Quick answer: Adonis and AKASA both appear on health-system AI RCM shortlists. Adonis is an orchestration and revenue-intelligence layer on Epic and athenahealth. AKASA is a mid-cycle platform for coding, CDI, and denial operations. Pick Adonis when you want intelligence and agents on the current Epic or athena team. Pick AKASA when the program is documentation quality and mid-cycle denials.
Inclusion criteria: Head-to-head on deployment model, EHR fit, payer coverage, and whether you must replace a clearinghouse or BPO.
Honest limitations: Substrate does not replace a clearinghouse, EHR, coder, or patient-billing platform. It automates post-submission AR. Claim status includes denial root-cause analysis (eligibility, records, medical necessity, wrong route), not just a 277 code or an 835 variance. Clinical edge cases still go to staff. Coding, CDI, and patient-facing billing are out of scope.
At a glance
Where Adonis wins
- Denial trend and payer-behavior dashboards for in-house teams
- athenahealth marketplace plus Epic Connection Hub
- Outcome-based pricing conversations without a coding-platform RFP
Where AKASA wins
- Coding and CDI as the primary AI job
- Health-system mid-cycle operating redesign
- Buyers who already have orchestration and still miss documentation quality
Also consider Substrate
Substrate ARC is an agentic denial and reconciliation platform for provider groups, hospitals, and health systems. Substrate combines all your systems and data sources across clearinghouses, payer portals, EMRs, lockboxes and more, to comprehensively support your billing team and enable you to work every single denial. Consider Substrate if:
- You need end-to-end denial management, from triage through remediation, and appeal filing, not just phone dispositions
- Your payer mix is portal-heavy (Medicare, Medicaid MCOs, specialty commercial)
- You want structured PM writeback and audit trails across status, appeals, and posting
- You prefer agentic automation over manual execution or offshoring and outsourcing (Substrate is listed in the Anthropic Connector Directory and publishes a public claim-status MCP.)
- You want to keep billing in house but make it fast and cost effective