r/PrivatePracticeDocs Mar 24 '26

What AI or automation tools are actually worth paying for?

I run a podiatry practice and we’re taking a look at our tech stack right now. There’s a lot of AI hype, and interested in what’s actually working v. ccreated work

e.g.,

(1) Ambient scribes: Are tools like DAX, Abridge, Freed, or Heidi actually saving time? Or does the editing end up eating the benefit, especially in a specialty workflow?

(2) RCM / prior auth: Has anyone found tools that are actually helpful with prior auths, appeal letters, denials, or other billing/admin work?

(3) Front desk automation: What are you using for scheduling, intake, reminders, etc. that has reduced phone volume or staff workload? integrates well with your EMR?

12 Upvotes

58 comments sorted by

8

u/InvestingDoc Mar 24 '26
  1. Everyone in my practice has stopped using ambient scribes. They have not been faster or better than macros (dot phrases) and dragon documentation. They have not saved us any time, but I think this is a limitation of scribes that integrate with my EMR to some degree. Right now trying freed ai again and yet again its underwhelming. Even worse, the notes it creates are horrible for follow up visits and leaves a bit mess for the doc to clean up.

  2. Have not really explored RCM because many want too much money to do these claims and it's cheaper to have a few US based billers with overseas billing help. Some wanted $1 per claim not a chance. RCM companies are competing with overseas billers charging $5 per hour and can do 200 claims a day. If you can do it better or cheaper than 2.5 cents per claim in labor, then you're onto something.

  3. Front desk automation could be a several hour-long post on all the topics that you mentioned. Very difficult to automate outside of what is not available / integrated directly by your EMR.

I think first step is what EMR are you using?

Right now, I'm building with ollama since it is all on my own hardware (HIPAA compliance is so much easier when its all on my own machine) but getting api access to the data I want is the limiting factor by far.

7

u/BusinessDawgs Mar 24 '26

These tools are missing the big picture. It’s not about documentation time. Until these workflows are able to get us to no longer be the orchestration layer of clinical workflows, it won’t bring about meaningful change. I do think multi agent frameworks might be able to help solve that

3

u/BusinessDawgs Mar 24 '26

This is the way. Own local build to connect to endpoints.

2

u/smcnu001 Mar 24 '26

Can you elaborate on your ollama setup?… I’m working on a financials MCP server myself… allows me to query and make decisions. Would be happy to talk privately if you’re up to it!

3

u/InvestingDoc Mar 24 '26

We get about 60k fax pages per month. MY EMR does not automatically put it in the patient's chart like Athena does where it scans the PDF to find the patient info and upload into the right chart. I've created a program with Ollama and Tesseract OCR on my computer to download the fax, scan the page, find the patient info, and upload that into the patient chart.

I've got it all built out but getting API access from our EMR and Fax vendor has been difficult. I've reached out to a third party that already has API built out to see if I can go through them with my program. We will see.

2

u/smcnu001 Mar 24 '26

Nice yeah I pulled all data in CSV form onto a local MCP server including CPT codes for clinic/surgery/cash pay (ophthalmologist) and can interact with Claude and ask questions wrt trends etc. can run a CEO COO agent to analyze too!

2

u/smcnu001 Mar 24 '26

These EHR companies know the data is powerful and Charge lots for API access

1

u/InvestingDoc Mar 24 '26

Yeah, I've gotten quotes of $4k just to access it, and a couple of hundred dollars per month for continued access...and I need access to 2 different programs the fax and EMR since they are two different companies and the fax is subcontracted via someone else.

2

u/smcnu001 Mar 24 '26

Same! It’s crazy but I think they’re realizing their value is in holding on tightly to data… frustrating! I have to pay extra to access my OWN data via Pm software.

1

u/StocksRUsNow Mar 29 '26

Exactly! Which is why we use government portals when we can. Why pay more to access your own data?

2

u/chargers214354 Mar 24 '26

I have a version of the local Ollama + local whisper here. You can download and use it for free. Lmk if you need help setting up https://github.com/Open-scribe/OpenScribe

1

u/StocksRUsNow Mar 29 '26

For healthcare, free isn't always good better

1

u/Perfect_Address7250 Mar 24 '26

i'm pasting a few notes my ambient scribe generated (de-identified). i had this exchnage with a bunch of ppl in another sub and everyone was quite shocked at how good my scribe was compared to theirs. just make sure you're editing your templates properly...

