Why your practice’s EHR needs direct payer integrations

How smarter technology improves revenue, reduces denials, and frees up time for care

If you’re running an independent medical practice, you know how much of your team’s time and energy goes toward making sure insurance information is accurate. Eligibility checks, prior authorizations, unclear benefits, missed incentives — these aren’t just minor annoyances. They’re daily roadblocks that slow down care, strain staff, and squeeze your bottom line.

But what if your EHR and practice management system could take that friction off your plate?

With built-in, direct integrations to the nation’s largest payers, today’s most advanced EHR platforms are helping independent practices verify insurance, check benefits, surface open and potential gaps in care, and capture value-based incentives — automatically, without extra portals, paperwork, or guesswork.

Let’s take a closer look at how these integrations work, and why they can make all the difference for independent practices.

Stop chasing eligibility. Let it come to you.

Manual eligibility checks are time-consuming and prone to error. Staff often spends valuable minutes per patient on payer websites, phone calls, or data entry — and still risks missing key coverage details like deductibles, pre-authorization rules, or plan-specific copays.

With real-time payer integrations, your system can automatically verify eligibility several days before the appointment, surfacing everything from network status to copay amounts to prior authorization requirements — all in one place, without having to log in somewhere else. Your practice can be confident about the patient’s coverage, well ahead of the appointment.

When eligibility checks are automated, you reap the rewards:

• Less time confirming status with payers
• Faster patient check-in and reduced wait times
• Better upfront collections with clear out-of-pocket costs
• Fewer denials due to coverage issues

Cleaner claims mean faster payments

Every denied or delayed claim cuts into your revenue and your team’s time. Many of those denials come from missing or mismatched information that could have been caught earlier.

An EHR with direct integrations with regional and national payers catches those issues before the claim goes out — helping ensure your submissions match payer requirements the first time.

Submitting cleaner claims helps you collect more with less work:

• Fewer rejections and resubmissions
• Shorter reimbursement cycles
• Reduced billing workload
• A more predictable revenue stream 

When a new payer is added to our network, that connection becomes immediately available to every provider on athenaOne.

Make the most of value-based care without adding administrative burden

Value-based contracts can bring new revenue opportunities — but only if you have the right data to address gaps in care, capture accurate coding, and meet payer quality measures. Most small practices don’t have the time or resources to manage these programs manually.

That’s where having direct payer connections inside your EHR makes a difference. These systems surface real-time insights into open care gaps, suspected and inferred diagnoses, and performance targets — so your team can act while the patient is in the room, not weeks later.

With the right support, you can succeed with value-based care:

• More complete documentation for risk and HCC coding
• Higher Stars/HEDIS performance
• Increased value-based incentives
• Better outcomes for your patients

Stay independent with less administrative overhead

Every hour your staff spends on coverage verification, authorization chases, or claim resubmissions is time — and money — taken away from delivering excellent patient care. The right EHR and practice management system reduces that burden by automating the work that drags your day down.

And because direct payer integrations happen behind the scenes, you don’t need to manually opt in each payer separately or chase down custom connections; the clinical data comes to you automatically.

Automation helps you get paid faster and deliver great care

You didn’t go into medicine to chase insurance coverage or fix billing issues. And in today’s healthcare environment, small practices can’t afford to waste time or miss out on revenue opportunities.

Choosing an EHR and practice management system with direct payer integrations helps you:

• Reduce staff burden
• Improve your cash flow
• Get paid faster with fewer denials
• Succeed in value-based care without the administrative overhead
• Deliver a smoother, more transparent experience for your patients

The right technology doesn’t just make your systems work better. It helps your practice work smarter — and stay independent.

Why athenaOne® makes integration effortless

With athenaOne, these advantages are built in. Our AI-native platform already connects directly to many of the nation’s largest payers. When a new payer is added to our network, that connection becomes immediately available to every provider on athenaOne — no separate builds, no new contracts, and no added work for your team. It’s a smarter, scalable way to keep your practice connected without getting bogged down in technical complexity.

Get to know the AI-native athenaOne solution

One system. One connection. One cloud-based network with nationwide reach. See how a fully integrated EHR, medical billing & practice management, and patient engagement solution can transform your practice. Meet athenaOne.