Welcome to the future of healthcare revenue cycle management with Thoughtful AI! 🚀 We're thrilled to introduce EVA, our cutting-edge AI Agent designed to revolutionize eligibility verification for healthcare providers. In this inaugural blog post, we’ll delve into how EVA is poised to transform your practice, making your RCM processes more efficient, accurate, and ultimately, more profitable.

Who is EVA?

EVA, short for Eligibility Verification Agent, is Thoughtful AI’s innovative solution to one of the most time-consuming aspects of healthcare administration: eligibility verification. With EVA, you can say goodbye to the manual, error-prone process of checking patient insurance coverage. Whether you’re processing primary or secondary eligibility checks, from Medicaid to commercial payors in any state, our AI Agent ensures that you have accurate, up-to-date information at your fingertips, empowering your team to focus on what truly matters—providing exceptional patient care.

EVA can catch eligibility changes prior to all patient visits to prevent claim denials downstream. Our Eligibility Verification automation can initiate communication with the patient and/or payor to resolve eligibility issues with little to no impact on the patient and on the revenue cycle. As eligibility rules change across payors, Eligibility Verification houses a dynamic rules engine that’s seamless to update. It can even initiate communication with the payor or provider to resolve unexpected changes in eligibility status.

The Challenges of Traditional Eligibility Verification

Eligibility verification has always been a critical step in the healthcare revenue cycle. However, traditional methods are fraught with challenges:

• Manual Processes: Staff spend countless hours on the phone or navigating insurance websites, which is both time-consuming and prone to errors.
• Delays and Errors: Manual verification often leads to delays in patient care and billing, not to mention the risk of errors that can result in claim denials.
• High Costs: The administrative burden of eligibility verification can be costly, diverting resources away from patient care and other essential operations.

How EVA Transforms Eligibility Verification & Proven Success Metrics

EVA leverages multiple advanced AI and automation tools to streamline eligibility verification, providing numerous benefits for your practice:

• Unmatched Accuracy and Speed: EVA performs eligibility checks with unparalleled accuracy and speed, reducing the likelihood of claim denials due to eligibility issues. By automating the verification process, EVA can quickly access and analyze insurance data, ensuring that patient information is always current and correct. EVA is 95% faster than a human team, allowing for more timely and accurate processing.
• Cost Efficiency: By automating labor-intensive tasks, EVA significantly reduces administrative costs. This allows your team to allocate resources more effectively, focusing on high-value tasks and improving overall operational efficiency. The increase in approved claims due to fewer denials results in higher revenue. EVA has led to a 20% decrease in denials due to eligibility discrepancies.
• Enhanced Patient Experience: With EVA, patients experience fewer delays and misunderstandings regarding their insurance coverage. This leads to a smoother, more transparent patient journey, enhancing satisfaction and trust in your practice. EVA’s automation allows for an 11x increase in the frequency of eligibility checks, ensuring patients are always informed and can plan accordingly.
• Scalability and Flexibility: EVA is designed to scale with your practice. Whether you’re a small clinic or a large healthcare provider, EVA can handle varying volumes of eligibility checks, adapting seamlessly to your needs. Being able to handle nearly unlimited workloads, EVA is able to scale with your business, increasing her Eligibility Verification capacity from tens to thousands as needed.
• Impact on Administrative Workload and Cost Savings: By automating the tedious process of eligibility verification, EVA drastically reduces the administrative workload on your staff.  EVA has effectively 2xed the output of practice’s managed per employee for Signature Dental Partners. This reduction in manual labor translates to significant cost savings, allowing you to reinvest in other areas of your practice. The streamlined process also minimizes the risk of human error, leading to more accurate billing and faster reimbursement cycles.

Testimonials from Early Adopter Cara Perry, VP of RCM for Signature Dental Partners

Signature Dental Partners is a top-rated DSO with 98 practices nationwide. Cara has over 12 years of Revenue Cycle Management experience and has been a part of Signature Dental Partners' rapid expansion for 5 years.

"Thoughtful AI brought us to the next level and helped us break through industry standards. The most surprising thing has been how easy it's been and how little distraction it's been ... it's like training that perfect employee that works 24 hours a day, exactly how you trained it. My advice would be to start now," says Perry. "We've gone up in collections, our turnaround days are quicker, and we only had two practices under 90% for the year. My staff has gone from being able to work five practices to being able to work 10 or 12. Everything Thoughtful AI has been able to do so far has brought us to the next level."

Future Possibilities with EVA

The potential of EVA is immense, especially when integrated with Thoughtful AI’s other AI Agents, CAM (Claims Automation) and PHIL (Payments Posting). Together, these AI Agents can create a seamless, end-to-end solution for your revenue cycle management.

Big Picture Integration

• CAM (Claims Automation): By automating claims processing, CAM works alongside EVA to ensure that verified eligibility data leads to faster and more accurate claim submissions.
• PHIL (Payments Posting): Once claims are processed and paid, PHIL automates the payment posting process, ensuring that your accounts are updated promptly and accurately.

Integrating EVA with CAM and PHIL provides a comprehensive automation solution that optimizes every step of your revenue cycle, from eligibility verification to claims processing and payment posting. This holistic approach not only boosts efficiency but also enhances the financial health of your practice. And, if you have unique RCM needs, Thoughtful has fully customizable options to automate redundant administrative tasks.

Join the AI Revolution with Thoughtful AI

At Thoughtful AI, we believe in the transformative power of automation and AI to solve complex, existential problems in healthcare. Our mission is to build the most trusted and reliable AI Agents, delivering exceptional ROI and peace of mind to healthcare providers.

EVA is just the beginning. By embracing Thoughtful AI’s advanced solutions, you’re not only enhancing your operational efficiency but also joining a forward-thinking community dedicated to the future of healthcare.

Are you ready to revolutionize your eligibility verification process? Discover the power of EVA today and take the first step towards a more efficient, productive, and prosperous practice.

For more information on EVA and our suite of AI Agents, visit Thoughtful AI. Let's embark on this journey to a smarter, more efficient healthcare system together!

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