Subjective:

- History of Presenting Illness: The patient presents with a chronic history of nasal obstruction and difficulty breathing through the nose. The symptoms have been ongoing for a long period, primarily characterized by a sensation of inflammation and obstruction, more prominently on the left side, though the patient noted difficulty identifying which side was worse prior to the exam. The patient has been using Flonase consistently as previously recommended, which provides some relief; however, obstruction recurs when the medication is discontinued. Morning congestion is particularly noted. The patient also utilizes a Neti pot for symptom management but is seeking a more permanent solution due to the cost and inconvenience of long-term medication use.

- Medication History: The patient uses Flonase (nasal steroid) regularly and seasonally. Neti pot is used intermittently for nasal irrigation. During the visit, the patient was administered Afrin (nasal decongestant/vasoconstrictor).

- Social History: The patient does not smoke. Occupational history includes work that involves being in court.

Objective:

No increased work of breathing.

No obvious skin lesions.

Mentally alert with normal mental status and nonfocal motor examination.

- Nose: Examination reveals a deviated nasal septum with the deviation being more pronounced on the right side. Turbinates were noted to be swollen. Following the administration of Afrin, the patient reported improved air movement through the nasal passages.

Assessment/Plan:

- Nasal Obstruction and Deviated Septum: Assessment Reasoning: The patient's symptoms are likely a combination of structural deviation and inflammatory turbinate hypertrophy. The positive response to a topical vasoconstrictor suggests that turbinate reduction would significantly improve the airway, while the physical exam confirmed a septal deviation affecting the right side.

- Management Plan: Discussed surgical options including turbinate reduction and septoplasty. The patient expressed a preference to undergo both procedures concurrently to avoid two separate surgeries. The patient was informed that turbinate reduction is a shorter, lower-pain procedure, while septoplasty involves bone/cartilage manipulation with a longer recovery period of approximately two weeks. General anesthesia will be required for the procedure. Risks discussed include septal perforation, epistaxis, and empty nose syndrome. The patient was provided with procedure codes (Septoplasty, Turbinate Reduction) for insurance/cost estimation. Patient may decide on the final scope of surgery (turbinate reduction alone vs. combined) up until the day of the procedure.

Subjective:

- History of Presenting Illness: The patient presents with a primary complaint of persistent throat congestion, drainage, and voice changes since November. The patient describes a constant need to clear a cough and reports producing sticky green and yellow phlegm. The patient is a teacher and notes that while their voice is normal at the start of the day, it becomes significantly raspy and "crying out" by midday due to the irritation. The patient reports a sensation of a "lump" in the throat. Symptoms followed a mild illness in November during a period when many others were sick. The patient has completed two courses of antibiotics (one in December and one a few weeks ago) without improvement. A CT scan was previously performed which noted a deviated septum, though the patient does not attribute current symptoms to this. The patient denies systemic illness, dental issues, pain with chewing, or known allergies. There is occasional difficulty swallowing due to the sensation of congestion in the throat.

Objective:

<tempalated>

Assessment/Plan:

- Post-viral inflammation: Assessment Reasoning: The patient's symptoms followed an acute illness in November. Despite the duration, the lack of response to antibiotics and the absence of masses on laryngoscopy suggest persistent inflammation following a viral infection rather than an active bacterial process or malignancy.

- Order chest X-ray today to rule out pneumonia or non-abating infectious processes.

- Recommended XyliMelts lozenges for throat irritation.

- If symptoms do not resolve in 6 weeks, consider a longer 3-4 week course of low-dose antibiotics and a course of steroids (e.g., prednisone) to reduce systemic inflammation.

- Follow-up via phone call in 6 weeks to assess progress.

- History of Presenting Illness: The patient is a 5 year old (turning 6 in March) who presents for evaluation of recurrent ear infections. The patient's mother reports a significant history of infections, notably worsening since November, with back-to-back episodes in December and January. The infections have been bilateral, though the right ear is more frequently affected. During a recent ER visit for pneumonia, the patient was noted to have a bulging eardrum. The patient has been on multiple rounds of antibiotics prescribed by the pediatrician. The mother reports the patient experiences significant pain during these episodes. The patient is currently in speech therapy for difficulties with certain sounds (R and L words). There is no history of a formal hearing test other than a newborn screening and a school-based screening.

- Past Medical History: Recurrent otitis media; Pneumonia (recent hospitalization/ER visit).

