athenaOne collects the claims. We recover what it leaves behind.
athenaOne already scrubs against its shared rules engine. What it does not do is work your denials, rank your A/R by recoverable dollars, or draft appeals in your voice. A private AI system does that alongside athenaOne — no configuration changes, no new module to buy.
Signed BAA before any PHI moves. Your data stays yours.
athenaOne is doing its job. The gap is everything that happens after the rules engine says no.
You still pay a percentage of collections
athenaOne bills against what you collect. Everything the rules engine misses is worked by your staff — and still costs you a percentage.
The rules engine is shared, your payers are not
National edits catch the common cases. Your regional payers, plan quirks, and specialty modifiers are learned the hard way, by rejection.
The worklists are long, not ranked
Hold buckets and claim worklists show everything. Nobody tells your team which twenty items are worth today.
Our position: compound with the rules engine instead of fighting it, human approval on every action, one flat fee — not a percentage of collections.
The work athenaOne surfaces — and the work that actually gets it paid.
One workflow at a time, phased in. Your team approves every action. A live dashboard tracks clean-claim rate, denial rate, days in A/R, cash collected, and hours saved alongside your existing athenaOne reporting.
Denials & rejections
PILOTWorked when there is time; many written off
Every denial categorized the day it arrives, recoverable dollars ranked, appeal letters drafted for your biller to approve
Eligibility & benefits
PHASE 1Checked manually, often day-of
Every scheduled visit verified 48 hours ahead; problems routed to your front desk
Claim scrubbing
PHASE 1Payer rules live in billers' heads
Every claim checked against payer-specific rules, modifiers, and coding edits before it leaves
A/R worklist
PHASE 1Oldest-first, or whoever remembers
Daily follow-up list ranked by dollars, age, payer, and likelihood of payment
Claim status & posting exceptions
PHASE 2Portal checks one claim at a time; mismatches found late
Automated status checks; unposted or mismatched remittances flagged for review
Coding review & prior auth
PHASE 2–3Coder memory and document-by-document packet assembly
Charges compared to the note; auth requests drafted and tracked
Reporting
PILOTMonth-end, by hand out of athenaOne reports
Live dashboard: clean-claim rate, denial rate, days in A/R, cash collected, hours saved
Nothing runs on its own until you say so. The system prepares; your team approves. Every action is logged. No patient-facing calls or messages are part of this program.
We layer on top of athenaOne — its rules engine stays exactly as configured.
We read through athenahealth APIs, FHIR, and scheduled exports. Approved actions return through the same channels your team already uses — nothing is reconfigured.
athenahealth
- Scheduling, charge entry, claims, and the athenaOne rules engine stay exactly as configured.
- Data leaves via athenahealth APIs and standard report exports.
Standard interfaces
- athenahealth API · FHIR R4 (read + write-back)
- Claims & remits (837 / 835)
- Eligibility (270 / 271) · claim status (276 / 277)
- Scheduled report exports and hold-bucket extracts
Lonestar private AI
- Your dedicated environment — private cloud or on-prem.
- Reads, checks, categorizes, ranks, drafts. Learns your payers and rules. Every step logged.
Your billing team
- Reviews a ranked worklist and drafted appeals.
- Approves, edits, or rejects. Nothing is sent without a person.
We never fight the rules engine. Our checks run before submission and after remittance, so athenaOne's edits and ours compound instead of colliding.
Guardrails that respect both your BAA and your athenaOne setup.
Human approval, always
For the first 90 days no claim, payer, or patient is touched without a person clicking approve. After that, you decide what earns autonomy.
Back office only
No patient-facing calls, texts, or messages are part of this program. We make sure you get paid for work already done.
Your data, your control
Signed BAA before anything moves. Dedicated private environment or a server in your office. Full export in standard formats whenever you want it.
Full audit trail
Every read, suggestion, edit, and approval is logged with a user and timestamp, retained for six years.
Controls we hold ourselves to: encryption at rest and in transit, VPN-only access, MFA, per-user audit logs, PHI never sent to a model endpoint without a BAA, and six-year audit-log retention. More on security.
No upfront cost. You pay nothing until you've seen results on your own data.
Prove it on your data
- 90 days of denial, hold-bucket, and A/R aging exports — files only, no athenaOne login
- Recoverable dollars identified and ranked
- Appeal drafts reviewed by your own biller
- Live KPI dashboard delivered
- No integration, no invoice, no obligation
Deploy
- Denials → eligibility → scrubbing → A/R worklist, one at a time
- Your team approves everything
- Private environment stood up under BAA
- Weekly check-in with your billing lead
One flat monthly fee
- Hosting, security, monitoring, backups included
- Payer-rule, model, and athenaOne changes handled by us
- Enhancement hours every month
- Monthly value report: dollars recovered, hours saved
12-month initial term, then month-to-month with 60-day notice. Implementation-rate pricing for the first two months while workflows go live. Exit any time with a full data export in standard formats within 10 days.
One number on the invoice.
What a typical AI project costs a practice versus what you pay us.
Typical AI vendor
- Large upfront build fee, paid before anything works
- Cloud bill (AWS / Azure) in your name — variable, unbudgeted
- Model subscriptions the developer chose, billed to you
- Security, backups, monitoring: your responsibility
- Model gets deprecated; nobody updates the system
- Data locked in; leaving is painful
Lonestar flat fee
- No upfront fee — the 14-day pilot is free
- Hosting, GPU, and model costs are inside our fee
- Security, backups, monitoring, on-call: ours
- Payer-rule, athenaOne, and model updates every month
- Monthly report of dollars recovered and hours saved
- Your data exports in standard formats, any time
The fee is set by practice size and claim volume, and sits below the cost of adding billers. We quote after the pilot, based on what the pilot measured. See plans.
A one-time build stops working by month twelve.
The system that works in month one keeps working only if someone keeps it working.
athenaOne ships releases continuously
API fields, report layouts, and rule packs move without notice. We track the releases and re-validate our checks so nothing silently stops working.
athenaOne and clearinghouses ship updates
Screens, exports, and interfaces change. We absorb the breakage before your team notices.
AI models get replaced
Models are deprecated and replaced on months-long cycles. We swap and re-validate; you never see it.
Your practice changes
New providers, new payers, new specialty codes. Included enhancement hours cover it.
Same model as every software subscription you already pay for — except this one is built for your practice.
Your choice: dedicated private cloud or a server in your office.
Dedicated private cloud
- Isolated environment for your practice only — no shared tenants
- HIPAA-eligible services under a signed BAA
- Encrypted at rest and in transit; VPN-only access; MFA
- Fastest to stand up — live during the pilot
- Included in the monthly fee
On-premise server in your office
- Single AI server installed on your network
- PHI never leaves the building
- One-time hardware cost (purchased or leased); hosting portion drops out of the fee
- We maintain, patch, and monitor it remotely
- Best fit for practices with strict data-residency policies
Either way, you can move from one to the other later without rebuilding. Support runs business hours with a 99.5% uptime target and one-business-day fixes on billing-blocking issues.
Three reports. Fourteen days. Then you decide.
Sign mutual NDA and BAA. A 45-minute session with your billing lead to export three athenaOne reports: denials (90 days), A/R aging by payer, and current hold buckets. That is the only commitment.
Free pilot on those files. We present recoverable dollars, appeal-draft acceptance rate, and hours saved per month.
You decide. If the numbers work, we sign a 12-month agreement and start deploying. If not, you keep the analysis.