Top 5 Thoughtful AI Alternatives & Competitors 2024

With the global labor shortage predicted to persist for years to come, the shift to healthcare revenue cycle automation is accelerating. In one survey, all 200 revenue cycle professionals reported that RCM staff shortages negatively impact their revenue and/or patient engagement. A 2023 CWH Advisors study found that 63% of providers were dealing with staffing shortages in their revenue cycle departments. 

When AI- and automation-driven technologies can shoulder much of the stressful and tedious work our moderately-paid healthcare workers once endured, organizations are racing each other to modernize. Grand View Research forecasts spend on healthcare revenue cycle management software to more than double by 2032, an annual 8.8 percent growth rate. Many other revenue cycle solutions (for example, contract management and modeling, prior authorization, and coding assistance software) will also experience significant growth. 

Thoughtful AI joined the revenue cycle software industry in 2018 when its founders recognized that manual RCM processes were time-consuming and prone to costly mistakes. They knew AI and automation could take on repetitive tasks, speed workflows, streamline operations, and reduce human error. By integrating cutting-edge technology with industry expertise, ThoughtfulAI aims to drive better financial outcomes for healthcare organizations. 

What is Thoughtful AI and whom does it serve?

In the revenue cycle management automation space, Thoughtful AI offers targeted solutions for mid-market healthcare organizations’ most problematic areas, including:

• Eligibility verification
• Patient intake and prior authorization
• Coding and notes review
• Claims processing
• Collections and payment posting
• Revenue reporting and reconciliation

To simplify complex concepts, Thoughtful AI refers to its software options as “AI agents” for various RCM tasks. Users can provide each “AI Agent” with data or direction and unleash the “agents” to perform their work without human intervention. They notify staff upon completion. Thoughtful AI personifies these tools as:

• EVA: conducts eligibility verification 
• CAM: Focused on claims processing
• PHIL: Specializes in payment posting

With EVA or eligibility verification, healthcare organizations not only confirm eligibility, they can identify any eligibility changes before all patient visits, preventing claim denials. Should eligibility issues arise, this system automates outreach to both the patient and payer so they can be resolved before the visit. As payers change their restrictions, staff can upload these to EVA’s rules engine to ensure all subsequent visits and charges are compliant. 

CAM or claims processing generates, cleans, and submits claims through your clearing house or payer portals. These steps help to lower denials, avoiding expensive rework.  CAM also identifies the patient’s secondary payor and any balance to apply there. CAM collects the primary EOB from the primary payor portal and attaches a cover sheet if needed before sending the secondary claim to the payor. CAM monitors for the receipt of the secondary, updates the claim, and alerts staff.

Phil or automated payment posting logs into payer portals, pulls remit data (even from individual EOBs), and posts the payments directly in your EHR. It eliminates errors and improves precise and timely financial record-keeping.  PHIL also identifies denials and the reasons behind them. It pulls required documentation from your EHR or PM to update the claim and resubmit. Should a denial require human intervention, PHIL alerts a manager so that the claim can be resubmitted immediately. To sweep in better revenue, PHIL flags any outstanding patient balances. All of these steps diminish the workload for denial handling and patient billing.

“Revenue intelligence” or analytics measures improvements and vulnerabilities in all three RCM areas. It generates custom intelligence reports with detailed insights into performance. EVA, CAM, and PHIL create their own reports autonomously. 

Thoughtful AI is not considered an end-to-end RCM solution like Experian or R1 RCM because it does not include key revenue cycle points like prior authorization, automated good faith estimates, or contract management.  

In addition to providing revenue cycle management software, Thoughtful AI also provides AI- and automation-driven solutions for providers’ finance and accounting arms, human resources, and information technology. Its plans are “Pilot,” “Pro,” “Premium,” and “Enterprise. ” Thoughtful AI emphasizes that their platform is designed to scale with clients and integrates with existing healthcare systems (EHRs, PMs, payer portals) with some customization. 

Ratings

Thoughtful AI has a score of 5.0 from 2 reviews on Capterra. 

