Ever felt like you’ve climbed the highest mountains, run through the fields, crawled, and scaled city walls—but you still haven’t found what you’re looking for?
Well, AI might not be able to help Bono, but if you’re a behavioral health compliance professional who’s responsible for finding—and correcting—noncompliant provider documentation, we’re betting Eleos’ newly launched Compliance product can completely reshape the way you work.
During our Winter 2025 Launch Event, Eleos CEO Alon Joffe teamed up with Rony Gadiwalla, CIO of GRAND Mental Health, and Tom Morgan, CIO of Merakey, to chat about the transformative power of Eleos’ latest product innovation: Eleos Compliance. This AI-powered note quality tool empowers Clinical Documentation Improvement (CDI) and Continuous Quality Improvement (CQI) teams to scan 100% of notes for six of the most common compliance red flags on a continuous basis—enabling them to quickly hone in on high-risk areas and refocus time on staff education and training to remediate issues.
As early adopters of Eleos Compliance, the teams at both GRAND and Merakey have already seen the almost unbelievable impact of this revolutionary AI use case—in some cases, moving them to tears. (Yes, really! 🥲)
Read on for a deeper dive into the Eleos Compliance product and the results shared by Gadiwalla and Morgan during the live event.
Missed the launch event or want to re-live the magic? Watch the full recording here.
The “old” way of monitoring note compliance is inefficient and ineffective.
Prior to discovering Eleos’ AI-powered compliance monitoring, Merakey’s compliance team conducted retrospective documentation audits on a quarterly basis. They typically reviewed 5–10% of notes, mainly via random sampling. The process was mostly manual, though they did leverage some built-in EHR tools. Results were tracked in spreadsheets.
Similarly, GRAND Mental Health previously aimed to review about 10% of notes, with manual reviews divided among four full-time internal auditors. However, due to the organization’s rapid growth, this team was only able to successfully review about 5% of notes. “We’re up to around 2,400 employees now, and one of our biggest challenges as we grow is scalability,” Gadiwalla explained. “As you grow, you need more processes in place that are automated.”
The Limitations of Random Note Sampling and Manual Review
This labor-intensive auditing process required compliance teams at both organizations to spend the vast majority of their time conducting manual note reviews—rather than actually addressing documentation issues at the individual or organizational level. “It did not allow us to focus on the high-risk charts,” Gadiwalla said. “And we were looking at a feedback loop of around 6 months. Talking to a clinician 6 months after they wrote the note—that’s not very useful.”
Even worse: A lot of that manual review time was essentially wasted, because many of the randomly selected notes were already compliant. Meanwhile, the truly problematic notes were still out there, lurking in the 95% of documentation that was never seen by a reviewer. Their compliance teams were putting in a massive amount of time and effort—with very little impact to the organization’s overall risk level or care quality.
When compliance teams spend most of their time reviewing notes, they can’t focus on taking action for improvement.
And even when issues are identified, the sheer amount of time it takes to deliver the feedback and correct problematic documentation habits largely renders the whole process ineffective—especially in light of high turnover rates. Meanwhile, new providers—many of them inexperienced in documentation best practices—are constantly coming in, adding more and more risky notes to the pool.
The bottom line: It’s nearly impossible for traditional compliance teams to stay above water using this process—let alone make any measurable headway in improving note quality. “Trying to actually modify clinician behavior is really hard when the feedback loop is so disconnected,” Morgan said.
Lack of Relevant and Timely Feedback
Due to the inherent lag of these manual processes, the average provider was only receiving feedback on their documentation once or twice a year. This also reduced the impact of the feedback, since most providers had trouble recalling the details of specific client cases months after the fact—making the guidance they received less relevant, contextual, and actionable.
Additionally, Morgan said the lapse between the clinician actually writing the note and having it flagged for compliance issues made the feedback feel more punitive—like the clinician was “getting in trouble” for something they did months ago. And the subjectivity that comes with a manual review process certainly doesn’t help matters, as it’s sometimes difficult to articulate exactly what about the note puts it at risk—and context can get lost in translation.
Compliance teams at Merakey and GRAND Mental Health are now reviewing 100% of notes in near real-time—thanks to the power of AI.
