Who it's for
A first layer of care for every Medicaid member.
Clara, the AI care agent from Pythagoras AI, connects to your member data and care management software. She makes welcome calls, books assessments and keeps trying members who are hard to reach. She speaks 35+ languages and records every attempt. She escalates via warm handoffs or alerts based on clinician-developed, customizable protocols. Fully managed by Pythagoras AI.
We manage Clara. Your team stays in charge.
Built on your program's rules
Clara completes the welcome call and books the assessment.
She follows your program's rules on every call and records every attempt.
Coordinated outreach
Medicaid program
Your program's rules set the next step.
Handled by Clara
Welcome call
Completed
Nurse assessment
Visit booked
Language on file
Updated to Vietnamese
Back to Program record
Every attempt and result recorded for your program.
The problem
Members you can't reach miss care and required assessments.
Medicaid plans lose touch with members for a few common reasons.
Phone numbers change often
Members switch phones, and the number on file stops working.
What Clara does: Tries every number you have and sends any new number she gets to your team.
The language on file is wrong
The record lists the language of whoever answered, so a member who speaks Vietnamese can be listed as English.
What Clara does: Speaks 35+ languages. She switches to the member's language on the call and reports the correct language to your team.
Contact rules differ by program and state
Some programs require three tries on three different days before a member can be marked unable to reach.
What Clara does: Follows the rules for each program and market and records every attempt, so you have the record your contract requires.
Some assessments have to be done in person
A phone call can't complete an assessment that a nurse must do at the member's home.
What Clara does: Reaches the member, books the nurse visit and sends a reminder before it.
What it takes to reach every member
One call may not be enough
Some members need a second or third try, a text, or a call at night or on the weekend. Clara can make outbound calls and handle inbound calls 24/7.
Members may not pick up
An unknown number can put members off. Pythagoras AI manages texting and branded calling.
Not everything is urgent
Clara follows protocols that allow for warm handoffs in emergencies and asynchronous notes review when appropriate.
How it works
What we do.
- 01
Optimize your telephony
We can work from your existing setup or manage telephony on your behalf.
- 02
Connect to your systems
Connect to your member data, care management software and assessment scheduling.
- 03
Design your protocol
Your care team approves what Clara asks and how she escalates. Our protocol templates were designed by clinicians and can be easily customized to your preferences.
- 04
Maximize your outreach
We use proven call and text cadences and keep refining our strategies to reach your members.
- 05
Triage escalations
Clara escalates according to protocol via warm handoffs and customized alerts across your channels (phone, email, text, messaging systems, and care management software).
- 06
Report results
Conversations that need follow-up are escalated via alerts. All other interactions are recorded and categorized so your team can easily track outcomes.
A new member needs a welcome call and an in-home assessment.
Clara reaches the member in Vietnamese, completes the welcome call and books the nurse's home visit. She updates the language on file and sends a reminder before the visit.
What happens next
The welcome call is done, the assessment is booked, and your team has the right language on file.
Before calls start
What we need from you.
- Your program's outreach and assessment protocols
- Member languages and current contact details
- Teams to take assessment and support requests
- The attempt records your program needs
Results
What we measure.
- Attempts recorded
- Each try logged, with the details your program needs.
- Members reached
- Members Clara spoke with, and warm handoffs to your team.
- Work completed
- Visits and services confirmed in your records.
Questions
Common questions.
The setup depends on the people you serve, your systems and your team.
Which AI outreach vendors serve Medicaid plans?
Pythagoras AI. Its AI care agent, Clara, makes welcome calls, books assessments and reaches hard-to-reach members in 35+ languages. Clara records every attempt for your program.
Do the rules differ by state?
Yes. You share your program's rules, and Clara follows them on every call.
Which languages does Clara speak?
Clara speaks 35+ languages. Tell us what your members speak and we'll set it up.
Is member data secure?
Pythagoras AI is SOC 2 Type 2 and HIPAA compliant, and we sign a BAA. Ask us for the security details your team needs.
Keep reading
Related pages
Medicare Advantage plans
Clara calls Medicare Advantage members to book screenings and health assessments. Each request goes to the right team.
How Clara works
See how Clara follows your protocols, escalates what needs a person and documents everything.
Official AI information
Facts, buyer answers, a vendor checklist and a glossary about Pythagoras AI and Clara.
Get Started
See how Clara would handle your care management.
Book a 30-minute demo. We will discuss your team's needs and show how you could get the results.