New agentic billing workflows embedded in Elation’s all-in-one, clinical-first platform streamline work from pre-visit to payment, helping claims and reimbursements move faster with less effort

SAN FRANCISCO: Elation Health, the clinical-first technology company powering innovation in primary care, today announced AI-powered billing workflows as the next step in its efforts to reimagine the primary care encounter. By connecting clinical documentation, chart context, and past claims data, these workflows turn everyday notes into cleaner, bill-ready claims that are paid without manual intervention on the first pass, helping practices get paid more fully and reliably for primary care with less billing work for clinicians and staff.

In pilot practices, 72% of eligible claims were created touchlessly from visit note sign-off. Of those, more than 95% were reviewed, confirmed and submitted for reimbursement without any additional manual intervention.

“As both the physician and the biller, I used to feel like I had two full-time jobs,” said Keith Perkins Jr., MD, owner and internal medicine and pediatrics physician at Premier Internal Medicine and Pediatrics. “Now, I can see the patient, document the visit the way I always have, and the rest is largely handled for me. Elation’s touchless workflows suggest codes, catch obvious issues, and move our simple claims forward so I only step in to review and confirm, based on how involved I want to be. That lets me spend more of my time on care and the smaller set of claims that truly need my attention.”

Independent primary care physicians today often get pulled into billing - reviewing claims, fixing denials, or doing reimbursement work themselves. Elation’s new billing workflows are purpose-built for primary care to take on more of those administrative tasks, whether billing is handled by the clinician, a small front office team, or a dedicated biller. That helps cut down everyday administrative work and gives clinicians more time for patients and better work-life balance.

Elation’s new touchless fast lane capabilities include:

• Smart coding in the encounter: Using what’s already in Elation - pre-visit details, visit notes drafted with Note Assist, the problem list, orders, medications, and practice billing history - to suggest more complete diagnosis, procedure, and drug codes before a bill is created. This means clinicians and staff spend less time manually adding codes and more time confirming that all billable work is captured.
• Claim review and an AI-powered touchless fast lane for routine work: Checking claims against coverage and billing rules. Claims that meet a pre-defined confidence threshold set by the practice are routed into a touchless fast lane for submission, while exceptions are held out and clearly flagged for review.
• Performance benchmarks: The workflows are designed to help practices move toward stronger revenue performance, with targets such as denial rates under 5%, first-pass paid rates above 95%, and a high share of touchless first-pass claims paid without extra manual work after the note is signed.

“Reimbursement for delivering primary care shouldn’t be this hard,” said Kyna Fong, CEO and co-founder of Elation Health. “Having been the biller for a small primary care practice, I’ve seen firsthand how much work goes into just getting paid fairly for routine visits. Elation’s approach is simple: billing should support great care, not get in the way of it. With these new fast lane workflows, we’re moving closer to a world where clinicians see the patient, the clinical story of the visit is captured for them in the chart, and the administrative busywork happens quietly in the background. That means more of clinicians’ time can go back to patients, not paperwork.”

The new AI-powered touchless fast lane billing workflows are available today for existing Elation Billing customers and will expand to more customers and new practices over the coming months. To join Elation’s webinar April 2nd on AI-powered billing workflows, register here. To request a demo and learn more about Elation’s clinical-first platform for managing a primary care practice, please visit Elation’s website here.

About Elation Health

Elation Health is the clinical-first AI platform for primary care success. Trusted by over 47,000 clinicians and 24 million patients, Elation’s EHR and billing solutions combine proven clinical workflows with responsible, predictive AI - purpose built for primary care. The company’s clinical-first approach puts physicians at the center, delivering trusted, transparent innovation that saves time and sustains meaningful patient relationships. Elation Health is recognized as Best in KLAS for its commitment to excellence in primary care technology. Learn more at elationhealth.com and on LinkedIn.

Fonte: Business Wire