Tahoma offers Cascade, an AI-driven platform designed to streamline healthcare revenue cycle management by automating administrative tasks and enhancing financial outcomes. By deploying AI agents that mimic human billing specialists, Cascade reduces manual effort, minimizes errors, and scales operations without increasing headcount.
Key Features and Functionality:
- AI Agents Across Revenue Cycle Stages: Cascade includes five specialized AI agents:
- SAGE (Eligibility): Verifies patient coverage in real-time, preventing denied claims by identifying coverage gaps before service.
- ATLAS (Claims): Builds, validates, and submits claims with payer-specific formatting, ensuring a high clean claim rate by catching coding errors pre-submission.
- ARIA (Denials): Manages denied and rejected claims by identifying appeal pathways, drafting necessary documentation, and submitting appeals autonomously.
- Zephyr (Accounts Receivable): Prioritizes accounts receivable based on recovery probability and payer behavior, deploying automated follow-ups to expedite high-value claims.
- PACE (Payments): Automates payment follow-ups with payers and patients, delivering timely messages through appropriate channels to reduce manual posting time.
- Vault – Intelligence Layer: Captures and standardizes organizational knowledge, ensuring consistent application of payer rules, denial management strategies, and billing procedures across all engagements.
- Seamless Integration: Operates within existing payer portals, electronic health records (EHRs), and legacy systems without requiring new integrations or system replacements.
Primary Value and User Solutions:
Cascade addresses common challenges in healthcare revenue cycle management by:
- Reducing Administrative Burden: Automates routine tasks, allowing staff to focus on complex cases, thereby decreasing administrative hours.
- Enhancing Financial Performance: Improves key financial metrics such as denial rates, audit readiness, EBITDA, free cash flow, and SG&A efficiency through automation and error reduction.
- Accelerating Revenue Collection: Speeds up the claims process and reduces days in accounts receivable by ensuring timely and accurate claim submissions and follow-ups.
By implementing Cascade, healthcare organizations can achieve a more efficient, accurate, and scalable revenue cycle management process, leading to improved financial health and operational efficiency.
