Offices of optometrists

How this differs from general EHR and practice management (6211). The general record is about Epic and the hospital market, where certification and clinician training decide who wins. An optometry office is a clinic with a shop attached. The software has to run the eye exam (refraction, pre-test device data, retinal imaging) and also an optical store: frame and contact-lens inventory, a point-of-sale counter, and lens orders sent to labs. The money side runs on two tracks. Routine eye exams and eyewear are paid through vision plans (VSP, EyeMed and others), which have their own eligibility checks, authorizations and claims. Medical eye care is billed to ordinary health insurance. Generic EHRs do not do frames, lab orders or vision-plan claims, which is why the category exists. The incumbent is a payer. Eyefinity is part of VSP Vision, the largest vision plan, and sells the only optometry software with a direct connection to VSP for real-time eligibility, authorizations and claims [C, vendor]. That claims link is the moat. In October 2025 NextGen Healthcare licensed it too: its ophthalmology and optometry customers now get Eyefinity's VSP claims, frame inventory, point of sale and lab ordering [B, NextGen release]. The independents are old and private. RevolutionEHR (Madison, founded 2006, majority-owned by the RevOptix investor group since 2014 [B]) claims 13,000+ eye care professionals [C]. Crystal PM (Austin) claims 8,000+ independent optometry providers [C]. Compulink (since 1985) also sells to ophthalmology and other specialties. Sightview, formerly Eye Care Leaders, was sold to unnamed owners in July 2024 and carries My Vision Express alongside iMedicWare, Medflow and ManagementPlus [B]. Ocuco (Dublin; €60M minority investment from Accel-KKR in 2023 [B]; 6,750+ sites in 88 countries [C]) sells optical retail and lab software, and its Canadian arm grew out of the EMRlogic acquisition. The one funded newcomer is small. Barti raised a $12M Series A led by Five Elms Capital in August 2025, with AOAExcel (the American Optometric Association's for-profit arm) as an investor [B]. It sells an AI-first all-in-one system and has onboarded about 200 practices [C]. Patient messaging is a separate layer owned by Weave (NYSE: WEAV; $239.0M revenue in 2025, 39,625 customer locations across dental, optometry and other verticals [A]), and Eyefinity lists Weave as an integration partner. The buyer is consolidating. By the end of 2023, private-equity platforms ran hundreds of offices each: MyEyeDr 842, AEG Vision 400+, EyeCare Partners 385+, Keplr Vision 278 [B, Vision Monday]. Those groups standardise on one system and negotiate enterprise terms, which leaves a shrinking independent market split among 25-year-old vendors that each claim thousands of providers. A new entrant would need the vision-plan claims link the payer owns, the device and lab integrations the incumbents built over two decades, and a buyer that is not being acquired. Incumbent vulnerability decides it. No optometry software vendor publishes revenue.

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.