Following the success of its first three AI Agents specializing in key healthcare revenue cycle management (RCM) roles, Thoughtful AI announced the launch of its latest RCM AI Agent: PAULA. PAULA is a true RCM game-changer – revolutionizing healthcare providers’ prior authorization processes by automating submissions, tracking and appeals with unmatched accuracy and speed, and an impressive 98% first-pass resolution rate.
“Healthcare providers hiring AI Agent PAULA will see an exponential decrease in the time spent manually submitting claims and an increase in claims approval and resolution rates,” says Alex Zekoff, co-founder and CEO of AI-powered revenue cycle automation company Thoughtful AI.
That’s extremely valuable at a time when healthcare administrators are grappling with a long and costly prior authorization process. To obtain authorizations for procedures, healthcare providers typically face a high administrative burden, spending significant time waiting on hold and completing forms. This process is further complicated by high denial rates, often due to avoidable mistakes and confusion over insurers’ requirements. As a result, patient care is frequently delayed or even abandoned due to authorization delays.
AI Agent PAULA automates the entire prior authorization process, from initial submission to appeals, with minimal human intervention. This ensures faster approvals, fewer denials, and improved patient care outcomes, and benefits providers, payers, and patients alike.
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By hiring prior authorization AI Agent PAULA, companies will benefit from greater:
- Speed: PAULA submits prior authorization requests perfectly in minutes.
- Accuracy: PAULA removes 100% of human errors from the process resulting in a 98% first-pass resolution rate.
- Efficiency: PAULA empowers healthcare providers to cut their administrative time on prior authorizations by 80%, and to receive real-time insights and status updates.
- Volume: Healthcare providers tackle 10x more prior authorizations per AI Agent compared to their previous, manual processes.
- Revenue Impact: PAULA enables providers to achieve a 95% initial claims approval rate, accelerating cash flow and reducing their write-offs.
PAULA and Thoughtful AI’s other RCM AI Agents are the first of their kind, opening the door for rapid implementation and scalability. AI Agent PAULA can be designed, trained and put into production in less than 90 days, which is faster than hiring and training a human for the role.
Here’s what healthcare providers are saying about the value Thoughtful AI’s AI Agents deliver:
- Cara Perry, vice president of RCM at Signature Dental Partners, says using an AI Agent is “like training a perfect employee that works 24 hours a day, exactly how you trained it.”
- Kathrynne Johns, chief financial officer at Allegiance Mobile Health, reveals that, “With Thoughtful AI’s support, we reduced our claim scrubbing team by an impressive 50%, seamlessly managing thousands of claims daily with minimal human intervention.”
Source: Businesswire
