Meridian Technologies
Confidential · Seed Round
Business Plan · 2026
Cadence.
AI scheduling & operations software for outpatient clinics — recover the 30% of capacity that no-shows and broken booking workflows quietly burn.
Prepared by
Dr. Priya Nandakumar & Eli Park
Round sought
$1.5M Seed
Date
June 2026
01

Executive Summary

The thesis

Cadence is the AI scheduling and operations layer for outpatient clinics. We sit on top of the EHR and turn a clinic's calendar into a self-optimizing system — predicting no-shows, auto-filling gaps from a smart waitlist, and rebalancing provider load in real time.

Outpatient clinics run on calendars they can't control. The average practice loses 14–20% of booked slots to no-shows and last-minute cancellations, and front-desk staff spend hours a day playing phone tag to backfill them. Cadence replaces that manual scramble with a model that predicts risk per appointment and fills the gap before it happens — lifting utilization without adding a single hour of staff time.

$84K
Current ARR · run-rate
22%
MoM revenue growth · 6-mo avg
$3.1B
Serviceable market (SAM)
$1.5M
Seed round we're raising
Why now

EHR vendors finally opened FHIR write-access APIs in 2024, making real-time schedule automation possible for the first time without a custom integration per clinic. The plumbing exists; nobody has built the intelligence on top of it.

Why us

Priya practiced as an outpatient physician for eight years and lived the no-show problem daily; Eli led ML infra at a digital-health unicorn. We pair clinical credibility with the engineering to ship against messy healthcare data.

The raise

$1.5M seed to go from 9 paying clinics to 80.

An 18-month runway to harden the EHR integrations, prove the no-show model across specialties, and build a repeatable sales motion into mid-size clinic groups — reaching default-alive on a Series A trajectory.

$1.5M
Cadence, Inc.Confidential · 02
02

Product & Solution

What we built

Cadence connects to the clinic's EHR in under a day, learns its booking patterns, and runs three loops continuously — predict, fill, and balance. Staff keep their existing calendar; Cadence works underneath it, surfacing actions instead of dashboards nobody reads.

The wedge

No-show prediction. We start with the one number every clinic feels in revenue: the empty chair. Cadence scores every upcoming appointment for risk, then proactively fills high-risk slots from a ranked waitlist — a sharp, measurable ROI that gets us in the door before we expand across operations.

How it works
  • Predict — a per-appointment no-show model trained on history, weather, lead time, and patient signals.
  • Fill — auto-offers freed slots to a smart waitlist over SMS, confirming without staff lifting a finger.
  • Balance — flags overbooked providers and reroutes new bookings to protect throughput.
Pricing — per-provider SaaS, billed monthly
Measured impact · pilot cohort

+11 points of slot utilization in 90 days.

Across our first nine clinics, Cadence lifted filled-slot rate from 81% to 92% and cut no-shows by a third — an average of $5,800 in recovered monthly revenue per provider, against a sub-$150 software cost.

Cadence, Inc.Confidential · 03
03

Market

The opportunity

There are ~280,000 outpatient clinic sites in the US employing roughly 1.1M providers. Scheduling inefficiency is a universal, recurring tax on every one of them — and it compounds with every empty chair.

Market sizing — top-down, US outpatient
TAM
All US providers
$9.2B
SAM
EHR-integrated
$3.1B
SOM · 3-yr
Reachable wedge
$140M

TAM = 1.1M providers × $700/provider/yr blended ACV. SAM = clinics on FHIR-capable EHRs we can integrate today. SOM = realistic 3-yr capture at planned sales capacity.

Ideal customer profile
  • 4–40 provider clinic groups — big enough to feel the loss, small enough to buy without an 18-month committee.
  • High-volume specialties — primary care, dermatology, behavioral health, PT — where no-show rates run highest.
  • On a modern EHR — athenahealth, Elation, eClinicalWorks, or Epic Community.
Trends in our favor

Margin pressure is pushing clinics to recover revenue from existing capacity rather than add staff. FHIR write-access went GA across major EHRs in 2024–25. And patients now expect SMS-first, self-serve rescheduling — the exact surface Cadence automates.

280K
US outpatient clinic sites
14–20%
Avg booked slots lost to no-shows
$150B
Annual US no-show revenue loss
$700
Blended ACV per provider / yr
Cadence, Inc.Confidential · 04
04

Competitive Landscape

The edge

Reminders are a solved, commodity problem — and that's exactly the trap. Incumbents send texts; they don't decide who to overbook, which slot to fill, or how to protect a provider's day. Cadence is the only player closing the loop from prediction to action.