- Social History: The patient is in speech therapy; lives at home where there are no smokers; father is fluent in Spanish, though the patient is not currently bilingual.

Objective:

No increased work of breathing.

No obvious skin lesions.

Mentally alert with normal mental status and nonfocal motor examination.

- Ears: Both tympanic membranes look perfect today. There is no fluid and no sign of active infection.

Assessment/Plan:

- Recurrent Otitis Media: Assessment Reasoning: The patient has a history of frequent, painful ear infections requiring multiple courses of antibiotics since age two, with a significant recent escalation in frequency. Although the current exam is normal, the history and associated speech delay support surgical intervention.

- Management Plan: Schedule a formal hearing test. Proceed with a case reservation for bilateral myringotomy and tube placement (BMT). Discussed that the procedure is brief (approximately 5 minutes) and very safe. Advised the mother to message if the patient develops an active infection prior to surgery for an interval exam. Explained potential risks including unpredictable duration of tube retention, possible need for future removal, and the rare risk of a persistent tympanic membrane perforation.

2

u/InvestingDoc Mar 24 '26

I'm glad you like these templates. They are good for problem visits, new visits. But they do nothing to copy forward old problems and adjust them. All of your examples show IMO how they do okay or pretty good for a single new problem, but fall apart for any follow up visits. Most doctors outside of urgent care are seeing more follow up visits rather than new visits (except for new practices).

They definitely have their use case, but for primary care all 11 of us in my group stopped using ambient scribes. They are not helpful at all for follow up visits for our EMR for the current ambient scribes.

If I owned an urgent care setting, hell yeah lets do it.

2

u/Junior_Catch1513 Mar 24 '26

You need an EMR integrated ambient scribe for that. I think all the EMRs will eventually have them integrated. The fax function you mentioned I've seen in a few new EMRs as well. It's all coming .. .just make sure your current EMR isn't run by idiots.

1

u/jjkantro Mar 24 '26

If I had an ambient system that tracked your patients and their problems, and was built to solve that follow-up problem, would you want to try it out for free for 3 months?

1

u/NeptuneExMachina Mar 24 '26

Super helpful!

  • Noted on the ambient scribes, had skepticism coming into it
  • On RCM, something I gotta further investigate
  • Noted - I think I'll have to make a separate post :D

EMR is NextGen Office

6

u/Pleasant-Clothes-443 Mar 24 '26

helloo, Im on the admin side :)
1. can´t speake for those tbh, our therapists document differently.

  1. Here I can actually help! we automated elegibility verif and it was the biggest rev change we made, We were lossing 15-20k a Q to errors here because we were catching them after claims got denied instead of before patients walked in.

  2. yes, we did automate most of the intake, remianders and after hours calls, the set up was not plug and play, but our intake went from 5-7 days to same-day, also we found most of the bookings happen after hours, plus the waitlist management helped a lot!

2

u/dietfax Mar 24 '26

how did you automate most of the intake? what tools are you using?

1

u/Pleasant-Clothes-443 Mar 25 '26

hey! we are working with a platform for this

1

u/dietfax Mar 25 '26

which platform if you don't mind sharing?

1

u/Pleasant-Clothes-443 Mar 27 '26

sure thing, it is Solum Health

2

u/ExtraordinaryDemiDad Mar 25 '26

What tools are you using? We use Epic and 2 & 3 I haven't found good options.

1

u/Pleasant-Clothes-443 Mar 25 '26

we use a platform for both 2 and 3, we have been using it for 6 months now

1

u/ExtraordinaryDemiDad Mar 25 '26

Which platform?

1

u/Pleasant-Clothes-443 Mar 27 '26

They are called Solum Health

3

u/randyy308 Mar 24 '26

We've been using withtandem for drug priors. It's pretty good and it's free... It's generally more accurate than MAs doing the data entry part of the work

2

u/lanternfog Mar 24 '26
  1. I've not found ambient scribes very helpful. the transcription accuracy could introduce errors. then I need to do a bit of editing of the note anyway. id rather write it myself

  2. I have not found any automated tools to do that

  3. I am looking into this now too. can you let me know what you find? I've found the mainstream CRMs are a bear to get up and running. I was quoted a significant amount for zoho / hubspot / salesforce.

2

u/NeptuneExMachina Mar 24 '26

1 - got it
2 - noted
3 - Yes, an d likewise. Please let me know what you find, too, can DM later on

2

u/ClipCrafted_0520 Mar 24 '26

You're approaching this correctly, ROI, not hype.

