of middle-market companies use generative AI. 70% of those say they need outside help to get its full value.
RSM Middle Market AI Survey 2025 · 966 respondents · fielded Feb–Mar 2025AI built inside the operation, not bolted on.
We map where your company loses time and revenue, build the system that closes the gap, and run the marketing around it. One partner for operations and growth.
For owner-led U.S. companies with $1M+ in annual revenue.
- New lead comes inAfter hours, nobody answersPriority 1
- Intake and qualifyTwo people, copy and pasteManual
- Schedule or quoteDays of email back and forthPriority 2
- Deliver the workRuns fineOK
- Bill and collectSpreadsheet, chased by handManual
- Follow up and reactivateNot happeningPriority 3
The problem
Most companies already use AI. Few get paid back.
of organizations studied saw no measurable profit-and-loss impact from their generative AI pilots.
MIT NANDA, “The GenAI Divide: State of AI in Business 2025” · July 2025of companies abandoned most of their AI initiatives in 2025, up from 17% the year before.
S&P Global Market Intelligence survey, 2025 · via CIO DiveThe tools work. What breaks is everything around them, and that is the part we do.
- Nobody owns the process the AI is supposed to run.
- The data lives in five places that don’t talk to each other.
- The system works, but nothing fills the pipeline it was built for.
How it works
Three steps. You can stop after any of them.
AI DiagnosticOperations Assessment
A fixed-scope engagement. We sit inside your operation, map how work actually moves, and show where time and revenue are lost.
ImplementationOne pilot, one metric
Two to three months. We build inside the tools you already use, train your team, and measure against the baseline from the diagnostic.
Operation + marketingMonthly
We run and improve the system, and build the growth side around it: content, campaigns, follow-up and reactivation.
What we don’t sell
Off-the-shelf chatbots, AI receptionist subscriptions, or software licenses. We design the system around your operation, then stay to run it.
Where we work
One method. Six places we see it break.
Examples, not a limit. The pattern is usually the same: work that only gets done when someone remembers to do it.
Cash-pay healthcare groups
- Where it breaks
- Missed calls and slow replies to new leads, booking by phone, past patients nobody brings back.
- What we build
- Intake and scheduling flows, reminders and deposits, reactivation, and marketing that fills the calendar.
BAA signed before any patient data.
E-commerce and DTC brands
- Where it breaks
- Support backlog on orders and returns, weak repeat purchase, creative that can’t keep up with ad spend.
- What we build
- Support and post-purchase flows, repeat-order programs, and a creative and content production system.
Distribution and light manufacturing
- Where it breaks
- Orders arrive by email and PDF and get retyped into the ERP. Quotes are slow. Collections are chased by hand.
- What we build
- Order intake into your ERP, faster quote turnaround, receivables follow-up, and reactivation of dormant accounts.
Law firms
- Where it breaks
- New-client intake after hours, repetitive documents, case follow-up that slips.
- What we build
- Around-the-clock intake and qualification, document prep for attorney review, and follow-up workflows.
Legal advice stays with your attorneys.
Insurance agencies
- Where it breaks
- Multi-carrier quoting by hand, renewals and certificates of insurance, keeping the existing book.
- What we build
- Quote intake, renewal and COI workflows, book reactivation, and referral marketing.
Accounting firms
- Where it breaks
- Chasing client documents, month-end close, client service during tax season.
- What we build
- Document collection, close checklists, and client communication that runs on schedule.
We also partner with firms that advise owners.
Who we are
Built by an operator, not a reseller.
Most AI projects fail between the demo and the daily routine. We design the operation and the marketing together, because one doesn’t pay off without the other.
- Background
- Founded by a physician who runs his own medical practice and builds the AI and marketing systems behind his companies.
- How we work
- Small senior team. You talk to the people who build the system.
- Clients
- U.S. companies with $1M+ in annual revenue.
Contact
Start with a 20-minute conversation.
Tell us where the operation slows down. We reply within one business day.
- 01We read your note and reply by email.
- 02A 20-minute call to see whether a diagnostic makes sense for you.
- 03If it does, you get a fixed-scope proposal. No obligation before that.
Prefer email? growth@rulehedge.com