List of top 5 Thoughtful AI alternatives

• MD Clarity
• Adonis
• Tribunus Health
• Infinx
• Trizetto

A Thoughtful AI alternative with a revenue recovery emphasis

MD Clarity

Description

For over 10 years, MD Clarity has provided contract management and modeling, underpayment recovery, and patient payment estimate software. MD Clarity provides RCM for MSOs, as well as provider groups and medical practices looking to sweep in more revenue and cut costs to collect. Its mission is to help healthcare providers win fair revenue from their payers and to provide patients with good faith estimates that reveal the financial impact of their care. MD Clarity’s client base includes dozens of specialties.

Its contract management and marketing tool, RevFind, ingests, digitizes, and analyzes all data. Keeping contracts centralized, simplified, and accessible diminishes staff time on these tasks. Unlike other RCM software companies, MD Clarity staff provides the service of uploading all contracts to the tool.

RevFind also compares every payment coming in from payers to the stated contract terms. Once it detects these underpayments, it alerts staff. Pursuing underpayments can result in millions of dollars in cash recovered.

MD Clarity’s pre-service estimate tool Clarity Flow automates patient payment estimate generation and sending. When today’s patients can access accurate pricing both upfront and throughout their journey, their satisfaction increases. Further, every dollar collected upfront stays out of provider A/R and bad debt.

MD Clarity features in common with Thoughtful AI 

While MD Clarity and Thoughtful AI both create solutions to improve the healthcare revenue cycle, they have limited overlap. Both offer automated eligibility and benefits verification solutions as well as analytics for that RCM point and others in the revenue cycle. 

Also, both MD Clarity and Thoughtful AI primarily provide point solutions software rather than software plus human resources in the form of specialists and consultants. Both build much consultant- and specialist-type expertise into the software itself. Of course, both provide the onboarding and support that facilitate implementation and continued use. 

Differences between MD Clarity and Thoughtful AI

Thoughtful AI’s services focus on workflow efficiency, productivity, and labor force cost control. MD Clarity, on the other hand, has built its good faith estimate and contract management and modeling tools to serve healthcare organizations looking to improve revenue quickly.  

RevFind’s underpayment tool compares actual payments to those listed in the fee schedule and alerts staff to discrepancies. Staff then reports them to payers via phone or portal. When underpayment trends are identified and rectified, healthcare organizations stand to save millions.  

RevFind also reinforces revenue via payer contracting. When RevFind measures contract performance among payers, ranking them top to bottom, you have the insights and the data to take a firm stand during contract negotiations. At renewal time, Revfind’s contract modeling spins up the revenue impact of the complex changes payers propose. Payers like to soft-sell their changes and try to get them through “under the radar.” Contract modeling reveals exactly how these changes affect your bottom line. 

Likewise, MD Clarity’s Clarity Flow simplifies self-pay patients and upfront collections (a critical strategy in the patient-as-payer environment). Pre-service payments are becoming increasingly prevalent at healthcare organizations, driven by a need for improved revenue cycle management and patient financial responsibility. Every dollar collected upfront stays out of accounts receivable and bad debt write-offs. 

Ratings

Recently, the employment platform Built-In recognized MD Clarity as a Best Place to Work. It also made Inc. magazine’s list of the 5000 fastest-growing private companies in America in 2024. 

G2 reviewers have given MD Clarity an average of 4.7 / 5 stars from 10 reviews. 

Take a quick, self-guided tour through a powerful contract performance optimization and underpayments recovery tool:

A Thoughtful AI competitor focused on denial prevention and management

Adonis

Description

Founded in 2022, Adonis tools streamline and optimize patient eligibility and prior authorization to prevent downstream denials. It also tracks and manages claim denials by payer and reason and provides real-time analytics and reports that help providers catch revenue shortfall issues in these areas. Aiming to simplify operational challenges, it serves healthcare providers across various markets, including hospitals, clinics, and specialty practices. 

Adonis revenue cycle management tools include:

• Automated insurance verification -  streamlines patient insurance coverage verification in real-time, reducing manual work and minimizing claim rejections. Accurate verification improves billing from the outset, leading to quicker reimbursements and fewer denials.
• Claims management - provides a comprehensive claims management system that automates claims submission, tracking, and resolution. This tool helps reduce errors and accelerate claims processing.
• Revenue integrity analytics -  uses advanced analytics to identify potential revenue leakage and ensure compliance with payer contracts.  
• Patient financial clearance - ensures that patients are financially cleared before receiving services, reducing the risk of non-payment. It integrates insurance verification, eligibility checks, and patient payment estimations.
• Denial management: Adonis offers a denial management tool that identifies and addresses the root causes of claim denials. It analyzes denial patterns and provides actionable insights.

