athenahealth: Optimizing Revenue Collection
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athenahealth: Optimizing Revenue Collection

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Bob Segert, Chairman & CEO, athenahealthBob Segert, Chairman & CEO, athenahealth The field of medicine has undergone widespread innovation, thanks to the rise of cutting edge digital technologies. The permeation of these technologies has led to swift physician intervention and care delivery. However, income streams of the organizations in the healthcare domain have remained narrow. With increasingly complex regulatory requirements, evolving market conditions, and growing operational overhead, participants in the healthcare industry are operating on a thin profit margin. Care providers must remain sufficiently profitable to keep their doors open and serve the communities. To generate and sustain profits, hospitals and medical centers are modernizing their revenue cycle management (RCM) systems. Enabled with analytics, the modern RCM systems streamline accounting and administration, which, in turn, improves the revenue cycle and puts care providers in a better position to collect payment for their services. Importantly, they act as the bridge between the finance and IT, enabling superior management of everyday hospital management procedures such as billing and accounts receivables.

One network-enabled service provider for hospital and ambulatory customers, athenahealth is revolutionizing healthcare payments and collections. athenahealth offers “athenaCollector,” a medical billing solution that empowers healthcare organizations to reduce revenue leakage and improve profit. It refines the front-end patient registration process and back-end billing, offering patients the chance to enrol for a suitable payment plan and gain insights into their eligibility for government-sponsored insurance programs. Besides the billing solution, athenahealth maintains a knowledge database that comprises information about payers, regulations, patient health conditions, and the best practices of successful physicians. The aggregate data gathered from more than 160,000 healthcare providers and 100 million patients enable athenahealth to have one of the most connected healthcare networks. The company injects the insights derived from the overall information into clients' workflow for smarter process execution and higher efficiency.

The robust dashboard built into athenaCollector allows physicians to focus more on patient care rather than on administrative tasks. The medical billing solution allows for better control and visibility of all required data through its comprehensive reporting functions. athenaCollector is cloud-based that makes it user-friendly and easily upgradable. It ensures clients are always up-to-date in terms of the solution and rules database at no additional costs.

A Medical Billing Solution with Guaranteed Profit

athenahealth understands all the challenges in the RCM landscape, and the need for hospitals to deploy digital solutions to mitigate all of their financial woes quickly. athenaCollector opens up avenues for new possibilities that can improve a client’s accounts receivables process.


Since its inception, athenahealth has remained dedicated to improving the RCM systems and assisting its clients in viewing billing information and collecting account receivables in real-time

It allows physicians and financial management teams at medical centers to identify patients that require assistance in setting up payment plans. Community hospitals equipped with this knowledge can make informed decisions on the methods to bill patients, and then arrange for payment collection based on the patient’s financial track record. For individuals with insurance, the solution can run an eligibility test that aids hospitals in pre-determining coverage and reducing billing liabilities.

Medical billing errors can cause considerable disruption in revenue streams. The integration of athenaCollector can help administrative staff and management accurately identify the issues and remediate the situation before it goes out of control. Besides, athenahealth employs its athenaNet Intelligence team—a team of data experts—to analyze any changes in insurance regulations. These experts implement the latest standards across athenahealth’s patented billing rules database to handle accounts receivables. This information hub is available to all clients through a cloud-based interface, and the feedback it generates helps medical practices reduce claims rejections from the insurers.

Additional RCM Enhancements

athenahealth offers solutions such as athenaClinicals, athenaCommunicator, and athenaCoordinator as part of its integrated cloud-based services suite “athenaOne.” These software solutions can be implemented together as one or individually to streamline RCM.

athenaClinicals empowers physicians to gain greater clinical insight and control. The cloud-based approach to EHR streamlines workflows, including patient visits, thereby, optimizing patient engagement and care coordination, and enhancing the payment opportunity.

Follow-ups on patient health are essential for a physician to assess conditions in real-time. To that end, athenahealth offers athenaCommunicator, a patient interaction and engagement service that allows seamless, real-time automated patient-physician connectivity that goes beyond the exam room. Front-office staff saves time from the burden of calling patients and scheduling meetings.

athenaCommunicator promotes healthcare in the community by decreasing the number of patients that do not return or discontinue treatment.

Medical practices must be in an optimal position to offer better community healthcare services that are beneficial to patients. athenahealth's “athenaCoordinator” is a perfect solution to address this issue. It allows healthcare institutions to transform the medical order process to improve the quality of service.

Since its inception, athenahealth has remained dedicated to improving the RCM systems and assisting its clients in viewing billing information and collecting account receivables in real-time. The firm turns millions of denials into payments and performs 324 million eligibility checks every year. In an instance, a community hospital riddled with many issues throughout its revenue cycle sought a solution to improve the entire RCM process in a cost-effective and timely manner. athenahealth was engaged to this end. An assessment by the team from athenahealth revealed that the client had claims files with incomplete information and a fragmented billing process that was overwhelming for its medical billing staff. In no time, athenaCollector was deployed, which led to the improved workflow for the client. The solution enhanced the client’s total cash flow substantially through faster payments, cleaner claims, and more efficient use of staff time.

RCM of the Future

athenahealth's tailored approach to RCM and the company’s experience in the healthcare RCM landscape separate it in the market. The solutions it offers always remain in sync with its client’s unique requirements. The delivery of modern, agile, and efficient medical technology services and solutions allow athenahealth to reduce healthcare costs for its clients.

"The robust dashboard built into athenaCollector allows physicians to focus more on patient care rather than on administrative tasks"

Besides aiding its clients to achieve financial success and happy customers, athenahealth is investing in “athenaGives,” a program through which it strives to improve the health of local communities and the uninsured across the US. Moving forward, athenahealth aims to be more committed than ever to invest in innovation, deliver superior customer experience, and remain steadfast on its mission to transform healthcare. Acquired by Veritas Capital and Evergreen Coast Capital recently, athenahealth will look to eradicate the use of paper at medical facilities by providing fully digital solutions.

- Alex D'Souza
    September 11, 2019

Company
athenahealth

Headquarters
Watertown, MA

Management
Bob Segert, Chairman & CEO

Description
athenahealth offers revenue cycle management services to the healthcare industry;...