Now, instead of reviewing a random sample of 5–10% of notes each quarter, the compliance teams at GRAND Mental Health and Merakey are leveraging Eleos Compliance to automatically scan 100% of eligible notes every day—an increase of 20x.
“The immediate ROI is just our ability to audit every note, and that’s protecting us from paybacks and things of that nature,” Morgan said. “We are a large company with a lot of data moving around, and we do miss things at times—and so paybacks happen. Eleos Compliance allows us to get out in front of that, and that alone saves us a lot of dollars.”
Using AI models trained specifically to identify behavioral health documentation issues, Eleos Compliance instantly flags notes that demonstrate risk in one of six areas:
1. Note Cloning: The notes contain duplicate content or content that was copied-and-pasted from a previous note.
2. Empty Notes: The notes are empty or too short to meet payer and regulatory requirements.
3. Missing Interventions: The notes do not adequately account for interventions used during the session.
4. Missing Progress Mentions: The notes do not sufficiently describe the client’s progress in care.
5. Missing Action Plan: The notes do not include a plan of action for the client’s next session.
6. Lack of Golden Thread: The documentation does not connect services rendered to the client’s care plan.
Want to see real examples of progress notes that are compliant—and not compliant—in these six areas? Download our Compliant Progress Note Examples for Behavioral Health.
The speed of impact across both organizations has been nothing short of remarkable. “This tool is so revolutionary to staff,” Morgan said, adding that the compliance team at Merakey has embraced the technology with open arms. “This isn’t a burden to them. Most of the technology I’ve seen in my career, I think people would tell you it’s a burden.”
He joked that many tech implementations cause tears of frustration—but with Eleos Compliance, there were tears of joy. Most early users of the product said the dashboard was easy to use and work with—and they appreciated the ability to plug the tool into existing systems and workflows. “I actually had somebody call me up in tears, overjoyed by what this could do,” Morgan said, noting that this person is a quality leader who has been with the organization for 25 years.
Better Risk Visibility and Transparency
With instant visibility into the “who, what, and where” of documentation issues, compliance teams can redirect the bulk of their time to fixing those problems: digging into high-risk notes, identifying problematic habits, and addressing the root causes proactively. Leaders can also analyze trends and identify patterns across noncompliant notes—potentially informing training efforts at the team and organization level.
“The visibility we suddenly got from turning this on—we were starting to see data we had never seen before,” Gadiwalla shared. “The idea that we are going to audit 100% of our notes without increasing staff is a game changer—no one even thought this was possible.”
This visibility has unlocked new, innovative, and more holistic approaches to risk management. “Now we can think bigger and think about doing more with the people we have,” Gadiwalla continued. “Because now that you’re not spending time reviewing all those notes manually, you are taking that time to prioritize risks and dive deeper into the 5% of notes that are actually at risk.”
At Merakey, data visibility also created greater transparency for compliance leaders, clinical supervisors, and individual providers—which helped feedback on documentation issues feel less like a punishment and more like a professional growth opportunity. “Having this technology puts that feedback much closer to the front line,” Morgan said. “Nobody wants to get anybody in trouble—all we want to do is make our consumers better, safer, and healthier—and by putting this tool in front of our staff and giving them that visibility, I think it helps create some transparency around this process. It doesn’t feel so punitive then—everybody starts to see data in real time and can make those changes.”
Faster, More Targeted Feedback Loops
“There’s a saying in quality that you can’t improve what you don’t measure,” Gadiwalla said. Eleos Compliance enables teams to keep a consistent, up-to-date pulse on their compliance performance—which in turn empowers them to take swift and informed action for improvement.
Having this information at their fingertips in near real-time also helps leadership teams at both organizations better prioritize improvement efforts (e.g., adding urgency around interventions for higher-risk programs, supervisors, or staff members).
At GRAND, this has reduced that 6–12 month provider feedback cycle to, in some cases, a single day—a 180x improvement. Instead of waiting months to receive any kind of communication about the quality of their notes, the highest-risk providers receive feedback on a monthly basis—regardless of which facility they’re located in. This is a major value-add for a large organization like GRAND, which divides compliance resources among 13 counties across the state of Oklahoma.
Fewer Downstream Claim Issues to Chase and Correct
This not only makes feedback more timely and contextual, but also helps prevent costly downstream problems like denials and clawbacks. “The further downstream you catch a problem, the harder and more expensive it is to correct it,” Gadiwalla said.
