From Tech Debt to Time to Value: How Tava Boosted Patient Conversions by 12% in 3 weeks

Tava’s clearinghouse-driven eligibility workflow was unreliable, with more than half of 270/271 responses unusable, frequent false negatives from payers like UMR, and carve-out networks that returned generic or incomplete benefit details. Complex TPAs such as AvMed and FirstCare required extensive manual review, and monthly batch checks—rather than real-time verification—created delays and friction for patients and internal teams. 

Ops and Support were routinely pulled into resolving ambiguous payer data, while engineering carried a substantial maintenance burden building and updating payer-specific exception logic, managing multiple clearinghouse fallbacks, and maintaining dual synchronous/asynchronous workflows that often failed unpredictably. The result was high operational strain, increased denials, and a growing pile of technical debt that distracted from core product development.

Sohar implemented an API-first Eligibility & Verification platform purpose-built to handle behavioral health payer nuances—including TPAs, carve-outs, and inconsistent payer metadata.

• Real-time Verification API with structured, normalized outputs
  
  
• Asynchronous webhooks to retry payer calls and handle slow or partial responses
  
  
• Automated fallback workflows managed by Sohar’s support team
  
  
• Carve-out detection intelligence (e.g., Baylor Scott & White via FirstCare routing)
  
  
• Payer-specific enrichment for plans with vague or incomplete descriptions
  

• Error breakdowns that helped Tava refine upstream insurance data collection

• Reduce dependency on manual eligibility checks for high-volume appointments
  
• Improve the accuracy of patient-facing financial data during intake
  
• Lower operational burden on front-office staff while improving billing transparency

Fast Integration, Minimal Disruption

‍Despite parallel platform work—including a transition to Candid Health—Tava implemented Sohar in ~3 weeks of a single engineer’s time. This allowed Tava to bgin running eligibility checks at the start of every month and saw immediate improvements in accuracy and latency.

• API integration completed rapidly with webhook architecture
  
• Sohar’s team supported payer-specific edge-case training
  
• Immediate visibility into input data quality and benefit discrepancies
  
• Ability to run monthly re-checks confirmed shifts in payer behavior and patient coverage
  
• Operational fallback handled entirely by Sohar, with portal checks and phone calls to payers
  
  

Sohar equipped Tava with a real-time eligibility infrastructure that replaced manual workflows, removed engineering bottlenecks, and strengthened financial transparency across the patient journey. Operationally, Tava saw a sharp reduction in manual verifications, fewer internal support escalations around failed checks, and a significant decrease in engineering time previously spent maintaining clearinghouse logic. With clearer, more reliable coverage intelligence, patients moved through onboarding with greater ease and fewer interruptions.

Accuracy and performance also improved meaningfully. Sohar delivered a 94%+ API resolution rate, consistently low ~30-second P95 latency, and a material drop in false negatives for complex payers and TPAs. These improvements reduced friction in scheduling, enhanced patient financial clarity, and created a more dependable intake experience for employees and their families.

With accurate, timely insurance data now embedded upstream, Tava is building toward a more proactive financial workflow—expanding into pre-service cost estimation, real-time financial transparency for employees, and stronger employer reporting and RCM predictability to support its growing national footprint.