Healthcare technology company athenahealth is fully committed to revenue cycle AI, announcing new features for users and charting a roadmap for future applications of its popular technology.
The company today announced a roadmap for more than 80 AI capabilities for its athenaOne platform, a cloud-based healthcare software and services platform used by many healthcare organizations to manage operations, billing, and patient care.
According to athenahealth, the platform is AI native and announced this new approach to the tool in August 2025. The company says this means AI is the foundation of the platform rather than an add-on feature. Since then, athenahealth has deployed several AI advancements, including ambient digital scribes and agent AI built into its billing and billing infrastructure.
The latest update adds new AI capabilities to revenue cycle tasks such as insurance selection, out-of-pocket cost estimation, pre-authorization, and denial resolution, as well as revealing upcoming capabilities in coding and payer monitoring.
Currently available features include Automated Insurance Selection, which leverages AI to identify the correct insurance package from a patient’s insurance card photo, and AI Co-Pay, which uses AI to assess the status of scheduled appointments and estimate patient out-of-pocket costs.
Users using athenaOne’s authentication management tools also have access to an AI voice agent for pre-authentication calls. The company also plans to expand representation to include referral and billing status, according to the announcement.
Athenahealth also said it plans to expand its AI capabilities for payer monitoring and anomaly detection throughout the year, as well as automate denial resolution, which is now available.
Additionally, the company plans to extend express coding capabilities to users this summer. Currently in beta for over 500 clinicians, it uses AI to automate medical coding and provides coding support that can match or exceed the performance of human programmers.
According to the announcement, Expresscoding will be an add-on feature.
Athenahealth said its new AI capabilities target “the most difficult points in the revenue cycle,” leading to significant administrative burden and revenue loss.
athenaHealth reports that early results from features already included in athenaOne are promising.
The company said recoveries for coding-related denials increased by 30%, while insurance-related denials decreased by 16%. The AI voice agent also completes pre-authentication calls within an hour.
Lalami Oliver, vice president of revenue cycle management at Heart & Vascular Care, an early adopter of new AI capabilities, said in the announcement that the use of AI has significantly reduced manual work, increased visibility, and improved on-time payments.
”[A]thenahealth’s AI works silently in the background within your existing workflows. Healthcare providers and staff do not need to change the way they work,” Oliver said.
Adoption of revenue cycle AI is accelerating as more providers move from basic pilot programs to early-scale enterprise use. Leading medical billing and revenue cycle management vendors are emerging to meet demand, adding AI capabilities to their products and services to reduce administrative burden and manual effort within the revenue cycle.
However, budget concerns and high initial implementation costs remain the biggest barriers to full AI integration in the revenue cycle. Data security, accuracy, and reliability are also top priorities for revenue cycle leaders as they deploy and scale AI.
Jacqueline LaPointe is Executive Editor at Xtelligent Healthcare Media, where she has covered revenue cycle management, healthcare payers, healthcare policy, and healthcare IT since 2016.
