Introducing AI-enabled Express Coding in athenaOne®

Medical coding shouldn't be this hard 

If your billing team spends more time chasing down the right codes than reviewing actual claims, you're not alone.

Medical coding is one of the most detail-intensive workflows in any ambulatory practice. It's also one of the most consequential.

Every missed modifier, incorrect code, or under documented encounter has a direct impact on your bottom line. The challenges are systemic: They stem from the way coding is structured, not just how it's executed. Common mistakes drive preventable claim denials, and persistent assumptions keep many practices from ever fully solving for them.

The result? Preventable revenue loss. Overburdened staff. And a billing cycle that never quite runs as smoothly as it should.

athenahealth built Express Coding to change that, starting with the moment an encounter is signed off.

What Is Express Coding?

Express Coding is an AI-powered coding capability built directly into the athenaOne® Billing tab. It automatically reviews clinical documentation from the encounter and inputs E&M and CPT codes for review and sign off by your teams with transparency into selection logic.

Think of it as a knowledgeable coding colleague working alongside your team in real time: one who has read every payer policy, knows current coding guidelines, and speed reads clinical documentation.

For practice managers and administrators, this can help support:

• Fewer coding errors making it through to claim submission
• Less time spent on manual charge entry and coding lookups
• More consistent revenue capture across your patient volume
• A billing team that can focus on exceptions and escalations, not routine code review

And because Express Coding lives inside athenaOne, the platform your team already uses, there's no new software to learn, no separate login, and no disruption to existing workflows.

Simple for staff, sophisticated under the hood

You don't need to understand the technology to benefit from it. But for those who want to know what's powering the recommendations, here's what's happening behind the scenes.

When a provider completes an encounter and the case moves to billing, Express Coding automatically analyzes clinical documentation, visit information, and practice configurations and inputs E&M and CPT codes, complete with a transparency layer that shows the reasoning behind each suggestion. Your provider or billing staff reviews, confirms, and submits. The AI does the heavy lifting; your team stays in control.

As documentation volume grows with the adoption of ambient scribes and AI-assisted note capture, the pressure on coding teams to process more information accurately and quickly has only intensified. Express Coding is purpose-built to absorb that pressure. A few things that make it work well in practice: 

• The right technology for the job: Deterministic and rules-based automations help promote accuracy and reliability, supplemented by generative AI. 
• Tested by coding specialists: Express Coding was built and backed by athenahealth certified coders, with extensive testing and development work, to help optimize results. 
• In your athenaOne workflows: Embedded seamlessly in your athenaOne EHR and Billing workflows, Express Coding can help reduce handoffs and duplicative effort. 
• Full transparency: View documentation and decision logic behind each automated result before advancing to claim creation.

What Express Coding addresses 

Express Coding is designed to directly tackle the structural workflow gaps that drive coding errors and downstream denials. One of the most common and costly gaps is the disconnect between clinical documentation and coding. When documentation and coding happen in silos, details get lost, modifiers get missed, and the claim that reaches the payer is already impaired. Express Coding aims to close that gap by analyzing clinical notes and generating codes at the natural handoff point, before a claim is built.

Additional workflow gaps Express Coding is built to address: 

• Provider time pressure: Coding under volume pressure is a known driver of errors. Express Coding removes the burden of initial code selection from providers and billing staff, replacing manual lookups with AI-generated inputs for provider and staff review. 
• Modifier and specificity errors: Express Coding applies deterministic, rules-based logic to help ensure that recommended codes reflect the appropriate level of specificity, including modifiers, laterality, and time-based documentation requirements. 
• Undercoding and overcoding risk: Some practices undercode out of caution or overcode inadvertently, and both carry consequences. By grounding recommendations in documented clinical encounters and established payer expectations, Express Coding supports more consistent, defensible coding that reduces exposure on both ends.

The revenue impact: what this means for your practice 

Coding inefficiency is a quiet but significant revenue drain. Consider the numbers: 

• 84% of claim denials are potentially avoidable¹, and while coding denials are often recoverable, each denied claim costs up to $64 to rework² 
• athenahealth's Medical Coding Services — the testing ground for Express Coding — delivered 99.4% coding accuracy for existing customers, outperforming the 95% industry standard³ 
• Practices using athenahealth's AI-powered denials tools have seen, on average, a 30% increase in payment recovery on coding-related denials versus manual rework⁴ 

Express Coding brings that same accuracy and automation into your billing workflow and can help your practice capture more of what it's already earning with less manual effort to get there.

Built for busy practices — not just billing experts 

One of the most important things about Express Coding is how little new learning it asks of the people using it and reviewing the outputs. No need to retrain your billing team on a new platform. No separate tool that requires a separate login or multiple browser tabs. Express Coding is embedded in the modernized Billing tab in athenaOne, the same environment your staff already navigates every day, and it activates automatically as part of the existing charge entry workflow.

This matters especially for practices where: 

• Billing staff wear multiple hats and don't have time for initial manual coding lookups on every encounter 
• Provider documentation volume has grown with the adoption of ambient scribing and AI-assisted notes, creating more text to process at billing time 
• Turnover in billing roles has created knowledge gaps that make consistent coding harder to sustain 
• With denials and downcoding always looming, staff needs easy-to-access, transparent evidence that codes submitted represented the encounter.

Express Coding is built to adapt to these realities, not the other way around.

Part of a larger AI-native strategy

Express Coding doesn't exist in isolation. It's but one of the capabilities athenahealth has launched or is bringing to market as part of its AI-native RCM strategy: a broad effort to eliminate the manual, repetitive, and error-prone work that costs practices time and money across every step of the revenue cycle.

From automated insurance selection to AI-assisted denial management, athenahealth is applying AI precisely where it has the most impact. That means the workflows where errors occur, delays accumulate, and where staff time gets absorbed by manual and repetitive tasks.

Express Coding is where that strategy meets medical coding: directly, practically, and without added complexity for your team.

See what smarter coding looks like 

If your practice is looking to reduce coding errors, recover more revenue, and give your billing team back the time they've been spending on manual work, reach out to see how Express Coding might be able to help.

Request a demo to see Express Coding in action within athenaOne and find out what AI-powered medical coding could mean for your practice's revenue cycle.