How AI Medical Coding Software built by Hathr.AI Transformed a Client’s eClinical Works EHR Workflow —

100% correct coding and Saving $200K

Intro: The Bottleneck in Modern Medical Coding

Medical coding has always been one of healthcare’s most complex, time-intensive functions. Between coding backlogs, denial management, and the growing complexity of Medicare risk adjustment coding, even established systems struggle to maintain both accuracy and throughput. Traditional EHR platforms such as eClinicalWorks provide coding interfaces — but they don’t offer true automation. Coders still spend hours each day translating clinical documentation into CPT and ICD codes, leaving room for human error and delayed reimbursements.

That’s where AI-driven medical coding software is changing the landscape. By combining natural language processing (NLP), OCR HIPAA AI guidance, and domain-specific models, healthcare organizations can finally reduce coding denials, improve first-pass acceptance of medical claims, and speed up medical coding at enterprise scale.

Recently, Hathr.AI partnered with a large practice hosted on eClinicalWorks (eCW) to automate their medical record coding workflow. Within weeks, the results were transformative — zero coding errors, a projected $200,000 in annual cost savings, and full elimination of their coding backlog.

The Challenge: A Growing Coding Backlog and Rising Labor Costs

Like many multi-site medical groups, this organization’s billing department was overwhelmed and needed to expand. Their internal team did an excellent job, but manual coding and billing limited the organization's ability to keep up with documentation from physicians, leading to delayed claim submission and inconsistent code accuracy. Recruiting additional certified medical coders would have cost upwards of $200,000 annually, without guaranteeing improved turnaround.

The limitations of eClinicalWorks coding workflows were also evident. While eCW offers robust clinical and documentation modules, it lacks an integrated medical coding automation layer. Every code had to be entered manually — and cross-checked against payer rules and Medicare risk adjustment guidelines. This manual bottleneck persisted even though the client had strong EHR infrastructure.

This environment was ripe for a secure, AI-powered automation layer — one capable of integrating directly with eCW, interpreting provider notes via ai medical coding, and assigning auto CPT coding from notes with no data leakage.

The Solution: HIPAA-Compliant AI Medical Coding by Hathr.AI

Hathr.AI’s team deployed a custom AI medical coding solution directly into the client’s eClinicalWorks environment, hosted within AWS GovCloud (FedRAMP High) — ensuring full HIPAA compliance and alignment with NIST 800-171 controls. (Hathr.AI emphasizes this in its security docs: “hosted entirely on a FedRAMP High GovCloud … HIPAA & GDPR Compliant” Hathr AI.)

The deployment leveraged Hathr.AI’s autonomous medical coding platform, built on large language models fine-tuned for healthcare, along with OCR pipelines for scanned content. The system was configured to:

• Extract structured and unstructured data from clinical notes using natural language processing medical coding techniques.
• Apply OCR HIPAA AI guidance to scanned documents, ensuring PHI is processed in a zero-retention, secure environment.
• Automatically assign CPT, ICD-10, and HCPCS codes with contextual accuracy — enabling auto medical code assignment and medical billing automation.
• Integrate with the provider’s RCM automation software flow to continuously feed coded records into the claims path.
• Flag edge cases or ambiguous contexts for human review — thus enabling a human-in-the-loop safety net.

As part of Hathr.AI’s platform, we also made use of our HIPAA Compliant AI API to power internal integrations and ensure secure, private model inference endpoints. (You can see Hathr’s description of that offering here: HIPAA Compliant AI API Hathr AI.)

In addition, Hathr offers HIPAA Compliant AI Tools for Summarization, which helps with chart summarization and contextual extraction — a useful component in validating and cross-checking code suggestions. (Reference: HIPAA Compliant AI for Summarization Hathr AI.)

Because Hathr.AI was built from the ground up for regulated data environments, we were able to preserve zero data retention (no PHI stored). Hathr’s public site makes it clear: “we never reuse your data” and we maintain a zero-retention policy by default. Hathr AI+2Hathr AI+2

This resulted in a fully automated medical coding pipeline — eliminating manual data entry and cross-checking — all within a HIPAA-compliant AI medical coding environment.

