Building on athenahealth: How Midwest Provider Groups Are Improving Revenue Cycle Performance

For revenue cycle teams on athenahealth, a lack of data is not the problem. The real challenge facing teams daily is turning information into action quickly enough to improve financial outcomes. Teams using athenahealth have access to a wealth of information, but identifying emerging denial trends, payer changes, and underpayment issues before they affect revenue requires more than reporting alone.

That challenge has become even more important as provider groups balance reimbursement pressure, increasing payer complexity, and staffing constraints. During a recent webinar focused on the athenahealth ecosystem, several themes emerged consistently: denials and underpayments remain a significant obstacle to growth, payer behavior continues to evolve, and teams are looking for ways to improve performance without simply adding more manual work.

For many organizations, the opportunity lies in connecting visibility with action.

athenahealth provides a strong operational foundation, and many organizations are looking for ways to build on that foundation with greater visibility and faster issue resolution. Revenue cycle teams often spend significant time reviewing kick codes, ERA files, payer work queues, and month-end reports to understand what changed and determine where to focus next.

That is why Adonis is designed to complement athenahealth, helping teams surface issues earlier, understand root causes faster, prioritize work, and respond before revenue leakage becomes a larger accounts receivable problem.

The best way to understand what that looks like in practice is through the experiences of two athenahealth customers: Fox Valley Orthopedics and Redefine Healthcare.

Fox Valley Orthopedics Shows What Earlier Visibility Can Look Like

Fox Valley Orthopedics is an Illinois-based orthopedic provider serving 35,000 patients annually across physical therapy clinics, ambulatory surgery centers, and specialty practices. Like many growing provider groups, the organization was managing information across multiple systems and relying heavily on manual reporting, making it difficult to identify revenue-impacting issues before they affected cash flow.

Using Adonis alongside athenahealth, Fox Valley implemented real-time alerts and intelligent task prioritization to identify denial trends earlier and route the right work to the right people faster.

In one instance, Adonis detected a 104% increase in CO197 denials tied to a payer policy change affecting CPT code 97110 in the organization's physical therapy clinics. The team was able to quickly investigate the issue, secure retro-authorizations, correct impacted claims, and avoid more than $200,000 in potential lost revenue.

In another example, Adonis surfaced a spike in CO197 denials at Fox Valley's ambulatory surgery center that stemmed from mismatched billing codes. After the issue was identified and corrected, denial rates fell from 33% to 13% within a week.

Over time, the broader impact has been significant. Fox Valley reported a 25% reduction in denial rates within the first year of partnership and achieved a 5.7x ROI within the first four months of 2025 through Adonis' alerting capabilities.

These outcomes highlight the value of identifying payer changes and emerging trends early enough to take action before they create larger financial challenges.

Redefine Healthcare Demonstrates the Value of Proactive Workflows

Redefine Healthcare uses athenahealth for both clinical and revenue cycle workflows and has grown to approximately 140 providers, 72 office locations, and four ambulatory surgery centers.

According to Kathy Saunders, SVP of Revenue Cycle Management, athenahealth provides a strong foundation for the organization, while Adonis adds an additional layer of intelligence that helps the team identify issues and prioritize action more effectively.

Instead of waiting for trends to become apparent through traditional reporting cycles, the team uses Adonis daily to review highlighted issues, summarized trends, and denial patterns that require attention.

Kathy says one of the biggest changes has been having priority issues surfaced automatically each morning. The team can identify underpayments on specific codes, group prior authorization denials for more efficient follow-up, and move directly from Adonis into athenahealth claims to take action.

That shift has translated into measurable operational improvements. According to Kathy, reimbursement turnaround times have improved, clean claim performance is stronger than ever, and AI has helped the organization scale more efficiently as the business continues to grow.

Turning Visibility into Action

What do these examples have in common?

Neither organization replaced the systems they already relied on. Instead, they focused on extending the value of their existing technology investments and giving revenue cycle teams the tools to act more quickly and effectively.

Fox Valley Orthopedics demonstrates how earlier visibility into payer policy changes can help prevent revenue loss. Redefine Healthcare illustrates how adding intelligence and prioritization to existing athenahealth workflows can help teams work more efficiently and improve performance over time.

Across both organizations, the common thread is the ability to identify issues sooner and focus resources where they can have the greatest impact.

For revenue cycle teams, that can translate into:

• Earlier detection of denial trends and payer behavior changes
• Better prioritization of high-value claims and follow-up work
• Greater visibility into underpayments, kick codes, and operational bottlenecks
• More capacity for teams to focus on root-cause resolution rather than manual triage

As provider groups continue to navigate reimbursement pressure and staffing constraints, many are looking for ways to extend the value of their existing technology investments. Connecting insight with action is becoming an increasingly important part of that strategy.

Ready to learn more? See Adonis in action.