Smarter Technologies provides an AI-powered platform that automates healthcare revenue cycle management (RCM) workflows. Its agentic AI virtual agents handle tasks like eligibility verification and denial management, aiming to increase efficiency and accelerate revenue reconciliation for hospitals and health systems.
Funding
Funding not disclosed
Founders
Product
Problem
Healthcare providers face significant challenges in managing their revenue cycles, leading to increased administrative overhead, delayed payments, and reduced cash flow. The complexity of payer interactions, claim denials, and eligibility verification processes diverts resources from patient care.
Solution
Smarter Technologies offers an AI-powered platform designed to automate and optimize healthcare revenue cycle management (RCM). The platform utilizes agentic AI, specifically virtual agents trained on provider-specific data and standard operating procedures, to automate up to 80% of revenue workflows. This approach enhances efficiency, accelerates revenue reconciliation, and reduces claim denials. By integrating seamlessly with existing systems, the solution aims to transform RCM performance without requiring disruptive system replacements. The platform also provides clinical AI and insights to identify revenue opportunities and improve coding accuracy, allowing providers to focus more on patient care.
Target Audience
The primary customers are hospitals, health systems, and industry partners seeking to improve their revenue cycle management efficiency and financial performance.
Features
- Agentic AI platform (Nebula) for automating RCM tasks with purpose-built virtual agents.
- Human-in-the-loop virtual agents capable of automating up to 70% of revenue cycle tasks.
- AI reasoning grounded in deterministic workflows that model organizational policies and procedures.
- Network-wide learning across virtual workers interacting with the same payer systems.
- Scalable global operations platform (Overwatch) for efficient RCM workflow management.
- Quality assurance processes with a stated goal of 99% accuracy against workflow specifications.
- Clinical AI and machine learning platform (Spotlight) for identifying revenue and quality opportunities.
- Over 5,500 clinical algorithms used to analyze complex clinical data for improved documentation and coding.
- Modular RCM service that can be integrated into existing workflows without software installation or staff training.
- Capabilities include eligibility and benefits verification, prior authorization, claim processing, denial management, and payment posting.