Features Adonis shares with Thoughtful AI

As with MD Clarity, both Adonis and Thoughtful AI are point rather than end-to-end RCM solutions. Both have several revenue cycle tools from which healthcare organizations can pick and choose. Similarly, the two companies provide the software to empower healthcare organization staff rather than finding and assigning revenue cycle specialists and consultants to clients. 

Thoughtful AI and Adonis both handle eligibility and benefits verification, claims processing, and revenue cycle analytics, but their tools diverge from there. More focused on staff productivity, Thoughtful AI’s tools streamline patient registration, prior authorization, coding support, payment processing, and provider management. 

At this time, Adonis does not have reviews listed on Capterra, G2 or Software Advice. 

A Thoughtful AI competitor focused on payer contracting

Tribunus Health

Description

Tribunus Health provides payer contracting solutions that combine expert consulting with proprietary software. Tribunus Health’s services include managed care contracting, underpayment management, enrollment assistance, and analytics. Its clients are private equity-backed physician groups, substance abuse treatment centers, specialist groups, and rural hospitals. Tribunus welcomes challenges such as stale contracts and the complexities involved in going in-network for the first time.

Tribunus Health’s detailed contract analyses let you know whether your fees and terms are fair and favorable. Payers are notorious for including terms that sweep revenue their way and undermarket fees. Comparing your contract details with those of its other healthcare clients, Tribunus spots payer abuse and identifies any opportunities where you could enter new, more lucrative payer networks. 

Differences between Tribunus and Thoughtful AI

Where Thoughtful AI’s tools address workflow efficiency and productivity, Tribunus sticks closely to all things contract management. In fact, it attacks contracts from two angles: software and consultant. Thoughtful AI leaves the execution of the automation to your staff. Both companies are considered point RCM solutions rather than end-to-end. 

Ratings

Tribunus Health has no reviews on G2, Capterra or others at this time. 

A Thoughtful AI competitor that offers end-to-end services 

Infinx

Description

An end-to-end revenue cycle software company, the Infinx intelligent payment lifecycle system optimizes the revenue cycle process and provides management solutions tailored. With a large outsourced workforce based in India, it provides software solutions and the specialists and consultants to implement these tools. It automates and streamlines prior authorization, medical coding, and more workflows for hospitals, clinics, imaging centers, and laboratories. 

Features in common with Thoughtful AI

Infinx provides the following solutions that are similar to Thoughtful AI's: 

• Coding Support: Both Infinx and Thoughtful AI have software that guides provider staff in medical claim coding. In addition, Infinx offers the option of using both software and coding experts certified in specialties like cardiology, gastroenterology, ophthalmology, and many more. Infinx’s two-pronged approach appeals to providers looking to completely outsource coding. 
• Eligibility and benefits: Infinx’s benefit checks, eligibility verifications, insurance discovery, CDSM consults, and patient out-of-pocket estimations all streamline patient intake. Thoughtful AI does not offer patient pay estimates. 
• Accounts receivable optimization: Infinx offers the Account Receivable Optimizer, which uses artificial intelligence and automation to reduce future denials and maximize reimbursements from denied claims and accounts receivable. Thoughtful AI does not offer A/R tools. 
• Claims processing streamlines the entire claims process from claim creation to submission. Their system automatically extracts relevant data from electronic health records (EHRs) and other sources, so that claims are accurately populated. It then validates the claims against payer requirements to minimize errors and rejections. Additionally, the system continuously monitors claim status, automating follow-ups and resubmissions if needed. Infinx can provide claims specialists if needed. 

Thoughtful AI’s claims processing tool carries out these tasks and, in addition, applies AI algorithms to validate claims against payer rules and requirements, reducing errors and minimizing the likelihood of claim denials.

• Collections and payment processing automate the identification and follow-up of outstanding patient balances by leveraging machine learning algorithms to prioritize accounts based on payment likelihood. Infinx automates the capture and posting of payments from various sources, including insurance payments and patient payments. The system reconciles payments with outstanding invoices, reducing manual effort and errors. Additionally, Infinx's platform can set up automated payment plans and reminders for patients, further enhancing the efficiency of the collections process and improving cash flow for healthcare providers. Thoughtful AI’s collection and payment processing tool handles these tasks as well. 

