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athenaCollector Review

Adam Uzialko
Adam Uzialko

Healthcare organizations are increasingly data-driven businesses that rely on thorough reporting and analysis to make their decisions. When it comes to medical billing, there's a lot to keep track of, so reporting prowess is crucial. Athenahealth not only enables exceptional reporting at the individual practice level, but also benchmarks them against similar organizations on its network. Using this data, athenahealth takes a consultative approach to medical billing services, proactively helping organizations optimize their billing processes. For this reason, athenahealth's medical billing service, athenaCollector, is our best pick for reporting.

athenaCollector

athenaCollector

The Verdict

AthenaCollector, athenahealth's billing service, shines in reporting and optimizing clients' processes. Using data from more than 160,000 healthcare organizations, it coaches clients to outperform benchmarks set by the network's highest performers.

athenahealth Editor's Score: 8.7/10

Pricing/value 7.5/10
EMR/PMS 9/10
RCM process 8/10
First-pass claims rate 9.7/10
Customer support 9.5/10

 

Editor's note: Looking for the right medical practice management solution for your business? Fill out the below questionnaire to have our vendor partners contact you about your needs.

 

Why athenahealth Is Best for Reporting

Athenahealth's Report Builder tool enables you to create custom reports from scratch across any module in the system, including the appointment calendar, EMR system and billing software. You can set up these reports with a series of clickable filters and tabs, which provide an intuitive way to zero in on the specific data a user wants to see. While this Report Builder tool is an above-average reporting feature even among the medical billing services we reviewed, it is only part of the reason we selected athenahealth as the best medical billing service for reporting.

Athenahealth makes visualizing data simple with crisp, color-coded graphs and charts.

Athenahealth doesn't just offer a wide range of customizable reports. It makes use of athenaNet, its network of more than 160,000 healthcare organizations, to contextualize the data that medical practices receive, juxtaposing their performance against the network's high performers. So, in addition to supporting fully customizable reports, athenahealth compares its client practices to the very best and then coaches them on how to get closer to that level of optimization.

Athenahealth offers a medical billing service and medical practice management software, called athenaCollector, that maintains a 99% first-pass claims rate for electronically submitted claims and leverages athenaNet's more than 160,000 member organizations.

If your practice drops too far below baseline performance, your dedicated athenahealth account manager will reach out to recommend corrective action. For example, if your cash flow is disrupted because your most important claims are spending more days in accounts receivables, athenahealth can pinpoint where the delay is occurring and help you get things moving again. This is a unique value-add that made athenahealth stand out in our review.

FYIFYI: The first-pass claims rate is around 95% for most billing services.

Athenahealth Pros

  • It leverages athenaNet to update billing rules engine in real time based on experiences of all clients, keeping pace with payer preferences and changes.

  • AthenaNet reports offer insight into other clients on the network, allowing you to compare your data to similar practices.

  • It takes a consultative approach to medical billing, relying on data from its highest-performing clients to help it coach underperforming clients.

Athenahealth Cons

  • It does not offer medical coding services, which means you must maintain a certified medical coder on staff.

  • The company would not disclose a typical cost range, only that it charges a percentage of monthly collections – which doesn't tell us much, because that's the standard pricing model for medical billing services.

  • Athenahealth does not manage denials for certain types of claims.

Athenahealth Medical Billing Process

Athenahealth does not manage medical coding services or charge entry, which means you will need to maintain medical coders on staff to begin the RCM process. Once your coded claims are entered into athenaCollector, the medical practice management software, athenahealth's billers will take over. From this point on, you can monitor the biller activity in real time. Athenahealth billers will review the charges and run them through the rules engine, which relies on data collected from the 160,000-plus healthcare organizations on athenaNet.

Charge entry can be reviewed in one location by date, patient, code, and more

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 be updated so that dermatologists' claims nationwide are scrubbed for that same error in the future. Practices can also create custom rules in the system if they are aware of payer preferences that are not already reflected within the rules engine.

Once athenahealth scrubs a claim, it will submit it through a clearinghouse or directly to the appropriate payer. Clearinghouse fees are built into the percentage of your monthly collections that it charges; some other medical billing services we examined charged this fee on top of the percentage of collections.

Athenahealth's denial management process 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 if they are rejected.

Athenahealth's first-pass rate for electronic claims is an impressive 99%, which is higher than most billing services we reviewed. It is worth noting that about 93% of all claims submitted by the company are electronic; the remaining 7% of claims are manually submitted and not included in that first-pass figure.

Collections can easily be reviewed in one place, with top line numbers emphasized to help track key performance indicators.

Bottom LineBottom Line: athenahealth offers an exceptional first-pass claims rate and a consultative approach to help improve your billing process based on insights from the most successful practices on athenaNet.

