How Turquoise Health cut their close time in half while building for healthcare's transparent future

"Our prior billing tool didn't connect across our stack, so we had to manually bridge gaps between billing, revenue, and tax compliance. QuickBooks wasn’t helping either, you can’t manage revenue and billing from there, and that blocked us from implementing a real FP&A tool." - Jim, Head of Finance, Turquoise Health

The Company

Healthcare's price transparency pioneer scales with modern finance infrastructure

Turquoise Health has become the definitive source for healthcare pricing data since launching in 2020. After raising $30M in Series B funding led by Adams Street Partners in January 2024, with participation from Andreessen Horowitz, BoxGroup, and others, the company now processes trillions of pricing records and serves over 160 healthcare organizations.

Their platform helps providers, payers, and patients access transparent healthcare pricing through comprehensive data and AI-powered contracting tools. With 30 health systems among their customer base, they're rapidly expanding. But while Turquoise was revolutionizing price transparency for the healthcare industry, their own financial operations remained frustratingly opaque.

The Challenge

Disconnected systems creating a financial bottleneck

Jim Maksian, Head of Finance at Turquoise Health, inherited a patchwork of financial tools that couldn't keep pace with the company's growth. The billing system didn't connect to their tax compliance software, forcing workarounds through QuickBooks. Every month brought the same problems: duplicate transactions, manual reconciliation marathons, and delayed financial reporting.

"We do semi-annual company retreats where 150 people converge on a single city," Jim explains." The expense volume during those months was crushing. We'd have duplicate transactions from both the bank and Ramp hitting QuickBooks. Our accounting manager would spend hours, sometimes days, just figuring out what was real."

The 10-day close process meant leadership meetings often relied on estimates rather than actuals. For a data-driven company building transparency tools for healthcare, presenting "napkin math" to the board felt particularly ironic.

Key Pain Points

• ‍Fragmented billing workflow - Manual data transfers between billing, QuickBooks, and tax compliance systems‍
• Cash reconciliation chaos - 4+ days monthly lost to sorting duplicate transactions and manual matching‍
• Delayed financial visibility - 10-day close prevented timely reporting to leadership and board‍
• Collections friction - Biweekly manual Slack messages to chase past-due invoices‍
• Scaling constraints -Growing team meant exponentially more manual work without system improvements

The Solution

Speed and partnership over lengthy implementations

With their billing contract expiring and limited time for transition, Turquoise needed a solution that could deliver immediate value. Rillet's approach stood out from traditional ERP implementations.

"Within two weeks of signing, we were connected to Salesforce and billing through their platform," Jim recalls. "We even imported all our historical data to maintain continuity. While other systems would have taken months, we completed the full migration in six weeks."

The implementation timeline:

• Weeks 1-2: Salesforce connected, billing live, Rillet automations deployed‍
• Weeks 3-6: Complete migration from previous systems‍
• Month 2: Old QuickBooks processes replaced entirely

"One of the key things we look for when transitioning systems is a partner who'll go along with us on the journey," says Jim. "Rillet was exactly that. They had the experience to add real value, not just check boxes."

The Results

From manual chaos to automated clarity

The impact was immediate. Cash reconciliation, which previously consumed 20% of the accounting manager's time, now runs virtually untouched. The team went from spending days untangling duplicate transactions to handling only occasional lockbox deposits from JPMorgan.

Month-end close dropped from 10+ days to consistently under 5, giving leadership accurate financial data for their monthly all-hands meetings instead of estimates. The enhanced Salesforce integration transformed collections from a manual, biweekly process taking several hours into real-time visibility for customer success teams.

"Our customer success managers can now look at past-due invoices anytime they have a customer call coming up," Jim explains. "No more biweekly reminders, no more administrative burden. The information is just there when they need it."

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Building for Healthcare's Future

The operational efficiency gained has freed Turquoise's finance team to work on what matters: negotiating vendor contracts, optimizing cash flow, and building processes that scale with the business.

"Ten years ago, a company our size may have looked like it needed a controller, accounting manager, AP clerk, staff accountant, and senior accountant," Jim reflects. "That's not the world we're living in anymore. Technology like Rillet is the reason why."

For a company dedicated to bringing transparency to healthcare pricing, aligning their internal operations with their external mission was critical. No more disconnected systems. No more napkin math. Just clean, accurate financial data powering their growth.

"Every time Rillet ships a new feature, I'm amazed," says Jim. "They're not just moving fast. They're shipping meaningful improvements that actually matter."

About Turquoise Health

Turquoise Health eliminates the financial complexity of healthcare through the industry's most comprehensive price transparency platform. Backed by Andreessen Horowitz, Adams Street Partners, and other leading investors, they help providers, payers, and patients access transparent pricing data and streamline contracting. Since launching in 2020, they've grown to serve over 160 healthcare organizations while processing trillions of pricing records.

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