The Results: Zero Errors and $200K in Annual Savings

Within 60 days, Hathr.AI’s medical coding software processed thousands of patient records streaming from the eClinicalWorks system — with zero coding errors reported. The accuracy rate exceeded 99.9%, well above internal benchmarks and industry norms.

Some of the quantified outcomes:

MetricBefore Hathr.AIAfter Hathr.AIAverage coding turnaround time72 hours< 4 hoursCoding backlog3,000+ charts0Coding accuracy~92%99.9%Manual FTE cost~$200,000/yearEffectively eliminatedClaim denial rate~8%< 1%

With coding fully automated, the organization reallocated staff to higher-value roles such as utilization review, auditing, and payer negotiation. Their first-pass acceptance of medical claims improved dramatically. Revenue cycle metrics, cash flow, and visibility into coding throughput all improved.

Moreover, Hathr’s internal deployment allowed for real-time dashboards and auditing capabilities, ensuring compliance oversight at every step.

The Broader Impact: Speed, Accuracy, and Compliance at Scale

The implications of AI medical coding extend far across healthcare. In many billing organizations, coders spend 10–15 hours per week on manual review, lookup, and cross-checking. A midsize operation can easily expend 1,000+ labor hours per month on low-value tasks.

By using autonomous medical coding, providers can:

• Reduce coding errors in healthcare by over 90%
• Improve first-pass acceptance of medical claims across payers
• Speed up medical coding and accelerate revenue cycle timelines
• Eliminate reliance on contract coders or offshore labor
• Strengthen compliance with HIPAA, HITECH, and payer audit standards

No other medical coding software in the market offers the combination of automation, privacy, and contextual intelligence within a FedRAMP-High / HIPAA environment.

Hathr’s homepage underscores this: “Hathr AI is the only AI software … Hosted entirely on a FedRAMP High GovCloud … HIPAA & GDPR compliant.” Hathr AI

Also, Hathr’s “Healthcare” page describes how their HIPAA-compliant LLM helps automate clinical and administrative tasks: “Translate notes to billable codes … be >10x productive.” Hathr AI

Why Hathr.AI Stands Apart

Unlike generic AI tools, Hathr.AI was built from day one for regulated data environments. It is not just a ChatGPT wrapper — it’s an AI platform designed specifically for healthcare compliance, EHR integration, and secure operations.

Key differentiators:

• GovCloud Hosting — fully hosted in AWS GovCloud with FedRAMP High accreditation
• Zero Data Retention — PHI is never stored or reused
• BAA / Legal Protections — Hathr signs Business Associate Agreements on request
• NIST 800-171 Alignment — continuous adherence to federal security frameworks
• Fine-tuned Models — optimized for Medicare risk adjustment coding automation, CPT/ICD assignments, and clinical context
• Secure API Integration — firms can embed Hathr’s inference endpoints via the HIPAA Compliant AI API link above
• Document summarization & contextual tools — via Hathr’s summarization modules (see link above)

These capabilities give healthcare organizations confidence that automation can be both powerful and private — a combination that other tools lack.

Looking Ahead: The Future of AI in Medical Coding

This eClinicalWorks coding automation success story is evidence of what the future holds — AI will not replace professionals, but amplify them. With the grunt work automated, coders and revenue cycle leaders can reclaim their time for high-impact tasks: audits, exception handling, analytics, and care-level strategy.

As payer rules evolve, reimbursement models shift, and compliance demands tighten, AI-enabled medical coding software that is HIPAA compliant and enterprise-grade will become a necessity — not just an advantage.

Hathr.AI’s platform — now battle-tested with zero-error performance and rapid ROI — offers healthcare leaders a secure, scalable, and compliant path forward.

If you’d like to explore how Hathr can integrate with your EHR environment, reach out to contact the team here at Click Here to contact the Team at Hathr AI.

‍