Vasant Kearney
CEO
Los Angeles, California, United States
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Vasant Kearney is founder and CEO of Onlay AI, where he builds agentic healthcare revenue-cycle infrastructure across claims, eligibility, attachments, payer follow-up, payment posting, and bank reconciliation.
He was previously co-founder and CTO of Retrace, an AI company focused on healthcare automation. Before startups, Vasant was an Assistant Professor of Radiation Oncology Physics at UCSF, completed a medical physics residency there, and earned a PhD in Biomedical Engineering. He mentored radiation oncology residents at UCSF and machine learning students at the University of San Francisco. His scientific work spans a broad range of topics, including generative MRI-to-CT translation, tumor localization, anatomy segmentation, treatment-planning optimization, NVIDIA CUDA programming, and dental disease classification.
His work sits at the intersection of healthcare operations, regulated workflows, multimodal AI, and production agent systems.
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Area of Expertise
Healthcare’s Agent Bytecode: X12 as the Harness for AI Agents
LLMs made old languages newly useful: COBOL for mainframes, Fortran for scientific code, and Rust, SQL, and Prolog as strict substrates for agentic systems. Healthcare has its own old language hiding in plain sight: X12.
Before LLMs, X12 was mostly treated as ugly plumbing: loops, delimiters, companion guides, clearinghouse edits, payer-specific quirks, rejections, and acknowledgments. In an agentic workflow, those constraints become the feature. They give stochastic agents a deterministic target.
This talk shows how healthcare agents can compile messy operational evidence into X12-shaped workflows: chairside audio into 837D claim narratives, imaging systems into 275/PWK attachment flows, payer portals and phone calls into 270/271 eligibility and 276/277 claim status, preauth evidence into 278 workflows, and EOBs, scanned mail, and bank data into 835/820 payment reconciliation.
The core pattern is simple: LLMs reason over ambiguity; X12 provides the syntactic and semantic harness for validation, auditability, acknowledgments, rejections, human review, and high-volume automation.
This is not an EDI nostalgia talk. It is a production architecture talk about building reliable agents in one of the messiest enterprise domains.
Vasant Kearney
CEO
Los Angeles, California, United States
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