How Thoughtful AI and Infinx differ

Thoughtful AI and Infinx both focus on automating revenue cycle management, but they differ in several ways. 

Thoughtful AI is heavily centered on AI-driven automation and workflow improvements in claims processing, payment posting, and collections.  Infinx also emphasizes automation but includes a broader focus on additional pain points like preauthorization and patient payment estimates. Additionally, Infinx provides more tailored solutions for specialties like imaging centers and laboratories, whereas ThoughtfulAI offers more generalized automation with its claims processing wheelhouse.  

Ratings

Infinx has a score of 85.2 on KLAS Research.

TriZetto Provider Solutions

Description

TriZetto is an end-to-end revenue cycle management provider. It offers a comprehensive suite of solutions that cover the entire RCM process, from patient access and eligibility verification to claims processing, payment posting, and collections. 

While TriZetto is predominantly a software-driven platform, it does offer professional services, including consulting and support, to help healthcare organizations optimize their use of the software and improve overall revenue cycle performance. However, it is not as heavily focused on the use of specialists and consultants as some large RCM companies which emphasize a combination of technology and hands-on consulting services.  

TriZetto Provider Solutions include patient engagement, claims management, denials and contract management, billing and coding services, and credentialing. Unlike Thoughtful AI which primarily serves providers, TriZetto offers revenue cycle management and more services to payers as well. 

Features in common with Thoughtful AI

ThoughtfulAI and TriZetto share several common services

• Claims Processing Automation: Both ThoughtfulAI and TriZetto automate the claims processing workflow, from data extraction and claim submission to validation and tracking. Their systems aim to reduce errors, speed up processing times, and improve the likelihood of successful reimbursements.
• Payment Processing: Both platforms automate payment posting and reconciliation, ensuring that payments from insurers and patients are accurately recorded and matched with outstanding invoices. This service helps reduce manual workload and minimizes errors.
• Collections Management: ThoughtfulAI and TriZetto offer automated collections management tools that prioritize and streamline follow-up on outstanding balances. These tools help increase the efficiency of collections efforts and improve cash flow.
• Eligibility Verification: Both ThoughtfulAI and TriZetto provide automated insurance eligibility verification, which checks patient coverage in real time. This service helps prevent claim denials and ensures accurate billing from the start.
• Revenue Cycle Analytics: Both platforms offer analytics tools to monitor and optimize RCM performance. These analytics help healthcare providers gain insights into their revenue cycle, identify areas for improvement, and make data-driven decisions.

While they share these services, ThoughtfulAI focuses more on AI-driven automation, whereas TriZetto provides a broader range of integrated RCM solutions and professional services, positioning itself as a more comprehensive end-to-end provider.

How Thoughtful AI and Trizetto differ

While TriZetto provides a full-service RCM platform, ThoughtfulAI specializes in using advanced AI to enhance efficiency in targeted areas of the revenue cycle.

Ratings

TriZetto has a rating of 4.3/5 stars on G2.

MD Clarity finds the revenue you’ve earned

Crushed among rising costs, increasing patient volume and diminishing staff availability, today’s healthcare organizations often need to generate additional revenue fast. 

MD Clarity has the tools to accelerate your underpayment discovery and recovery, get more upfront payments from patients, negotiate more lucrative contracts, and identify and avoid future denials. 

RevFind scrutinizes each actual payer payment against the contract terms. Often, payers are underpaying one CPT code or a location. In aggregate, these deficits amount to significant revenue, even millions. Staff are alerted to discrepancies, allowing them to address improper reimbursements with payers. By identifying and addressing systemic root causes, future underpayments can be prevented and revenue is boosted for the long term.

RevFind centralizes all agreements in a single digital platform and automates alerts for contract expiration, renewal, and exit dates, ensuring no deadlines are overlooked. You can set it to notify you 90 days in advance of these critical dates, allowing for early negotiation. Additionally, it automatically generates reports that compare reimbursements by CPT code and provider location, and it includes Medicare benchmarks to provide an extra layer of comparison for payer contract performance.

Schedule a demo to see how RevFind catches payer underpayments, empowering you to pursue them. Get insights into payer contract performance so you can strengthen your contracts and boost net revenue.

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