Offices of chiropractors

How chiropractic differs from rehab therapy (621340). Rehab software is built around insurance: WebPT and its rivals compete on documentation that survives payer and Medicare review, and the visit is billed to a third party. A chiropractic office sells many more short visits, usually as a care plan: a course of adjustments scheduled ahead and often paid up front or as a monthly membership. Part of the profession runs cash-only. That changes what the software has to do. It needs recurring card billing for memberships and prepaid plans, a ledger for plan balances, fast spinal-adjustment SOAP templates, and personal-injury and auto-accident case files alongside ordinary insurance claims. Discounting is also a compliance problem: charging cash patients less than insurers invites dual-fee-schedule trouble. A whole product, ChiroHealthUSA, exists to sell practices a 'compliant membership model' as a discount medical plan; it claims 7,700+ providers [C, vendor]. These are analyst framings of the workflow; the vendor pages confirm the features (ChiroSpring sells 'Memberships', ChiroTouch's CT Pay sets up recurring payments, ClinicMind sells a 'Cash-Only / Private Pay' plan) [C, vendor]. The incumbent is ChiroTouch, and it now sits inside a private-equity roll-up. It claims 12,500+ chiropractic practices [C, vendor]. K1 bought it in 2014, Waud Capital Partners took a stake in 2017 [B, socaltech], and in September 2023 Waud's platform (Integrated Practice Solutions, whose chiropractic line is ChiroTouch) merged into PracticeTek under Lightyear Capital majority ownership, with Greater Sum Ventures and Waud keeping stakes [B, Lightyear release]. PracticeTek also owns ChiroSpring, the cloud challenger that sells memberships; ChiroSpring's founder is quoted on PracticeTek's site, and the two share a San Diego address [C]. So the incumbent and one of the best-reviewed challengers have the same owner. Second consolidator: ClinicMind, which absorbed Genesis Chiropractic Software (its homepage now offers 'ClinicMind EHR 1.0 formerly Genesis') and sells EHR plus outsourced billing [A for the merger; date January 2024 from search summary, not opened]. The best-funded challengers. ChiroHD (Atlanta, founded 2017) raised $26M of growth capital from Mainsail Partners in April 2025 [B]. Jane (North Vancouver) is multi-discipline rather than chiropractic-only. It raised under $10M of primary capital, including $2M of CIBC debt in 2019 [B], and was valued at about $1.8B in a May 2025 secondary of $500M-plus led by TCV with JMI Equity and Tidemark [B]; reported revenue was about US$100M [B, The Logic via techcouver]. Practice Better (Toronto; US$27M led by Five Elms, April 2023, and US$13M of CIBC growth debt, November 2024) [B] named chiropractors as a target vertical when it raised. A new entrant would face a PE-owned incumbent that already bundles payments and recurring billing, a venture-funded cloud challenger aimed squarely at it, and a Canadian multi-discipline platform worth more than any of them. Incumbent vulnerability decides it. No vendor publishes revenue except Jane's reported figure.

What this category is. The back office between a care provider and whoever pays: eligibility checks, claims and the clearinghouse that carries them, coding, denials and appeals, payer-to-provider payments, patient statements and collections, and the credentialing and enrolment that let a clinician bill a plan at all. The coded customer is ambulatory care (621): physician groups, clinics, labs and home health. But the largest buyers of several segments are hospitals and health systems (outsourced revenue cycle, inpatient coding) and health plans (payer payments, provider data, credentialing). How it differs from the neighbouring records. Electronic health records and practice management (6211) sells the chart and scheduling; athenahealth appears here only for its revenue-cycle business, and its funding is not re-researched. EHR+ patient engagement (6211) sells the portal and intake. Patient booking (6211) sells patient acquisition. HIPAA compliance (6211) sells security and audit. Medical imaging (621510) sells PACS. This record is the money and paperwork layer. Who owns the rails. Optum completed its combination with Change Healthcare on 3 October 2022 [A, Optum]. The February 2024 ransomware attack on Change touched about 192.7 million individuals, the largest US healthcare breach on record [B, CyberInsider citing the HHS OCR filing], and stopped claims for providers across the country. That shows how much of the network runs through one company. Availity says it connects over two million providers to every US health plan and handles over 13 billion transactions a year; its shareholders include Anthem (Elevance), Humana, HCSC and GuideWell, and Novo Holdings bought Francisco Partners' stake in July 2021 [A, Novo Holdings]. Waystar (Nasdaq: WAY) earned $1,099M of revenue in 2025, up 17%, from about 30,000 clients representing over 1 million providers [A, Waystar release]. Experian Health sells patient access, eligibility and identity inside Experian plc. Zelis runs the payer-to-provider payment side: 725 payer clients, 850K+ providers and $300B+ of payment volume by its own count [C]. Bain Capital and Parthenon sold a minority stake to a Mubadala-led group that closed on 26 November 2024 [A, Kirkland & Ellis]; the reported $17B valuation is Bloomberg's, not opened here. Who owns the outsourced work. R1 RCM was taken private by TowerBrook and CD&R at about $8.9B, closing 19 November 2024 [A, CD&R]. Ensemble Health Partners began as Bon Secours Mercy Health's revenue-cycle arm; Golden Gate Capital bought 51% in 2019 in a deal reported at about $1.2B [B, Becker's]. athenahealth, bought by Bain Capital and Hellman & Friedman for $17B [B, Healthcare Dive], bundles billing with its ambulatory record. The AI wave is already funded. AKASA (inpatient coding for 500 hospitals, by its own count) raised a $60M Series B led by BOND in 2021 [A]. Adonis raised a $40M Series C led by Quadrille Capital in March 2026, over $95M in total, and claims more than 4x revenue growth in 2025 [A, company release]. Candid Health raised a $52.5M Series C led by Oak HC/FT, $99.5M in total [B, HLTH]. Infinitus raised a $51.5M Series C led by Andreessen Horowitz, $102.9M in total, for AI agents that call payers [B, Pulse 2.0]. In credentialing, Medallion has raised $130M (latest $43M led by Acrew Capital, August 2025) and has acquired Andros [A]. CertifyOS raised a $40M Series B led by Transformation Capital in June 2025 [A]. Uno Health (Medicaid and benefits enrolment) was bought by Findhelp in October 2025 [B]. Canada. Provincial plans pay physicians, so the US claims-and-denials problem mostly does not exist. Billing is bundled with the record: more than 40,000 Canadian health professionals use a TELUS Health EMR [A, TELUS], and TELUS's CHR files OHIP claims through MDBilling [A, TELUS help centre]. mdbilling.ca now redirects to Dr.Bill, which claims 13,000+ physicians across OHIP, MSP and AHCIP [C]. TELUS eClaims covers direct billing to private insurers for allied health. Why a newcomer cannot get in. The clearinghouse and payment rails are owned by Optum, Availity (owned by payers), Waystar and Zelis. Each depends on connections to thousands of payers and on volume pricing. The outsourced hospital work is owned by private-equity platforms worth billions. Every point task an AI startup might attack (coding, denials, payer calls, credentialing, patient billing) already has a venture-backed player with $50M–$130M raised, and the incumbents are buying or building the same AI. Waystar's acquisition of Iodine is one example. In Canada the pain is small and the record vendors bundle it. Incumbent vulnerability decides it.