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athenahealth Review

By
Adam C. Uzialko
,
business.com writer
|
Dec 20, 2019
Image Credit: Pornpak Khunatorn / Getty Images
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Athenahealth's medical practice management software excels at billing, leveraging a network of 160,000 healthcare providers and 100 million patients to create a system that delivers useful recommendations and scrubs insurance claims for more than 40 million potential errors before submission. In addition to the highly effective billing module, athenahealth offers the other major features we looked for in a medical practice management software program: a user-friendly scheduler, a HIPAA-compliant patient portal, an MIPS/MACRA dashboard for tracking compliance with government standards and a strong reporting tool.

athenahealth

athenahealth

The Best Medical Practice Management Software of 2020

The Verdict

athenahealth's vast network of 160,000 providers and 100 million patients contributes to a claim-scrubbing tool with more than 40 million rules to help improve billing operations. athenahealth is the best medical practice management software for billing.

To see all our recommendations for practice management software, visit our best picks page.

Athenahealth's medical practice management software comprises one component of the larger healthcare IT suite known as athenaOne. While the practice management software can be purchased as a stand-alone product, athenaOne includes access to the electronic medical records (EMR) system and athenahealth's revenue cycle management services. However, when outsourcing billing to athenahealth, you must maintain an in-house medical biller to handle claims creation.

Ease of Use

Athenahealth features a well-organized and user-friendly interface that makes navigating the software relatively intuitive. Along the top of the screen are several dropdown menus related to the major modules in the system, including the calendar, patient information, claims, financials and reports. The homepage appears as an inbox and allows users to cycle through a list of custom options, such as messages related to appointment requests, clinical documents or administrative messages.

A new user could easily learn most of the basic tools needed within athenahealth simply by clicking around, but for more advanced functionality, training sessions are likely necessary. While the interface is clean and well designed, role-specific training can help staff members quickly become proficient with the features they will use most often. In addition to training sessions, athenahealth maintains tutorial videos and self-guided training materials for ongoing learning.

Software updates are automatically applied by athenahealth. As a web-based program, athenahealth keeps all users on the same version of the system at all times.

Pricing and Fees

Athenahealth's pricing is percentage-based. Most practice management software relies on a per-provider, per-month pricing model, unless a medical practice signs up for medical billing services to outsource revenue cycle management. Athenahealth billers work alongside your in-house billing team. Rather than a fully outsourced medical billing service, athenahealth intends to augment and enhance your billing department's capabilities.

Generally, pricing is about 7% to 8% of net practice collections; however, those numbers vary depending on factors like claims volume, claims value and the complexity of your medical practice's billing structure. Included in the percentage price is access to athenaOne, athenahealth's full suite of healthcare IT products, including the EMR system and practice management software. You also gain access to document management tools and patient engagement software. There are no long-term contractual requirements associated with an athenaOne subscription.

Features

Athenahealth offers all the major features we looked for in a practice management solution. Here's more about those features.

Scheduling

The athenahealth scheduling tool can be used to quickly add appointments to an open time slot and available provider on the calendar. Existing patients can be selected from the registered list. Current patient information will automatically be imported when the appointment is set. New patients can quickly be registered, too, eliminating a lengthy intake process when they arrive for their first appointment.

Once an appointment is set, you can send recurring reminders to a patient via email, text or phone. Athenahealth also enables A/B testing for appointment reminders so you can determine which method of communication is the most effective for your patients. A tool called athenaCapture simplifies the registration process further. AthenaCapture scans a patient's driver's license, insurance documentation, etc., and adds it to the system. When a patient arrives for their appointment, checking them in involves filling out any missing information not obtained through the patient portal or previously sent intake forms.

Insurance eligibility is automatically checked as well. Once a patient is checked in, their co-pay and deductible appear alongside their insurance information, enabling front desk staff to collect any balance due before the encounter. (Athenahealth offers payment plans that the company's staff will manage for you, notifying patients when payments are due and allowing them to set up an auto-debit payment schedule.)

Billing

Billing is where athenahealth shines – the platform leverages athenaNet to help streamline your billing operations and improve claims collections. When you sign up for revenue cycle management with athenahealth, you must have a medical biller on staff, specifically for determining E&M codes before sending out claims. Athenahealth's billing staff will pull in patient insurance information and track ICD-10 diagnosis codes in the superbill related to each encounter. The claims are scrubbed through an integrated clearinghouse. Scrubbing occurs within 8 seconds of your staff creating the claim.

