A decade of disputes revealed how confusing medical bills can be
Every year, millions of Americans are blindsided by medical bills riddled with errors – sometimes paying hundreds of thousands more than they should.
For most people, that would be the whole story. But for Angel Onuoha, who is now the co-founder of medical AI startup Avelis Health, it became the starting point.
Why millions of Americans struggle with medical debt and billing errors
For nearly a decade, Onuoha found himself dealing with something that lasted far longer than his recovery. After three knee surgeries, the hospital bills kept arriving and changing, eventually climbing to about $250,000.
What should have been a straightforward statement became a routine of long phone calls, repeated explanations, and billing codes he couldn’t decipher.
Each time he asked questions, new adjustments appeared, making it difficult to understand what he actually owed and why.
At first, it felt like an exhausting personal dispute. But the more he looked into it, the more he realized the confusion wasn’t unique to him.
Research suggests roughly 100 million Americans live with medical debt, and estimates indicate that up to 80% of medical bills contain errors. Whether that be from incorrect coding and inflated prices or charges that shouldn’t have been there in the first place.
His experience wasn’t just bad luck – it reflected a broader pattern.
Helping others identify incorrect charges and understand their bills
Once Onuoha, who is a graduate of Harvard, former product manager at Google, and repeat founder, started to realize he wasn’t alone, he got to work.
Why were patients who were trying to recover also stuck trying to make sense of complicated bills?
Surely there were more important things at stake. Resolving costs, for many, often depends on time, persistence, and the ability to even question the system in the first place.
So instead of focusing only on fixing his own bills, he decided to build something aimed at improving the process itself.
In early 2025, Onuoha partnered with his long-time collaborator Ahmad Shehu. The two had worked together before, co-founding Lagos-based fintech startup Zuvy that was eventually acquired by The BAS Group.
Through that experience, they became familiar with operating in regulated environments where processes are complex, incentives don’t always align, and important financial decisions depend on fragmented data.
When they turned their attention to US healthcare billing, they noticed similar dynamics.
Many existing cost-containment solutions review only a small sample of claims rather than examining them comprehensively, which means a large share of potential errors may never be evaluated in the first place.
The mission behind Avelis Health’s approach to medical billing
Ultimately, the two set out to build a system capable of reviewing every claim instead of just a subset to provide a more complete picture of billing accuracy.
The startup developed AI systems designed to analyze medical bills line by line. Similar to how a specialist investigator would examine a claim, but with the ability to operate quickly and at larger scale.
In early use, Avelis has said patients using the service collectively reduced hundreds of thousands of dollars in out-of-pocket costs.
While growth capital accelerates the work, the personal mission stays the same
Over time, the founders recognized that the same approach could extend beyond resolving bills after they were issued. It could also be applied earlier in the process to help prevent incorrect payments before they occur.
With support from Y Combinator – including a $500,000 pre-seed investment in 2025 – Avelis Health expanded its focus beyond individual bill reviews and introduced Payment Integrity, a product designed for self-insured employers and health plans.
Why? Because for employers that directly cover healthcare costs, even the smallest of error rates can add up at scale. Industry estimates suggest incorrect or avoidable claims account for tens of billions of dollars in spending each year.
Moving forward, despite the enterprise focus and technical infrastructure behind the product, the motivation seems to remain deeply rooted in a personal experience.
The same type of billing confusion that led to Onuoha’s years of disputes and hundreds of thousands of dollars in medical debt is what the startup now tries to address systematically.
The big picture, as a result, is clear: people seeking care shouldn’t have to navigate complex billing investigations on their own in order to understand what they owe.
