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Athenahealth Review

Best Practice Management Software for Billing

A Business News Daily Review

Product and service reviews are conducted independently by our editorial team, but we sometimes make money when you click on links. Learn more.

After conducting our research and analysis of practice management software, we recommend athenahealth as the best practice management software for billing.

We chose athenahealth from a pool of dozens of practice management software programs. To learn about our full methodology and for a more comprehensive list of practice management solutions, see Business News Daily's best picks.

One of the most important factors in medical practice management software is billing. Effective medical billing software is crucial to getting charges posted and claims submitted in an accurate and timely manner. Claim scrubbers can improve your practice's first-pass claim resolution rate, and denial management tools are key to getting denied claims revised and approved quickly. Medical practice management software is also responsible for generating reports based on billing activity, which are key to monitoring your practice's financial performance and proactively managing every facet of your operation to improve overall claim collections. Whether providing insight into your whole revenue cycle management or zeroing in on a specific payer, an effective medical billing tool is necessary for modern medical practices to boost revenue and increase profitability.

Editor's note: Are you looking for medical practice management software that can help your office run more efficiently? Fill out the form below for more information from our vendor partners.

 

We chose athenahealth as the best medical practice management software for billing because it leverages its extensive network of healthcare providers and patients to improve claim scrubbing and prevent denials. Athenahealth's partnership model also enables the company to deliver recommendations for improvement when your practice falls behind the baseline set by the nationwide network of healthcare providers who use athenahealth's software. Between the useful medical billing features and athenahealth's customer assistance, your medical practice has everything it needs to improve your medical billing and ensure you are paid accurately.

Athenahealth has a neatly organized user interface that displays tools in a reasonably intuitive manner. The top of the screen hosts several dropdown menus for scheduling, patient information, claims management, financials and reporting.

After you sign in, you see an inbox-style interface that displays new messages and pending tasks such as appointment requests, upcoming appointments, and clinical documents. The inbox is customizable based on different roles within the practice as well as individual user permissions.

New users can find most of the software's core features by simply clicking around and testing the system out for themselves. To become proficient at the more advanced functions and make the most of athenahealth's practice management software, however, training is likely necessary. Athenahealth offers role-specific training designed to help staff members navigate the system, tailoring the classes to the features each staff member is most likely to use in their daily workflow. In addition to these training sessions, the company offers multiple how-to guides and tutorial videos that can be referenced at any time.

Maintaining the athenahealth system is relatively easy. The web-based program applies software updates automatically, ensuring all practices are on the same version of the program.

Athenahealth offers all the major features we looked for in practice management software, plus access to a vast network that helps it consistently update its recommendations to clients. The company particularly shines when it comes to billing and managing the business end of medical practice operations. These are some of the key features:

Access to athenaNet, the company's network of more than 150,000 healthcare providers and 100 million patients, is a primary benefit of partnering with athenahealth. The company leverages this network to constantly update its billing engine of more than 40 million rules to identify common denials and changes in payer policies, and also to provide advice to medical practices on how to boost their performance. The company monitors top performers on the network to help struggling medical practices replicate their models when key performance indicators drop off, which is a helpful feature for new or small practices.

Athenahealth's scheduling tool has a central dashboard that provides an overview of scheduled appointments alongside patient and billing information. The calendar view makes it easy to set new appointments and even register new patients on the spot. To set a new appointment, you select a patient from the list of registered patients and set the desired date and time. The calendar displays scheduled appointments by provider or location. Once an appointment is scheduled, recurring reminders can be sent directly to the patient by text, email or phone. Athenahealth offers A/B testing so your medical practice can determine which method of reminder is most effective for your patients.

When a patient arrives for their appointment, they can be checked in through the scheduling tool. This involves the patient filling out or updating missing information and completing any intake forms associated with their appointment type. This process can be expedited with athenaCapture, which takes a snapshot of documentation such as a driver's license or insurance card. The information on these documents can be pulled directly from the card and imported into the system automatically. You can set custom fields in the scheduler and flag them as mandatory. The appointment cannot move forward until mandatory fields are filled out, allowing your front office to capture any patient information that is critical to your practice before the encounter begins.

Once a patient is checked in, their insurance information will appear on the screen, along with their expected copay and deductible. Front-office staff can capture any copayments or outstanding balances directly at the point of care, improving patient collections and minimizing the days in accounts receivable. Athenahealth can also manage payment plans for patients who can't pay on the spot, allowing them to set up an auto-debit schedule with the approval of your medical practice.

