Thoughtful AI

The worldʼs first AI operating system for healthcare RCM teams

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Description

Thoughtful AI introduces an advanced AI operating system specifically engineered for healthcare revenue cycle management (RCM) teams. This platform deploys fully human-capable AI Agents, such as Eva for eligibility verification, Paula for prior authorizations, and CAM for claims management, to streamline and automate critical RCM workflows. These agents are designed to work like perfect employees, operating 24/7 with precision, directly within existing healthcare systems.

By automating tasks from eligibility checks and prior authorizations to coding, claims processing, denials management, and payment posting, Thoughtful AI aims to significantly enhance operational efficiency and financial performance for healthcare providers. The system is built to be SOC 2 and HIPAA compliant out-of-the-box, ensuring data security and regulatory adherence. It offers extensive integrations with numerous healthcare applications, helping to reduce manual effort, lower the cost to collect, decrease days sales outstanding, and improve clean claim rates, ultimately allowing healthcare staff to focus more on patient care and strategic initiatives.

Key Features

Human-Capable AI Agents: Specialized AI agents (Eva, Paula, Cody, CAM, Dan, Phil) automate core RCM tasks including eligibility verification, prior authorization, coding, claims management, denials, and payment posting.
End-to-End RCM Automation: Automates the entire revenue cycle management process, from patient intake to payment posting, to reduce overhead and improve performance.
Revenue Intelligence Platform (Empower): Harnesses data across operations to provide strategic foresight and operational insights through customizable dashboards.
Seamless Integrations: Offers numerous pre-built workflows and templates, integrating with a wide array of healthcare applications, both in the cloud and on-premise.
SOC 2 & HIPAA Compliance: Ensures adherence to strict security and privacy standards, offering full transparency and access to compliance documentation.
Performance-Based Contracting: Provides value guarantees for all plans, focusing on delivering measurable ROI and improving the bottom line.
Unattended Automation with Parallel Execution: AI Agents can perform multiple tasks simultaneously without human intervention, significantly reducing processing time and handling fluctuating volumes.

Use Cases

Automating eligibility and benefits verification
Streamlining prior authorization request submissions
Automating medical coding and clinical notes review
Managing and processing insurance claims with high accuracy
Resolving and managing claim denials effectively
Automating payment posting and reconciliation processes
Improving financial reporting and revenue intelligence
Optimizing RCM for finance and accounting departments

Frequently Asked Questions

What is parallel AI execution?

Unlike human workers, AI Agents can perform multiple tasks simultaneously. While a human might have to process 1000 claims one by one, an AI Agent might process 100 claims at once, significantly reducing the time required to complete the task.

What is record-level reporting?

AI Agents can create audit reports of all the work they have done. These reports can include details about the specific records they have handled in each system (e.g., claims, providers, appointments).

What's the difference between attended and unattended automation execution?

Unattended execution refers to the situation where AI Agents carry out tasks without human intervention, either on a schedule or triggered by another system. On the other hand, attended execution occurs when a human initiates the module's work, or when human intervention or review is necessary as part of the business process.

What are the 'Art of the Possible' sessions?

'Art of the Possible Sessions' are collaborative workshops where Thoughtful AI partners with healthcare leadership teams to identify strategic opportunities for deploying our AI-driven solutions. These sessions aim to unlock significant value by optimizing key operational processes, improving financial outcomes, and enhancing patient care through automation.

What is performance reporting?

Thoughtful AI can configure each AI Agent to report on the work they’ve completed, customized to your use case and organization.