About Pivotal Health | Healthcare Reimbursement Technology

Josh Folds and Max Magnum
Co-Founders and Partners

Our Founding Story

Our story started in 2022, when co-founders Max and Josh, motivated by personal experiences in the healthcare system, set out to use their different backgrounds to change healthcare for the better. The release of new healthcare price data and new regulations like the NSA signaled a pivotal point for the industry, and they saw an opportunity to help reshape a system that had long been unfair to patients and providers.

One problem stood out: securing fair reimbursement had become a growing challenge for providers. As payors further employed new approaches and technologies towards cost-cutting, there were fewer innovations to support providers. The Independent Dispute Resolution (IDR) process resulting from the No Surprises Act opened a new avenue for fair reimbursement, but also further amplified reimbursement complexity.

Pivotal Health was built on the insight that providers don’t just need more information, they need better systems to make the reimbursement easier. By combining data intelligence with automation, we help providers get paid fairly for the care they deliver—restoring balance, reducing administrative burden, and bringing long-overdue clarity to a complicated process.

How we think about balance, fairness, and partnership

Our Vision

Restore the balance between providers and payers.

Our Mission

Create technology that helps providers achieve fair reimbursement.

Our Promise

We believe fairness should be built into the reimbursement process. That’s why we only get paid when clients do. No exceptions. No hidden fees. No restrictive contracts.
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Just a partnership rooted in trust, transparency, and shared outcomes.