Thursday, December 19, 2024

Thoughtful AI Launches Human-Capable AI Agents, Raises $20m in New Funding

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Thoughtful AI, an AI-powered revenue cycle automation company, unleashed a flurry of news highlighting its forward momentum, including the launch of the world’s first fully human-capable AI Agents specializing in healthcare revenue cycle management (RCM), exceptional growth metrics, and $20 million in new funding through a Series A round led by Nick Solaro of Drive Capital with participation from TriplePoint Capital.

“This investment will enable us to reinvest in cutting-edge research and development, make breakthrough progress in our flagship RCM AI products, hire top-tier tech talent, and expand our go-to-market strategy and operations,” said Alex Zekoff, Thoughtful AI co-founder and CEO. “Our goal is to continue innovating in the healthcare automation space, making AI integration seamless and impactful for our customers. We are grateful for the support of our investors and excited about the advancements this funding will bring to our platform and services.”

The new AI Agents launched today are among the latest innovations from Thoughtful AI. The first suite of these role-based, fully human-capable AI Agents – aptly named CAM, EVA, and PHIL – perform claims processing, patient eligibility verification, and payment posting.

Traditionally, healthcare providers were forced to do this tedious but critical work using costly, manually-intensive and error-prone processes. That left healthcare providers struggling with claim denials, cost to collect, and days sales outstanding (DSO) issues, as well as mounting costs and complications related to staffing, training, and employee retention. But now AI Agents from Thoughtful AI solve these challenges, enabling healthcare providers to stop hiring for these roles, benefit from significantly higher productivity, and focus more energy and resources on delivering optimal patient outcomes rather than trying to figure out how to get paid.

“Back office staffing and reimbursement are core reasons why the U.S. healthcare system is so expensive and inefficient,” explained Zekoff. “In many industries, collections cost less than a penny on the dollar, but collections can cost 10 times that in healthcare. Imagine a healthcare provider making $100 million a year yet having to spend $10 million to collect that revenue. Those dollars should go to the patient experience, not inefficient collections processes.”

The AI Agents from Thoughtful AI perform comprehensive and extensive workflows, materially reducing the amount of human intervention needed to run healthcare provider RCM departments. In the process they reduce denial rates, allow for unlimited throughput and deliver economic efficiency. That’s a far cry from what first-generation RPA bots can do.

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Why? Because Thoughtful AI empowers its AI Agents with multiple technologies – including large language models (LLMs), natural language processing (NLP), optical character recognition (OCR) and robotic process automation (RPA) – to solve problems like a human would. But AI Agents are even better because they are always available, error-free, fast and infinitely scalable.

AI Agents from Thoughtful AI are winning over CFOs at healthcare providers with their:

  • Expertise: AI Agents are experts specializing in RCM processes, including (EVA) patient eligibility verification, (CAM) claims processing, and (PHIL) payment posting.
  • Efficiency: Trained in the same amount of time it takes to train one employee, AI Agents can do the work of an entire team and integrate seamlessly into existing systems.
  • Scalability: Designed to handle large volumes of tasks and data, AI Agents can process hundreds of times more verifications, claims, and payment postings than humans and with perfect precision. And it’s easy to scale them across core back-office processes.
  • Proven Reliability: With extensive experience and deployments across many sizable healthcare providers, backed by Thoughtful AI’s powerful monitoring platform, the company’s AI Agents have demonstrated reliability and efficiency, making them excellent counterparts or replacements for human teams. Thoughtful AI provides enterprise-grade uptime and support SLAs, ensuring the continuity that healthcare providers require.
  • Continuous Learning and Enhancements: AI Agents can be trained and enhanced continually, ensuring they remain at peak performance and easily adapt to evolving needs. That enables healthcare providers to benefit from enhancements as models continue to improve. Thoughtful AI also continues to invest in AI Agent reporting and analytics, giving providers more visibility into revenue performance than ever before.

CFO Kathrynne Johns explains how her employer, Allegiance Mobile Health, was able to materially reduce its costs and increase its revenue integrity by using AI Agents from Thoughtful AI: “With Thoughtful AI’s support, we doubled the capacity of our claim scrubbing team by an impressive 100%, seamlessly managing thousands of claims daily with minimal human intervention.”

AI Agents are also making Cara Perry, Vice President of RCM at Signature Dental Partners, smile. She reveals: “Thoughtful AI’s creation of a digital employee revolutionized our claim processing, offering 10x efficiency and limitless scalability compared to traditional methods.”

Thoughtful AI healthcare customers see an average of 5-9x ROI, which has led to greater than 300% net revenue retention for that customer cohort. Existing Thoughtful AI customers are quickly expanding their adoption from one to 30 AI Agents. Thoughtful AI Agents have massively expanded the records processed for healthcare providers by more than 2,400%.

“Our AI Agents save healthcare providers millions of dollars through such KPIs as opex improvement, cost to collect, payment efficiency, and DSO reduction,” said Zekoff. “Watching people’s eyes light up during demos, hearing words of praise from customers’ CFOs, C-suite, and boards, and seeing customers get promoted because of our work together is truly exciting.”

Thoughtful AI’s incredible value to customers has fueled its extraordinary momentum. Since it began generating revenue, Thoughtful AI has exceeded 220% year-over-year growth and has already achieved revenue milestones typically associated with Series B companies.

“Thoughtful AI is re-inventing healthcare automation with AI,” said Solaro, partner at Drive Capital, which also led the company’s seed round and February 2022 seed extension. “We are thrilled to support the company’s mission and growth as it dramatically improves its customers’ ability to deliver excellent patient care while growing their practices’ efficiency and profitability. Thoughtful AI is defining the market in this new era of deep technology automation, and I am excited to see the incredibly positive impact that it is having on customers and their patients.”

Seth Feder, founder of OnTarget Advisors and veteran Gartner healthcare analyst, also noted: “Thoughtful AI emerges as a game-changing solution for healthcare providers grappling with the complexity of the U.S. healthcare system and the need to reduce waste in administrative tasks. By deploying AI Agents capable of handling 80-100% of manual tasks across various healthcare admin roles, Thoughtful AI addresses the critical staffing challenges facing the healthcare industry, which are only exacerbated by the 20% rise in labor costs since the COVID-19 pandemic. Further, Thoughtful AI accelerates the revenue cycle by reducing claims processing time from 35 to 25 days and boosts speed of collection by 40% which eases the financial strain felt by most healthcare providers today. When I was a healthcare analyst at Gartner, we nominated ‘cool vendors’ each year who turn disruptive digital technologies into innovative products. Thoughtful AI is a cool vendor in my book because they deliver cutting edge AI technology capable of expanding as a platform to additional roles in the future, all while delivering fast time to value for their customers. Anyone who can do that is very cool.”

Source: Businesswire

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