Athenahealth Pricing

Athenahealth, 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 provide the range of pricing for a typical client, instead pointing out the factors that influence the cost. It is the only medical billing service for which we were unable to obtain a ballpark pricing estimate.

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

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

  • Practice specialty and billing complexity: Every medical specialty has different billing needs; some are more straightforward, while others require more time and attention. More intricate specialties (such as mental health, which often requires additional authorizations from insurance providers) will naturally cost more than simpler ones.

  • Claims volume: The volume of claims can also impact the overall cost of athenahealth's medical billing service. A large volume of claims will likely be charged at a lower rate than a small volume.

  • Value of claims: Finally, 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. On the other hand, if you only submit a handful of lower-value claims, your percentage cost will likely be higher.

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

Athenahealth Software

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

AthenaClinicals features a relatively easy-to-navigate, modern user interface that neatly organizes a practice's clinical tasks and patient documentation. Practices can customize the central dashboard to best support their workflows, and there's a patient portal for keeping patients engaged in their healthcare around the clock.

AthenaCollector functions as a practice management system and a medical billing application. With it, you can schedule appointments and verify patients' insurance eligibility. The software also includes a reporting system that allows you to monitor the progress of athenahealth's billing teams. A robust reporting library includes all the data contained on 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 yourr liking.

To learn more, you can read our review of athenahealth's healthcare IT platform.

TipTip: Your healthcare IT platform and medical billing service must integrate seamlessly. Billers work within your medical practice management software, and full visibility into their process is essential for healthcare administrators.

Athenahealth Customer Support

You can reach an athenahealth support representative by phone or email. This service also provides multiple online resources, including FAQs and videos. You have access to an account management team that will contact you regularly to talk about 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 service 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 are valuable services that you will not find with every medical billing company.

Limitations

Athenahealth does not manage charge entry and coding, meaning practices are 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. For information on a medical billing service that offers coding, see our DrChrono review.

In addition, athenahealth only performs denial management on most claim types. Some claims will be referred back to the client practice for denial management, though it is unclear which types of rejected claims athenahealth 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 for its services. While the exact percentage a medical billing service charges depends on the specifics of each practice, other companies were able to provide an estimated range of the collections percentage they charge their typical clients. For example, our review of AdvancedMD includes an approximate range of its typical percentage fees. Athenahealth opted instead to only explain the factors that determine its pricing (which can be viewed above).

What Is a Medical Billing Service?

Medical billing services are outsourcing companies that maintain a staff of medical coders and billers. These companies manage various aspects of a healthcare organization's revenue cycle management (RCM), from coding claims and submitting them to payers to following up and managing rejected or denied claims. Generally, medical billing services work within a particular medical practice management software platform – in fact, many offer proprietary solutions or even require organizations to utilize them. Usually, medical billing services charge their client practices a percentage of their overall monthly collections, which means the more money the billing service helps the practice collect from its claims, the more money the billing service makes on that client.

Methodology

We spent hours researching and analyzing medical billing services, including athenahealth. Our research included software demonstrations, phone interviews and customer service calls. We also analyzed customer service reviews available on the internet, including on the Better Business Bureau website. To determine our best pick for reporting, we examined criteria such as specialty experience, company size, certified coding and billing staff, customizable reports, and dedicated account manager support and guidance. We chose athenahealth as the best medical biller for reporting because it met or exceeded our expectations in all these aspects.

Frequently Asked Questions

Will athenahealth perform medical coding?

No, athenahealth does not offer medical coding services. This means you cannot fully outsource your practice's RCM process to athenahealth and must keep a medical coder on staff or find a separate service to perform the coding. This is not necessary with all medical billing services. Kareo's medical billing partners, for example, include medical coding in their service. You can learn more in our Kareo review.

Does athenahealth employ certified medical billers and coders?

Yes, athenahealth maintains certified medical billers and coders on its staff. While the company does not perform coding, the certified coders can thoroughly scrub claims with the help of athenaNet's rules engine, which is updated in real time based on the experiences of every organization billing on the network. Athenahealth maintains a first-pass claims rate of 99% for electronic submissions.

Bottom Line

We recommend Athenahealth's medical billing service for …

  • Data-driven healthcare organizations that need dynamic reports and industry benchmarks.
  • Practices that want professional guidance on billing optimization.
  • Healthcare organizations with multiple locations or complex billing.

We don't recommend Athenahealth's medical billing service for …

  • Healthcare organizations in need of medical coding services.
  • Small practices that need a holistic RCM outsourcing service.
  • Healthcare organizations prioritizing the denial management phase of billing.

Image Credit: Lisa S. / Shutterstock
athenaCollector

athenaCollector

The Verdict

AthenaCollector, athenahealth's billing service, shines in reporting and optimizing clients' processes. Using data from more than 160,000 healthcare organizations, it coaches clients to outperform benchmarks set by the network's highest performers.

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.