Athenahealth’s “roadmap” for the AthenaOne platform includes more than 80 new and improved AI RCM functionalities

Athenahealth has unveiled over 80 new artificial intelligence (AI) capabilities for revenue cycle management (RCM) operations as part of its AI-powered athenaOne platform.

Athenahealth offers electronic health records (EHRs) software, RCM and patient engagement offerings to small and independent provider practices. The new RCM roadmap is designed to reduce manual administrative work across ambulatory revenue cycles and improve results, the company said.

What is so exciting about the current generation of AI “is that it can read and write and understand at its own AI level,” Paul Brient, athenahealth chief product and operations officer, told Fierce Healthcare. “That really lets us make huge strides across the software stack in providing enhanced services.”

New and expanded AI-native capabilities feature automated insurance selection, AI co-pay, voice AI, express coding, expanded payer surveillance, expanded anomaly detection, expanded denial resolution automation and more.

According to the company, early results from platform features indicate a 30% rise in coding denials and a 16% drop in insurance denials. The company also claims that its AI-driven voice agents are able to finalize prior authorization calls in less than an hour.

“What we’re doing is getting them to do less work to get paid,” Brient said. “And we are increasing the success rate of their payments.”

Heart & Vascular Care in Georgia is one of the first agencies to take advantage of the new features.

The organization’s experiences to date have been “very positive,” and the capabilities fit into their current workflow “in a way that makes it easier to adopt,” Heart & Vascular Care Vice President of RCM Larami Oliver told Fierce Healthcare.

Heart & Vascular Care serves around 55,000 patients around the state, according to Oliver.

We have seen good value in the areas that we have tried, and athenahealth has been collaborative with us in listening to our comments and making changes,” Oliver said. “This responsiveness has helped to ensure we have gained confidence throughout our team.”

Other than automated insurance identification and copay accuracy, Oliver said Ambience listening tools also are working for RCM.

Although they are frequently addressed as a provider documentation solution, they can also be used to help with revenue cycle performance by providing a more complete note, leading to better visit understanding, coding, and follow-up, Oliver said.

These new tools have enabled Oliver to significantly lower billing discord, resulting in increased efficiency, accuracy, and staff satisfaction for the practice.

“Having the right information, in the right place and the first time minimizes rework, and good claims get sent out the first time,” Oliver said. “On the patient side, more accurate copay and streamlined front-end processes enhance the patient experience by reducing wait time and reducing the number of unanticipated follow-up balances.”

Through the use of AI, Brient explained that athenahealth is able to continue eliminating friction from its RCM operations.

We started with this idea that we can remove the friction from the revenue cycle side and get our customers what they deserve,” Brient said. “And AI has simply enabled us to take that to the next level.”

Athenahealth has announced a major expansion of its AthenaOne platform roadmap, introducing more than 80 new and enhanced artificial intelligence-powered revenue cycle management (RCM) functionalities. The latest Athenahealth innovations are designed to help healthcare providers streamline billing operations, improve claim accuracy, and accelerate reimbursement processes.

As healthcare organizations continue to face growing administrative pressures, Athenahealth is leveraging AI technology to automate complex financial workflows and support more efficient revenue cycle management.

Athenahealth Strengthens the AthenaOne Platform

The expanded roadmap demonstrates how Athenahealth is investing heavily in intelligent automation across its healthcare technology ecosystem. By integrating advanced AI tools into AthenaOne, Athenahealth aims to help providers manage patient billing, claims processing, and payment collections more effectively.

The new enhancements within Athenahealth are designed to reduce manual work, minimize errors, and improve overall operational efficiency for healthcare practices of all sizes.