PlayerPredictsAuto-fillsBalances
Legacy reminder tools SMS / robocall remindersNoNoNo
EHR-native scheduling built-in, rules-basedNoManualNo
Patient-access point tools online booking widgetsNoPartialNo
CadenceYesYesYes
Our moat
  • Proprietary no-show data — every clinic we add sharpens the model; accuracy compounds with scale.
  • Deep EHR integration — write-access plumbing is hard to build and stickier than a reminder bolt-on.
  • Workflow lock-in — once the front desk stops backfilling by hand, ripping us out brings the pain back.
Honest risks
  • EHR platform risk — a vendor could ship a native feature. Mitigated by multi-EHR coverage and a model they can't match.
  • Long sales cycles — healthcare buys slowly. We wedge with self-serve no-show ROI to compress it.
  • Data & compliance — HIPAA is table stakes; we're SOC 2 Type II in progress, BAA-ready on day one.
Cadence, Inc.Confidential · 05
05

Traction & Go-to-Market

The proof

Nine paying clinics, $84K ARR run-rate, 22% MoM growth — all from founder-led sales and zero paid acquisition. The model works; we're raising to make selling it repeatable.

Current customers · representative
Riverline Family Health
PRIMARY CARE · 12 PROVIDERS
Northgate Dermatology
DERM · 7 PROVIDERS
Still Point Behavioral
MENTAL HEALTH · 9 PROVIDERS
Cascade PT Group
PHYSICAL THERAPY · 5 SITES
Unit economics · early
CAC founder-led, blended$1,900
Annual contract value per clinic$11,400
Gross margin82%
Net revenue retention118%
LTV : CAC7.4×
GTM motion
  • Land on no-show ROI — a 2-week pilot proves recovered revenue before they ever sign a contract.
  • Expand by provider & site — seats grow inside a group; 118% NRR does the compounding.
  • Channel via EHR marketplaces — listed where clinics already shop for add-ons.
12-month product roadmap
Q3 '26
EHR breadth

Ship Elation + eClinicalWorks write-back; reach 4 supported EHRs.

Q4 '26
Self-serve

Onboarding that goes live in under a day with no implementation call.

Q1 '27
Ops suite

Provider load-balancing and capacity analytics out of beta.

Q2 '27
SOC 2 II

Type II complete; unlocks larger multi-site clinic groups.

Cadence, Inc.Confidential · 06
06

Financial Plan

The numbers

The $1.5M funds an 18-month runway to 80 paying clinics and a ~$1.2M ARR exit rate — the shape that supports a Series A. Plan holds with a 20% miss on growth.

Use of funds · 18 months
CategoryAmount
Engineering 4 hires · EHR + ML$640K
Sales & success 2 AEs + 1 CSM$420K
Compliance SOC 2 II + legal$120K
Infra & data$140K
G&A + buffer$180K
Total raise$1.5M

~58% to product · ~28% to revenue · runway to Q4 2027.

Unit economics · at scale
MetricTarget
Blended CAC post founder-led$3,400
LTV 3-yr, 90% logo retention$26,800
LTV : CAC7.9×
CAC payback5.1 mo
Gross margin84%
Rule of 4062

Software-margin economics; SMS pass-through is the only variable cost.

Three-year ARR projection
YR 1
$1.2M
YR 2
$4.6M
YR 3
$11.8M · Series A scale

Year-1 ARR is the seed exit rate (80 clinics). Years 2–3 assume the Series A funds the sales scale-up; NRR of 115%+ carries ~40% of net-new growth.

Cadence, Inc.Confidential · 07
07

The Ask

Let's build

Cadence has the wedge, the proof, and the team. The seed is what turns nine clinics into eighty — and a working product into a category-defining company.

Milestones to Series A
MO. 0
Close & staff

Round closed; engineering and first AE hired against the plan.

MO. 6
4 EHRs live

Self-serve onboarding shipping; 30 paying clinics on the platform.

MO. 12
SOC 2 II

Compliance unlocked; mid-size groups closing on the new motion.

MO. 18
$1.2M ARR

80 clinics, default-alive trajectory — raise the Series A.

Bottom line

$1.5M to own the operations layer of outpatient care.

The empty chair is a $150B problem every clinic feels and no incumbent solves end-to-end. We've proven clinics will pay for the fix and stay for it. This round buys the runway to make that motion repeatable — and to be the system clinics run their day on.

$1.5M · Let's build.
Prepared by
Dr. Priya Nandakumar & Eli Park · Co-founders
Cadence, Inc. · San Francisco, CA
[email protected] · cadence.health
Cadence, Inc. · Nandakumar & ParkConfidential · 08