Most claims can be paid within two to three business days. Athenahealth also checks your claims against your contractual agreements with payers to ensure they are paying you accurately. Whenever a payer underpays based on a contractual agreement, athenahealth steps in to collect the difference and deliver it to your practice. Any claims that are paid out at $0 are chased daily by athenahealth's billers.

Patient Portal

Athenahealth's patient portal can be used to schedule new appointments, send HIPAA-compliant messages and capture outstanding balances or co-pays. Patients can update their existing contact information, preferred pharmacy as well as their current medication list, allergies, medical history, surgical history and family history. Patients can also request prescription refills. Through the patient portal, patients receive notifications when balances are due, as well as appointment and payment reminders. (Athenahealth will also mail patients a paper reminder every 28 days.)

Reporting

Athenahealth's reporting suite offers weekly or monthly reports on virtually every aspect of your practice. Reports can be customized to filter data in whatever way is most useful to your practice. If you are unsure how to format a custom report, you can click the Support tab to obtain assistance directly within the software.

A reporting expert will help you set up your reports. Athenahealth also maintains a workflow dashboard with 29 metrics to help you track the financial well-being of your practice. Each quarter, an athenahealth success manager will meet with you to review these reports and find opportunities where you can optimize your workflow. The workflow dashboard measures your performance against a network-wide benchmark to help you gauge how you compare with medical practice nationwide. Athenahealth monitors metrics like appointment cancellations, no-shows and days in accounts receivable. The company also tracks how much you make from each payer, as well as the most common codes you send to each.

In addition to these key features, athenahealth makes good use of the athenaNet, a network comprising more than 160,000 medical practices nationwide. Not only does it use this network to add to its library of 40 million potential billing and coding errors to scrub, it compares your medical practice against the top performers on the network and offers recommendations on how you can improve your processes. For example, the best performers against MIPS/MACRA criteria are identified and analyzed to help you better comply with the government standards for EMR systems and practice management software usage.

Implementation and Training

Implementation is included in the subscription price of athenahealth's software suite. For new practices or small practices with no need for data migration, the process can be completed in as few as four to six weeks. Practices that require data migration from a legacy system should expect a longer implementation period.

When you sign up with athenahealth, you are assigned a dedicated account representative who serves as your point of contact. This representative remains in touch with your practice throughout the entire implementation process and after the go-live date to ensure a smooth launch. Athenahealth works with medical practices to ensure providers are credentialed with payers when medical practices sign up for athenaOne. For staff training, athenahealth offers role-specific courses for staff members.

Customer Service

Our customer service experience with athenahealth was very positive, although the representative we worked with was unable to provide us with a recording of our live demonstration, which we specifically requested. Despite this oversight, the representative was responsive and forthcoming; he answered our questions thoroughly and provided us with additional educational materials that we had requested.

A particularly useful facet of athenahealth's customer service is that the company monitors various aspects of your practice's performance and will work with you to improve those aspects – we didn't see this type of monitoring and attention with other software solutions we evaluated.  

Limitations

The biggest limitation with athenahealth is that your practice must maintain a medical biller on staff even if you're outsourcing the bulk of your revenue cycle management to the company. Medical billers are required to generate E&M codes and create initial claims before athenahealth processes the claim.

Most practice management software vendors we evaluated offer full medical billing services that include charge capture, coding and claims creation. If you're looking for a medical billing partner alongside your practice management software, be aware that athenahealth only handles part of the billing process.

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.

athenahealth

athenahealth

The Best Medical Practice Management Software of 2020

The Verdict

athenahealth's vast network of 160,000 providers and 100 million patients contributes to a claim-scrubbing tool with more than 40 million rules to help improve billing operations. athenahealth is the best medical practice management software for billing.

Adam C. Uzialko
Adam C. Uzialko
Adam C. Uzialko, a New Jersey native, graduated from Rutgers University in 2014 with a degree in political science and journalism and media studies. He reviews healthcare information technology, call centers, document management software and employee monitoring software. In addition to his full-time position at Business News Daily and business.com, Adam freelances for several outlets. An indispensable ally of the feline race, Adam is owned by four lovely cats.