Athenahealth unveils over 80 revenue cycle AI features

Healthcare technology company athenahealth is going all in on revenue cycle AI, announcing new features for users and laying out a roadmap for future applications of the popular technology.

The company today unveiled its roadmap of over 80 AI features for its athenaOne platform, a cloud-based healthcare software and services platform that many healthcare organizations use to manage operations, billing and patient care.

The platform is AI-native, according to athenahealth, which unveiled 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 rolled out several AI advancements, including an ambient digital scribe and agentic AI embedded in its claims and billing infrastructure.

The most recent update adds new AI capabilities to revenue cycle tasks such as insurance selection, copay estimates, prior authorizations and denial resolution, while revealing upcoming capabilities in coding and payer surveillance.

The features available now include automated insurance selection, which leverages AI to identify the correct insurance package from a photo of the patient's insurance card, and AI copay, which uses AI to assess the context of a scheduled appointment to estimate the patient's copay amount.

Users with athenaOne's Authorization Management tool can also access AI voice agents for prior authorization calls. The company also plans to expand the scope of the agents to referrals and claim status, according to the announcement.

Athenahealth also said it has expanded its AI capabilities for payer surveillance and anomaly detection, which it plans to scale throughout the year, and denial resolution automation, which is available now.

Additionally, the company plans to expand its express coding capability to users this summer. It is currently in beta for more than 500 clinicians, using AI to automate medical coding and provide coding support that matches, and potentially exceeds, the performance of human coders.

Express coding will be an add-on capability, according to the announcement.

Athenahealth said its new AI capabilities target the "highest-friction points in the revenue cycle," leading to acute administrative burden and revenue loss.

Early results for features already live in athenaOne are promising, athenahealth reported.

The company said recovered payments on coding-related denials are up 30% while insurance-related denials are down by 16%. AI voice agents are also completing prior authorization calls in under an hour.

An early adopter of the new AI capabilities, Larami Oliver, vice president of revenue cycle management at Heart & Vascular Care, said in the announcement that this use of AI has significantly reduced manual work, increased visibility and improved on-time payments.

"[A]thenahealth's AI works quietly in the background within our existing workflows -- providers and staff don't have to change how they work," Oliver stated.

Revenue cycle AI adoption is accelerating as more providers move from basic pilot programs to early-scale enterprise use. Leading medical billing and revenue cycle management vendors are rising to meet demand, adding AI capabilities to their products and services to reduce the administrative burden and manual work within the revenue cycle.

However, budget concerns and high initial implementation costs remain the top barriers to full AI integration in the revenue cycle. Data security, accuracy and trust are also top-of-mind for revenue cycle leaders as they adopt and scale AI.

Jacqueline LaPointe is an Executive Editor at Xtelligent Healthcare Media, covering revenue cycle management, healthcare payers, health policy, and health IT since 2016.