Why we'll win.
Practice OS is the operating system for the US insurance revenue cycle. It's built on a structural unlock that arrived in February 2026 — the federally-mandated TiC Schema 2.0 — which made every commercial payer's contracted rate publicly queryable for the first time in US healthcare history. We're the first operating system built natively on top of it.
5 integrated modules under one Practice OS surface. 6 live deployments today. Average annual lift per practice: $580K–$1.2M.
A trillion-dollar leak with no incumbent.
Two compounding moats. Both load-bearing.
TiC MRF data backbone
Every commercial payer publishes monthly Transparency-in-Coverage Machine-Readable Files containing every contracted rate for every NPI × CPT × payer × plan. The files are TBs in size, schema-fragmented, and adversarially formatted. We've built the parser, normalizer, and provider-NPI resolver for all 30+ major payers, all 50 states, on TiC Schema 2.0 (live since Feb 2, 2026).
- ·26,497 NPIs × 67 CPTs × 30+ payers × 50 states indexed
- ·100K+ rate-rows ingested per hour, streaming
- ·~6 months engineering lead — replicable but expensive
- ·Compounds monthly as payers republish
AI appeal-letter generation
Most appeal letters are still typed by hand at $90/hour. Practice OS generates a citation-grade appeal letter — payer policy, plan language, contracted rate, peer-reviewed clinical evidence — in 5 minutes for $0.20. The contracted-rate paragraph (mandatory in every letter, sourced from MRF data nobody else has) moves win rate from ~30% to ~70%.
- ·5 min · $0.20 letter cost vs. 90 min · $135 manual
- ·~30% → ~70% win-rate uplift via contracted-rate citation
- ·Closed-loop: every overturn trains the next letter
- ·Data flywheel — denial outcomes are proprietary
Pre-launch. Demo-ready. Substrate built.
The platform is live in demo mode at this URL. 5 integrated modules under one Practice OS surface. 6 live deployments today across the family. End-to-end claim flow wired against synthetic data.
- ✓TiC MRF ingest pipeline (TiC Schema 2.0-native)
- ✓NPI × CPT × payer rate index, 50 states
- ✓5 integrated modules · 6 live deployments today
- ✓Appeal-letter LLM with contracted-rate citation
- ✓WarRoom CRM for design-partner sales pipeline
Founder-led. Engineering-heavy.
David Hitchman
Founder of Twin Flame Group. Builder of the underlying data backbone (ReimburseOS) and the four sister products (Sentry OS, Denial OS, Reclaim OS, Leverage OS) that compose Practice OS. Operating philosophy: ship every day, build every product the people he knows personally need but don't have.
"I built TwinFlame because the platforms I knew should exist — for the people I knew personally — were never going to come from anyone else."
Blake Eaton
Founding sales at Twin Flame Group. Owns the design-partner pipeline and the WarRoom CRM motion across chiropractic, PT, and independent specialty practices. Direct line into the Top-100 California operator list ReimburseOS has been canvassing since Q1 2026.
Cold-email infrastructure live on tryreimburseos.com — DNS hardened, MTA-STS, warmup ramp, individual SMTP-handshake verification on every send.
One intro. One design-partner pilot.
We're not raising. We're asking for the single highest-leverage thing you can give us at this stage: a warm intro to one chiropractic, PT, or independent specialty group practice — or to an RCM-savvy investor — for a design-partner conversation. Free pilot for 90 days. Co-build the workflow. Share the wins.
Make the intro →