APOLLOMD X ADONIS CUSTOMER STORY
The Revenue Leak Hiding in "Paid" Claims
Your denial management is sharp, but not every revenue leak shows up as a denial. Some claims post as paid while quietly reducing reimbursement.
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Expected Reimbursement
Actual Payment
Hidden Revenue Leak
A real customer story featuring ApolloMD's revenue cycle team and Adonis.
How Downcoding Slips Through the Cracks
When a payer pays a claim at a lower level than you billed, there's no denial code, no work queue, and no owner. The claim is 'paid,' so it never surfaces.
A claim can look resolved, post as paid, and still quietly reduce reimbursement.
Hear from Chris Pushor, VP RCM at ApolloMD:
"The payer makes a payment and thinks what they've made is acceptable. Unless you look at your EOB to find it's been downcoded, you wouldn't know — because like most EMR systems, they post the claim, post the contractual, and the claim gets closed."
THE HIDDEN LEAK
Chris Pushor
VP, RCM
ApolloMD
As healthcare costs continue to rise, payers have invested heavily in programs designed to ensure claims are billed at the appropriate level. Many of these efforts rely on increasingly sophisticated review processes, including automated claims editing, clinical policy engines, and AI-powered analytics that evaluate coding against documentation and payer guidelines.
These tools can improve consistency and help identify legitimate coding errors, but they also increase the likelihood that claims are reimbursed at a lower level when payer logic differs from the provider's interpretation.
For revenue cycle teams, this creates a new challenge: paid claims are often assumed to be correct simply because they weren't denied. In reality, payment does not always mean full payment.
Without the right visibility into reimbursement patterns, systematic downcoding can quietly erode revenue over months or even years before it's detected.
Why Payers Started Downcoding
$46.6M
ApolloMD uncovered $46.6M in downcoded claims when they started using Adonis.
The Visibility Gap
The good news? The downcoding signal is already in your athena data, you just need a way to see it clearly. Adonis layers directly on top of your athenahealth instance, enriching your existing claims, remittance, and reimbursement data with AI-powered analysis to surface patterns that are easy to miss in day-to-day operations. Instead of manually piecing together kick codes, payer behavior, denial trends, and reimbursement variances across reports, your team gets a unified view of where revenue is leaking and why.
With Adonis, teams are identifying systematic downcoding, recurring underpayments, and emerging payer trends early, enabling them to investigate root causes, prioritize the highest-value opportunities, and recover revenue before losses compound.
Hear from Janet Russell, Revenue Integrity Lead at ApolloMD:
ApolloMD is a privately owned, physician-led national group practice with more than 2,500 clinicians across emergency medicine, hospital medicine, and urgent care. Headquartered in Atlanta, Georgia, ApolloMD supports healthcare partners and clinical teams across the United States.
ApolloMD partnered with Adonis not only for its powerful technology and seamless integration with athenahealth, but for the team's deep RCM expertise, agility, and commitment to customer-centric innovation.
About ApollodMD
"Partnering with Adonis has transformed how we manage revenue cycle operations. Their technology delivers real-time alerts and visibility into payer anomalies and accounts receivable, empowering us to automate workflows and prevent denials. We're continuing to expand our collaboration with Adonis to drive greater efficiency and uncover new opportunities to maximize collections."
Tennille Lizarraga
Chief Revenue Cycle Officer
ApolloMD
MAXIMIZING COLLECTIONS
Increased Visibility Means Increased Revenue
$46.6M
ApolloMD uncovered $46.6M in downcoded claims when they started using Adonis.
$34.2M
ApolloMD identified $34.2M in outstanding balances with Adonis Intelligence.
2,000+
ApolloMD has estimated over 2,000 FTE hours saved with Adonis AI Agents.
Hear From the ApolloMD Team
It's Time to Look Beyond Denials
Every day a downcoded claim goes unnoticed is revenue your organization may never recover. As payers continue to expand automated reimbursement review, relying on denials alone is no longer enough to protect your bottom line.
The organizations that come out ahead will be the ones treating paid claims with the same level of scrutiny as denied claims and using data to identify reimbursement patterns before they become systemic revenue leaks.
If you're using athenahealth, Adonis can help you uncover hidden downcoding, underpayments, denial trends, and payer behaviors already buried in your existing data. Request a personalized demo to see where revenue may be slipping through the cracks and how your team can take action before another dollar is left on the table.
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