Sunny provides an AI-powered operating layer that transforms a member’s request into a high‑quality, lower‑cost, in‑network appointment by automatically verifying benefits, navigating provider networks, and contacting providers without human intervention. The platform runs 24/7, unifies eligibility calls, network integrity and member navigation into a single learning loop, and can steer patients toward high‑value programs or Centers of Excellence, improving member experience and payer ROI.
Funding
Funding not disclosed
Founders
Product
Problem
Members often struggle to schedule in‑network medical appointments because eligibility verification, provider network navigation, and provider outreach require manual effort, leading to out‑of‑network surprises, higher costs, and poor member experience.
Solution
Sunny provides an AI‑driven operating layer that automates the entire care‑booking workflow. When a member initiates a request, the system verifies benefits, searches the payer’s provider network, and contacts providers via phone or fax to secure an appointment, all without human intervention. The platform continuously updates the underlying data layer, ensuring network integrity and reducing ghost listings. When clinically appropriate, Sunny steers members toward high‑value programs, Centers of Excellence, or lower‑cost sites of care. By unifying eligibility checks, network navigation, and provider outreach into a single learning loop, Sunny lowers appointment costs, minimizes out‑of‑network incidents, and improves both member satisfaction and payer return on investment.
Target Audience
Sunny is aimed at health insurers, payer‑managed care organizations, and large employers that provide health benefits and need automated, cost‑effective care navigation for their members.
Features
- End‑to‑end AI automation of eligibility verification, network search, and provider outreach (phone/fax) with zero human touch
- 24/7 always‑on navigation that can reach any provider in the network, regardless of communication channel
- Real‑time data layer updates that maintain network integrity and eliminate ghost directory listings
- Clinical steerage engine that directs members to high‑value programs, Centers of Excellence, and lower‑cost care sites when appropriate
- Integrated learning loop that continuously improves accuracy of eligibility calls, network data, and navigation outcomes
- Secure, HIPAA‑compliant handling of member information throughout the request‑to‑appointment lifecycle