75–150 billion in addressable waste
Real-time processing eliminates rework, denials, and float. Savings flow through to premiums, coverage expansion, or treasury returns.
Proactive oversight, not punitive audits
Pattern analysis catches problems before they compound. Education and correction replace retroactive clawbacks.
Program-agnostic infrastructure
Works with Medicare, Medicaid, commercial plans, and self-insured employers. One infrastructure layer serving all programs.
Initial federal investment: $40–60B over 5–7 years.
Projected ROI: 10–20:1 over ten years.
$150B
Addressable annual waste
PIM Health was founded by Don Peterson, who founded IVX Health and was its CEO until 2018. IVX now has over 150 locations nationwide. He designed PIM because he experienced the system's dysfunction firsthand—by a regulatory framework that penalizes innovation rather than rewarding it.
He designed PIM because he experienced the system's dysfunction firsthand—including $3M+ in clawbacks caused by regulatory frameworks that penalize innovation rather than reward it.
This isn't policy written by consultants. It's infrastructure designed by someone who's signed the checks.
Before IVX Health, Don spent 20 years in technology, including a decade at AMD and founding DeskStation Technology (acquired by Samsung). He brings the same systems engineering mindset to healthcare's most intractable administrative problems.
The complete PIM whitepaper details the technical architecture, economic case, implementation roadmap, and policy positioning—including the provider attestation model that replaces prior authorization.