The Athelas AI RCM Assistant is redefining how your team manages your rev-cycle by bringing speed, precision, and intelligence to every part of your operation. Built on the power of conversational AI, it lives right inside your Insights dashboard, acting as your team’s digital partner. Whether you need answers, guidance, or help automating repetitive billing tasks, Athelas AI is here to do the boring work so you can focus on what really matters, delivering exceptional patient care. The RCM Assistant is now available to everyone on insights.athelas.com.

You can ask Athelas AI about:

• Appointment details and benefits

• Specific patients or accounts

• Claim and encounter details 

• Insights guides and FAQs

How Does Athelas AI Work?

Athelas AI RCM Assistant has a conversational interface for asking questions about patient demographics, insurance information, current balances, and past payment data. It combines instant data access, automated actions, and chat-based prompts, allowing practice staff to complete complex tasks easily.

Users can check account status, analyze claims, and resolve billing problems by simply prompting it. No more digging through web pages anymore because everything is just a question away.

What can the RCM Assistant help with?

Patient & Account Management Made Simple 

Athelas AI makes patient and account management faster and easier than ever. With a few quick prompts, your team can instantly retrieve patient demographics and insurance information, analyze balances with detailed breakdowns, and even generate quick one-pagers to share with staff members or patients directly. It can also help you manage credits, process refunds, and track payment transactions history with ease.

Tired of manually writing off balances? Athelas AI handles it all seamlessly, reducing administrative burden and giving your team more time to focus on patient care.

Example questions & tasks you can ask:

• "Write off $150 balance for John Smith - reason: financial hardship."

• "Search for the patient with the phone number (555) 123-4567."

• "Analyze all charges and payments for John Smith from January to March 2024."

• "Update insurance information for John Smith - new policy number ABC123."

Analyze Claims & Encounters Quickly

The Assistant helps staff find claims, review submission details, and analyze denials. Instead of struggling with endless screens and scattered data, providers have a single, chat-based interface to conduct research on all their claims.

Whether tracking in-person visits, telehealth check-ins, or lab follow-ups, Athelas AI Billing Assistant organizes and documents each interaction automatically, making it easy to retrieve encounter histories, find denied claims, and identify next steps in real time. It can search and filter encounters by patient, provider, date, or status, and instantly retrieve full encounter details, including billing summaries and timelines. It tracks claim status and submission history, allowing you to submit or resubmit claims to primary, secondary, or tertiary payers with ease.

You can even perform bulk claim submissions, update encounter data such as insurance assignments, CPTs, and diagnosis codes, and quickly identify encounters with billing issues or unprocessed claims.

Example questions & tasks you can ask:

• "Find encounters from 09/01/2024 to 09/30/2024 for Joanne Smith."

• "Get full details for encounter ID 45678 and provide a billing summary."

• “What's the current status of encounter 12345?”

• "Submit encounter 12345 to primary insurance."

• “Explain what the denial reason means for CARC code “XXX” on encounter 1234.”

Simplify Your Front Office Operations

Athelas AI also supports appointment-related insights and actions, transforming these time-consuming processes with a chat-based experience. It can answer questions related to a specific appointment, patient, or trends across an appointment type so staff no longer have to spend time digging for information through calendars.

Beyond basic scheduling look up, Athelas AI helps analyze eligibility and benefits information. Users can quickly retrieve detailed benefits information, copay amounts, and coinsurance for scheduled appointments, as well as easily break down suggested charges and pre-visit payment information.

Armed with this information, front office staff can easily answer questions about a patient schedule and explain why they owe anything pre-visit with little to no billing experience needed.

Example questions & tasks you can ask:

• “Appointment ID 74229 lists a copay of $40. The patient says they should not owe a copay. What should I tell them?”

• "Give me a summary of all appts for X facility tomorrow. Which patients have a high balance pending I should look at?"

• "Find all upcoming appointments for patient Sarah Wilson in October 2024"

Teach You Insights and Answer FAQs

Learning new tasks in any software can be difficult for even the most experienced staff members. With the help of your Assistant, you can ask questions as needed. It is always available to guide you through key workflows, explain common terms, and provide step-by-step instructions right inside the platform — no need to leave your workspace or dig through training manuals.

Whether you’re onboarding new team members or refreshing your own knowledge, the Assistant can walk you through processes, clarify errors, and surface documentation tailored to your role.

Example questions & tasks you can ask:

• “How do I post a payment to a claim?”

• “How do I refund a payment back to the patient’s card?”

• “What does ‘pending adjudication’ mean?”

• “Show me how to create a new patient statement batch.”

• “Where can I find claims that were denied this week?”

Features Coming Soon

• Reporting and Analytics - Users will be able to generate large custom reports directly from Athelas AI. From the same chat-based interface, users will be able to filter by charge type, provider, payer, or date and create detailed summaries on billing trends.

• Coding and Compliance - We will provide support for looking up CPT and HCPCS codes, modifier requirements, and documentation standards. Staff can check when specific modifiers are needed, find out if codes are bundled, and get a quick summary of compliance protocols without leaving their dashboard.

• Claim Resubmission - Don't want to fill out each claim edit form by hand when solving a denial? We got you. Soon you can ask your AI assistant to make claim updates and resubmissions on your behalf.

Get Started Today

Getting started is effortless. Simply head to your Insights Dashboard, open Athelas AI from the top header, and ask a question. In moments, you’ll receive a clear, detailed response with actionable next steps. When you request a task, Athelas AI confirms before taking any financial action, giving you complete control and peace of mind. It’s designed to surface key insights instantly and get smarter with every interaction, continuously evolving through your feedback. Reach out to your account manager to get started!