Tivara

What do they actually do

Tivara runs AI agents that take over routine phone and administrative work for medical groups. Today, the product acts as a 24/7 AI receptionist that answers calls, identifies or creates patient charts in the clinic’s EMR/PM, books and reschedules appointments, handles intake questions, processes prescription refill requests, sends reminders, and performs after‑hours triage. It also automates prior authorizations by generating requests from the patient chart, applying payer rules, submitting and following up with insurers, and surfacing status and analytics back to the clinic (site, prior authorization).

In practice, a patient calls the clinic and the agent authenticates and looks up the chart, schedules directly into the EMR/PM, and posts tasks/notes for items needing clinical review. For prior auth, it prepares submissions using clinical text and insurer rules, polls payers for status, and escalates to staff if a call or workflow is out of scope or uncertain (site). Tivara says it integrates with common EHR/PM and telephony systems and states HIPAA and SOC 2 Type II compliance (site).

They target larger specialty groups (roughly 20–500 physicians) and cite early customers in materials (e.g., Los Angeles Cancer Network, Astera Customer Care) (Business Insider). The company publishes outcomes for prior auth (e.g., “30x faster” and “80% lower cost”), but those are company‑reported figures without independent verification on their site (prior authorization).

Who are their target customer(s)

• Practice managers at mid-to-large specialty groups (20–500 doctors): High call volumes are expensive to staff, hiring/retention for reliable phone coverage is difficult, and after-hours coverage gaps lead to missed appointments and scheduling errors (Business Insider, Tivara).
• Oncology and other specialties with heavy prior-authorization needs: Frequent, complex authorizations delay care and require repeated follow‑ups with payers, creating bottlenecks and extra administrative labor (Business Insider, Tivara prior auth).
• Revenue-cycle/billing teams responsible for authorizations and payer follow-up: Manual, time‑consuming workflows drive long approval timelines, higher denial rates, limited status visibility, slower cash flow, and higher costs (Tivara prior auth).
• Multi-site specialty groups or networks: Inconsistent triage and scheduling across locations, inability to scale staff for call peaks, and the need for centralized, reliable call handling and chart updates to avoid confusion and missed care (Tivara).
• Clinicians and nurses pulled into admin tasks: Routine phone calls, intake, refills coordination, and chart follow‑ups take time from patient care, contributing to burnout and reducing clinical capacity (Tivara).

How would they acquire their first 10, 50, and 100 customers

• First 10: Founder-led, high-touch pilots with large specialty groups (starting with high prior-auth fields like oncology), integrating to phone and EMR/PM, and measuring before/after metrics on call handling and authorization timelines to convert short paid trials (Business Insider, Tivara).
• First 50: Turn pilot wins into a repeatable playbook: hire a small direct sales team targeting multi-site practice managers, standardize integrations for common EMR/PM and telephony stacks, and use referrals via discounts or shared‑savings pilots tied to case studies (Business Insider, Tivara).
• First 100: Add channel distribution via EMR/PM vendors, RCM platforms, and specialty MSOs; productize lower‑touch onboarding and an ROI/pricing tool to drive inbound; expand ops and customer success to keep integrations reliable and reduce churn (Tivara, prior auth).

What is the rough total addressable market

Top-down context:

Tivara targets mid‑to‑large U.S. specialty groups that run front‑desk phone operations and prior‑authorization teams across oncology, cardiology, GI, ortho, and similar fields. These are recurring, labor‑intensive workflows that sit on top of EMR/PM and telephony systems Tivara integrates with.

Bottom-up calculation:

If there are ~5,000 target specialty groups in the U.S. that fit Tivara’s size profile and the average annual contract for AI receptionist + prior‑auth automation is ~$200k per group, the annual TAM would be about $1.0B.

Assumptions:

• Roughly 5,000 U.S. specialty groups have 20–500 physicians and centralized admin ops.
• Blended annual contract value (reception + prior auth automation) averages ~$200k per group.
• Pricing captures a portion of current phone and prior‑auth staffing/outsourcing spend; excludes hospitals and payers.

Who are some of their notable competitors

• Notable: Automation for intake, registration, EHR updates, and prior authorizations; competes on replacing manual front‑desk and authorization tasks for large practices and health systems.
• Olive: Enterprise automation historically spanning hospital and payer workflows, including prior‑auth and payer interactions; overlaps on high‑volume authorization and RCM automation.
• CoverMyMeds: Widely used electronic prior‑authorization (ePA) solution for medication access, with status tracking and notifications; a direct alternative for medication‑related prior auth automation.
• Phreesia: Patient intake and scheduling automation that reduces front‑desk workload; overlaps on scheduling/intake even though it is more digital‑first than phone‑first.
• athenahealth (athenaOne Authorization Management): EHR with embedded authorization tools and optional managed services; practices on athenaOne may use native authorization workflows instead of third‑party automation.