Overview
What is AI Billing?
AI Billing is Elation’s native AI technology designed to expedite the revenue cycle management process for Elation Billing users. This technology is built to learn from the information it receives and will keep getting better. It currently uses native AI technology to speed up the claims generation, review and submission by- Generating appropriate CPT and Diagnosis codes based on demographics and visit note documentation.
- Scrubbing claims to check
- for insurance eligibility issues
- for Quality reporting requirements
- against NCCI rules
- for missing National Drug Codes (NDC)
- Clearinghouse validations
- against custom payer-specific rules
- Auto-queuing specific claims
What are the benefits of AI Billing?
AI Billing:- Reduces administrative burden by
- handling the clear, simple claims to reduce the number of manual touches required to get paid.
- using information from your patient’s chart and note to fill in billing details on your behalf.
- Prioritizes your practice first by continuously optimizing your accounts receivable by learning from your data over time.
Setup
All Elation Billing users automatically have access to AI Billing features.Enabling the AI Billing features
Workflows
AI Billing works alongside the documentation you already do. When you open the billing details on a visit note:- AI Coding suggests and populates diagnosis, procedure, and drug codes based on the visit note and the patient’s chart.
- Billing Analysis scrubs the bill for insurance eligibility issues, Quality reporting requirements, NCCI rules, missing drug codes, Clearinghouse validations, and any custom payer-specific rules your practice has configured.
- Claims that pass scrubbing and meet the auto-queue criteria go directly to the Claims Queue in Elation Billing, where a user reviews them and submits them to the Clearinghouse.
Frequently Asked Questions
How do I turn AI Billing on or off?
The Billing Analysis toggle in Settings > Billing > AI Billing controls the AI Billing features. An Admin Level User can turn it on or off at any time. When the toggle is off, the AI Coding and Billing Analysis sections do not appear on the bill, and claims are not auto-queued. Your bills and claims behave exactly as they do without AI Billing.Does AI Billing learn from other practices’ data?
No. AI Billing uses your own practice’s historical claims data — what your practice billed, what was paid, and how — to refine its coding suggestions, NDC population, and the confidence scores behind auto-queued claims. Another practice’s claims history does not influence the suggestions you see. Elation and its third-party AI providers do not use your patient data, including de-identified data, to train AI models. See Elation AI — Frequently Asked Questions for more about how Elation’s AI features handle your data.Do I stay in control of my billing?
Yes. AI Billing supports your billing process rather than replacing your review:- AI Coding adds to your codes rather than replacing them, and you can undo its changes with Revert to previous bill.
- Claim scrubbing surfaces errors for you to resolve. You decide what to correct and when.
- Claims are never billed automatically. A user always clicks Bill Now from the Claims Queue to send a claim to the Clearinghouse.