At Merakey, this new data analysis also gives the organization a concrete way to demonstrate their auditing capabilities to accreditors—and puts them in a much better position to acquire additional organizations, as they have an effective way to prevent company growth from undercutting documentation quality and rigorous care standards.
Results with Eleos Compliance at Merakey and GRAND Mental Health
| Before Eleos Compliance | After Eleos Compliance |
| Manually reviewed 5–10% of notes | Instantly review 100% of notes (20x increase) |
| 95% of notes not reviewed for risk | 0% of notes* left out of risk review |
| At-risk providers received compliance feedback within 6–12 months | At-risk providers receive compliance feedback in near real-time (180x improvement) |
*Notes that are eligible for review with Eleos Compliance
AI is a force multiplier for internal compliance teams—completely revolutionizing the way they work.
Rather than seeing AI as a replacement for their skills and expertise, compliance staff at Merakey and GRAND Mental Health have embraced it as a way to completely transform the nature of their work—and exponentially increase their impact to the organization.
Fostering Two-Way Learning Conversations
At GRAND, for example, compliance teams have shifted from working in a “back office” chart review capacity to taking a more active role in provider education—even traveling to onsite training sessions with their learning and development colleagues to share what they are uncovering in a face-to-face setting. This opens the door to a more interactive feedback process, where auditors can have a two-way conversation with the providers writing the notes—versus before, when staff would receive one-way communication about documentation issues without having the opportunity to dig into the “why.”
Supporting Value-Based Care
Furthermore, by tracking compliance improvement and performance over time, GRAND can compile deep, objective data demonstrating the quality of their services and the documentation supporting those services—which is crucial in light of the shift to a value-based care environment.
“The more visibility we get, the more ways we can document our progress—and that allows us to justify to payers how efficient we are getting over time,” Gadiwalla said.
On the flipside, by gaining visibility into which notes aren’t following the golden thread, for example, leaders and supervisors have a leading indicator of which providers might not be meeting standards for care quality—and can intervene accordingly.
This capability is particularly important in the case of government-backed funding opportunities, including those associated with GRAND’s designation as a Certified Community Behavioral Health Clinic (CCBHC). “We are responsible to be good stewards of the funding we get from the state and the feds, and this data gives us the confidence that we would be able to prove our case,” Gadiwalla explained.
Filling Gaps in Care Access
Also in that vein, Morgan alluded to the efficiency benefits of AI tools like Eleos Compliance—supporting Merakey’s effort to continually deliver better care to more people at a lower cost.
“We just have to learn how to do more with less,” he said. “The amount of people needing services is not changing—in fact, that’s going up. Demand is going up—and our ability to get paid is going down with the resources available. How do you fill that gap? Technology and AI is one way to fill that gap.”
Morgan believes that while AI will never replace human providers—or community behavioral health organizations—those who learn how to leverage it effectively will replace those who don’t. Using it to streamline and enhance administrative work is just the beginning; where Morgan really sees the opportunity for AI to shine is in its capacity for large-scale data processing.
“We’re all sitting on treasure troves of data, and we don’t always know how to mine that data, how to look at that data, how to analyze that data to really show the world how much our work matters to the healthcare of this country,” he said. “We haven’t figured out how to harness the data. Dashboards are great, reports are great, but that’s going to be the power of AI—to get in and tell us things about our data we didn’t even know about.”
AI-driven compliance review is just the beginning of what is possible with this technology.
While the teams at GRAND Mental Health and Merakey are already excited about the impact they’ve seen with both Eleos Documentation and Eleos Compliance, Gadiwalla and Morgan know that they’ve only scratched the surface of what is possible with AI. They foresee a future where augmented intelligence is integrated into every step of the care process—driving more accessible, efficient, impactful behavioral healthcare across the entire spectrum of services.
And here at Eleos, that vision for the future is at the heart of every product, tool, and feature on our roadmap. As Joffe said at the end of the event, “There’s a lot of people out there who need our help, and it’s our job to do the best we can to help them.”
Want to see how our purpose-built AI platform can transform documentation and compliance in your behavioral health org? Request a demo of Eleos today.
