Driving a 67% Reduction in Denials for Optum VA Claims: How ApolloMD Transformed RCM with Adonis Intelligence and AI Agents

Meet the Client

ApolloMD, a physician-led group with more than 2,500 clinicians across emergency medicine, hospital medicine, and urgent care, partnered with Adonis to stay ahead in an ever-evolving healthcare landscape. Committed to delivering high-quality, efficient care while fostering a supportive environment for their providers, ApolloMD has long embraced innovation, leveraging new technologies to enhance operational performance and elevate the patient experience.

The Challenge: Uncovering Hidden Revenue and Preventing Avoidable Denials

Emergency Medicine providers inherently face numerous front- and back-end revenue cycle challenges due to the diverse range of patients' insurance coverage, the variety of services provided, and the multitude of payers involved. To stay ahead in an industry that is constantly evolving and in which payers are constantly changing their behavior, ApolloMD recognized the need to be able to pivot quickly and make data-driven decisions.

Despite knowing revenue cycle inefficiencies were impacting performance, the team lacked visibility into the financial magnitude of those issues and which areas offered the greatest potential for improvement. They also struggled to distinguish avoidable denials from unavoidable ones, making it difficult to reduce their growing A/R backlog.

To overcome these challenges, ApolloMD set out to:

• Identify the highest-impact opportunities for improvement within their revenue cycle
• Identify and prevent avoidable denials to reduce rework and A/R backlog
• Uncover downcoded or underpaid claims across payers to enable proactive recovery

The Solution: Adonis Intelligence

As an early adopter of Adonis Intelligence, ApolloMD set out to bring greater visibility, precision, and control to its revenue cycle operations.

With Adonis Intelligence, ApolloMD gained full visibility into every aspect of its revenue cycle. Since going live in 2023, the platform has surfaced over $34.2 million in outstanding balances across payers. Armed with real-time insights, ApolloMD has enhanced its operational workflows, implementing EHR updates and automations to catch issues as they arise and accelerate revenue recovery.

In addition, through AI-powered anomaly detection, Adonis helped uncover a growing trend in downcoded payments, totaling $46.6 million across all payers since the start of the partnership, empowering ApolloMD to quickly capture hidden revenue opportunities and drive meaningful financial recovery.

Armed with these insights, ApolloMD has redesigned workflows, closed credentialing gaps, and strengthened payer connections, creating a more resilient, efficient revenue cycle operation built for long-term success.

Redefining What’s Possible with AI Agents

When Adonis launched AI Agents in 2025, ApolloMD was once again an early adopter. The team immediately saw an opportunity to tackle one of its most time-consuming manual processes, retrieving authorization numbers for VA claims.

Previously, staff had to call the VA and manually enter authorization data into athenahealth before claim submission. Alternatively, they could allow claims to be denied for missing authorizations and reprocess them later. Both scenarios created costly delays, administrative burden, and revenue leakage.

Since launching Adonis AI Agents, ApolloMD has automated this workflow, resulting in measurable and immediate impact:

• 2,000+ FTE hours were saved, allowing ApolloMD to repurpose 2.5 full-time employees to focus on higher-value tasks and uncovering new opportunities to increase collections.
• Optum VA denials dropped by 67%, dramatically reducing rework and accelerating cash flow.

Adonis AI Agents enable ApolloMD to scale its business more efficiently and without adding additional headcount.

A Partnership Fueled By Innovation and Collaboration

ApolloMD partnered with Adonis not only for its powerful technology and seamless integration with athenahealth, but also for the team’s deep RCM expertise, agility, and commitment to customer-centric innovation.

Adonis’ ability to pivot quickly in a fast-moving industry, deliver rapid product enhancements, and co-develop innovative solutions, has made the partnership a model for how technology and operational teams can collaborate to achieve measurable outcomes.

"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, EVP Revenue Cycle Operations

The Road Ahead

Looking ahead, Adonis is excited to continue partnering with ApolloMD to build and deliver forward-thinking innovations that empower RCM teams. Together, ApolloMD and Adonis are redefining what’s possible in AI-powered revenue cycle transformation, moving from insight to intelligent automation.