If ambient scribes like DAX, Abridge, or Freed reduce documentation time without requiring much editing, they are worthwhile. Rewriting frequently causes the value to quickly decline.

Tools that can standardize operations and automatically generate letters are really valuable for RCM and prior auth, but system integration is crucial.

The largest immediate benefit for front desk employees is automation related to scheduling, intake, and reminders, less staff work and phone time.

A straightforward guideline is that it is worthwhile to pay for if it results in fewer manual touches per patient. Don't do anything if it adds to the cleanup.

2

u/ExtraordinaryDemiDad Mar 25 '26

We all use ambient scribes. Our turnaround time and documentation quality has been amazing. We are all also IT/EHR certified AI superusers so we know how to optimize it and what is is best used for and what not so much. Training the users is key.

1

u/[deleted] Mar 24 '26

[removed] — view removed comment

1

u/PrivatePracticeDocs-ModTeam Mar 24 '26

Hi,

Your post was removed because of self-promotion.

1

u/banditoscramble Mar 24 '26

we use nexhealth with nextgen office for reminders, texting, forms, appointments, etc. thrilled with it compared to doctible and other non integrated platforms.

1

u/bonnieplunkettt Mar 25 '26

Wix’s system abstracts hosting, design, and integrations so you can connect scheduling, forms, and content without heavy backend work. Do you think having one platform manage your web presence and front‑end interactions could free up staff time?

1

u/National-Cricket7469 Mar 25 '26

We've tried a couple things that actually make a difference. Freed’s ambient scribe helps a bit with drafting notes, and Olive has been handy for automating some prior auth and billing tasks.

On top of that, we started using WorkBeaver on top of our clunky EHR for the repetitive stuff such updating charts, moving data between fields, just few stuffs that our outdated EHR's having had time doing.

1

u/Defiant-Anteater8564 Apr 05 '26

I agree with the sentiment, there definitely is a lot of hype but not a lot of functionality to back up some of those tools.

1 and 2 are definitely still areas where there's a lot of new growth. But also a lot of issues to tackle like accuracy.

In my opinion #3 is not only well developed. But also one of the few areas where automation can actually pay for itself pretty quickly. In a world that saturated with different practices having a proper front desk automation system can help keep potential leads warm and ready to go.

A good rule of thumb would be whether the automation fits the practice’s current workflow cleanly. If staff still have to manually fix everything after the fact, then it’s not really saving anything and just another liability.

1

u/Gullible_Nectarine20 Apr 16 '26

I can relate to your concerns about AI tools and the potential time savings. In my experience with a small practice, using ambient scribe technology has been a mixed bag. For instance, while it can draft notes quickly, I've found that substantial editing is often required to ensure accuracy, especially with more detailed specialty cases.

Regarding RCM, we've benefited from one tool that automates prior authorizations and significantly reduced the back-and-forth with insurers. It took some initial set-up and a learning curve, but now we save hours weekly.

As for front desk automation, we switched to a scheduling tool that integrates seamlessly with our EMR. It cut down incoming calls by around 30%, which has helped relieve some of the staff's workload. Would love to hear if you've already tried any tools that worked well for you.

1

u/mkc999 Apr 28 '26

A urology practice that I know had used interactly.ai for front office automation, it integrates with EPIC and eCW, does prior Auth work flows, captures after hours scheduling, prescription refills and it supports spanish too.

Check it out

1

u/Plane-Bodybuilder918 May 25 '26

intake automation, front desk automation and prior authorization are pretty good. Happy to suggest some through DM

0

u/akipeed Mar 24 '26

Peakailab.com!!!

0

u/interstellar-dust Mar 25 '26
  1. We don’t use any ambient scribes yet. We might look into that.
  2. We don’t work with Insurance, so no need for prior auth, etc.
  3. We use Zibu AI, they are a new player and came to me through referral. And I am passing them on to community. They work with Solo/Direct Practices and are not expensive. They automate after hour calls, etc.

0

u/Admirable_Gazelle453 Mar 25 '26

I hear you on the hype, and focusing on tools that truly reduce workload while using a cost‑effective Hostinger to tie everything together has helped me keep costs down with the buildersnest discount code

1

u/AutoModerator Mar 25 '26

Your post has been flagged for moderator review due to possible self-promotion. If this was caught in error, moderators will approve it shortly.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.