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athenaCollector Review

Adam Uzialko
Adam Uzialko
Freelance Editor

A key part of the medical billing process is reducing claims rejections and denials by implementing a thorough claims scrubbing process prior to submission. AthenaCollector does this by employing a rules engine that leverages the company's nationwide network of providers to catch errors and flag them before they are replicated by other practices around the country. Additionally, human medical billers review and revise claims, adding another layer of quality assurance to the process. AthenaCollector does not include claims generation and coding services, however, leaving that responsibility to the individual practices. Athenahealth generally works with large practices, though the company does have many clients in the small practice space of one to 10 providers.



The Verdict

AthenaCollector, athenahealth's practice management software and medical billing service, boasts a high first-pass claims rate, driven by its regularly updated rules engine that analyzes billing errors across its nationwide network of providers.

View all our recommendations for medical billing services on our best picks page.

Medical Billing Process

Unlike most of the other medical billing services in our review, athenaCollector does not manage charge entry or coding. Its billing process begins with taking claims that your practice has already generated and scrubbing them for errors. The company uses a rules engine to scrub claims, which is continuously updated based on the experiences of the nearly 7,000 practices in the athenahealth network.

For example, if a dermatologist in Ohio has a claim rejected for an error that is not already in the system, the rules engine will update so dermatologists' claims nationwide are scrubbed for that same error in the future. Practices can also create custom rules on the system if they are aware of payer preferences that are not already reflected within the rules engine.

Once athenaCollector scrubs a claim, it submits it through a clearinghouse or directly to the appropriate payer. Less than half of its claims are submitted through a clearinghouse; any fees incurred are not charged to your practice but instead built into the percentage of collections the company charges for its managed billing services. The remainder of claims are submitted directly to a payer.

AthenaCollector monitors all the claims it has submitted to ensure they are paid in a timely manner, and the company will follow up on unpaid claims.

athenaCollector has a denial management process in place that covers most rejected claims. There are some types of claims that the company doesn't revise and resubmit, however, making those claims the responsibility of the practice.

Athenahealth's organization-wide first-pass claims rate for electronic claims is an impressive 99%. Electronic claims make up about 93% of all claims submitted by the company. At the time of this review, we were unable to obtain information on the remaining 7% of manually submitted claims.

AthenaCollector Pricing

AthenaCollector, like the other medical billing services in our review, charges a percentage of the net collections it secures for your practice. Unfortunately, athenahealth was unwilling to disclose the range of pricing for a typical client, instead pointing out the factors that influence cost. It is the only medical billing service for which we were unable to obtain a ballpark pricing range.

These are some of the criteria athenahealth uses to determine pricing for its medical billing services:

  • Practice size: The number of providers in a practice generally influences the price. More providers typically means more claims as well as more complexity, so how much it pushes pricing up or down remains a case-by-case factor.

  • Practice specialty and billing complexity: Every specialty is unique when it comes to billing; some are straightforward, while others require more time and attention. More intricate specialties will naturally cost more than simpler ones.

  • Claims volume: Your volume of claims can also impact the overall cost of athenahealth's medical billing service. A large volume of claims will likely be charged less than a small volume, because the company charges by percentage of net collections.

  • Value of claims: The overall value of the claims your practice submits can affect the price. If you submit a lot of high-value claims, you can expect to pay a lower percentage. If you only submit a handful of low-value claims, your percentage cost will likely be higher.

AthenaCollector is the only medical billing service in our reviews that has no contract requirements and builds a clause into its contract that allows you to back out of the service at any time.

AthenaCollector Pros

Included in the percentage price athenahealth charges for medical billing is full access to its healthcare IT suite, including its electronic medical records software (athenaClinicals) and its practice management platform (also athenaCollector).

AthenaClinicals has a relatively easy-to-navigate, modern user interface that neatly organizes your practice's clinical tasks and patient documentation. You can customize the central dashboard to best support your practice's workflows, and there's a patient portal to keep patients engaged in their healthcare around the clock. To learn more about athenaClinicals, see our full review of the EMR software here.

AthenaCollector functions as both a practice management system and a medical billing application. You can use it to schedule appointments and verify patient insurance eligibility. The software also includes a reporting system that allows you to monitor the progress of athenahealth's billing teams. The robust reporting library includes all the data contained in the EMR and practice management software, which is automatically pulled into pre-generated reports on the software dashboard. These reports can be scheduled for regular delivery or pulled on demand. You can also use athenahealth's custom reporting tool to create your own reports and format them to your liking.

AthenaCollector Cons

AthenaCollector does not manage charge entry and coding, meaning your practice is still responsible for handling those operations in-house or for outsourcing that portion of the billing process to a third party. Most of the other billing services we reviewed do offer charge entry or coding, which are critical elements of the billing process.

In addition, athenaCollector only performs denial management on most claim types. Some claims will be referred back to your practice for denial management, though it was unclear at the time of this review's writing which types of rejected claims athenaCollector will not revise and resubmit. That could be a problem for practices looking to outsource their entire billing department, because if the appropriate in-house staff is not on hand to manage these denials, those claims may not be paid.

Finally, athenahealth was unwilling to provide a ballpark price estimate for its medical billing services. While medical billing service pricing fluctuates depending on the specifics of each practice, other medical billing services were able to give us an estimated range of what they charge their typical clients. Athenahealth opted instead to only explain the factors that go into determining its pricing, which can be viewed above.

AthenaCollector Support

You can reach an athenahealth support representative by phone or email. The company also provides multiple online resources, including FAQs and videos. As a client, you get access to an account management team that will contact you regularly to discuss ways to improve your practice's financial efficiency. However, there is no live chat support available for immediate answers to your questions.

This medical billing solution works with you directly. Before you agree to use the service, representatives will fly to your medical office to discuss your options face to face. They are also willing to come back if you need additional guidance. If they feel that athenaCollector cannot meet the needs of your practice, they will let you know without wasting any more of your time. This personal communication and honest evaluation is a valuable service that you will not find in every medical billing company.

Image Credit: Lisa S. / Shutterstock


The Verdict

AthenaCollector, athenahealth's practice management software and medical billing service, boasts a high first-pass claims rate, driven by its regularly updated rules engine that analyzes billing errors across its nationwide network of providers.

Adam Uzialko
Adam Uzialko
business.com Staff
Adam Uzialko is a writer and editor at business.com and Business News Daily. He has 7 years of professional experience with a focus on small businesses and startups. He has covered topics including digital marketing, SEO, business communications, and public policy. He has also written about emerging technologies and their intersection with business, including artificial intelligence, the Internet of Things, and blockchain.