Additionally, athenahealth monitors the efficiency of your registration and scheduling process, identifying bottlenecks and slowdowns. If there are any glaring inefficiencies in the process, athenahealth not only alerts you to their presence but provides recommendations for speeding up and optimizing the process.

Athenahealth's billing tools are the crown jewel of the system, relying largely on athenaNet to help its clients optimize their financial performance. When you sign up for revenue cycle management and medical billing services, though, you are still required to keep an in-house medical biller. This staff member is specifically responsible for the creation of E&M codes and charge posting. At this point, athenahealth takes over, pulling patient insurance information to review ICD-10 and CPT codes, and scrubbing claims prior to submission. Athenahealth scrubs claims within eight seconds of receipt and promises most claims will be paid in two or three business days.

For every percentage point below 95% of unposted claims not worked within three days, athenahealth will reimburse your medical practice 2% of the value. Similarly, if the company does not manage 95% of denials within 10 business days of a rejection notice, it will refund you the value of those claims.

Athenahealth staff also monitors your contractual agreements with payers to ensure you are being paid what you are owed. Once per quarter, athenahealth will send payers a bill for the balance of underpaid claims. Moreover, any claims that are paid out at $0 will be pursued daily by athenahealth's billing staff.

The patient portal in athenahealth's practice management software is where patients can request appointments or prescription refills and send secure, HIPAA-compliant messages. It also allows patients to update their demographics, preferred pharmacy, current medications and allergies information. Staff can use the patient portal to request payment on outstanding balances and send appointment reminders.

Athenahealth maintains a fairly robust reporting module. Reports can be viewed on a weekly or monthly basis and customized in virtually any way.

The workflow dashboard for the reporting tool features 29 key metrics of your medical practice's performance. These include information about collections by payer, days in accounts receivable and common reasons for denial. Once a quarter, an athenahealth customer success manager will schedule a meeting with you to go over these reports and find opportunities to improve your key metrics. The dashboard also displays your practice's performance against the athenaNet average, so you can regularly see how you stack up to other practices that use athenahealth.

Athenahealth also monitors front-office information, such as canceled appointments and no-shows. You can use this information to improve the way you send appointment reminders and set scheduling policies. It also tracks the most common codes you send to payers and the collections you bring in from them, helping you identify your most lucrative revenue streams. Anytime you fall below athenaNet benchmarks in any of these areas, a customer success manager will automatically reach out and offer to arrange a meeting to address the issue.

Athenahealth's pricing model is based on a percentage rather than a monthly per-provider model like most of the other vendors we reviewed. This is because athenahealth takes a partnership approach to healthcare IT, offering its software alongside professional support that leverages data collected across its network of healthcare providers. Access to athenahealth's practice management software, EMR system and medical billing services generally costs about 7% to 8% of medical practice collections. However, that percentage can vary based on your average claim volume, claim value and the complexity of your billing service requirements.

The percentage price includes access to athenaOne, the company's full suite of healthcare IT products, revenue cycle management services, and useful tools like document management software and patient engagement features. There are no long-term contractual obligations for athenaOne. It is worth noting that athenahealth does not conduct fully outsourced revenue cycle management through its billing services but requires medical practices to have an in-house biller who works alongside athenahealth's billing staff.

For new practices, athenahealth's implementation should only take about a month, which is one of the quickest implementation processes we found in our research. For existing practices with data migration needs, it is generally a longer process. During the implementation process, your practice is paired with a dedicated account manager who acts as your liaison with the company. Athenahealth will help configure the system to suit your workflows, establish any custom templates on both the clinical and administrative side, and build any desired integrations.

The company also provides training in the form of one-on-one calls, conference calls, and self-guided materials like videos and literature. Training is fully included in the cost of the system, and the dedicated account manager remains associated with your practice even after implementation. This person serves as your direct line to technical support, and you have access to a general customer service number as well.

When implementing athenahealth, you can also benefit from hundreds of thousands of integrations with other systems and applications that have been built since athenahealth was founded. Moreover, athenahealth will build out any desired integrations on behalf of its clients, so even if the connection you want does not already exist, it could with a simple request.

We had a positive customer service experience with athenahealth. Company representatives were very helpful and forthcoming about athenahealth's unique partnership model. They quickly responded to every request we had for additional information and gave us a thorough walkthrough of the software. We were, however, unable to obtain a recording of our live demonstration, which we specifically requested. The company representatives we dealt with were friendly and didn't make excessive sales pitches when we said we needed more time to investigate other options before making a buying decision.

Athenahealth offers an exceptional support model compared to other vendors in our review. The company will proactively reach out if it flags your practice as underperforming against its network in any key areas.

The primary limitation we encountered with athenahealth is the company's requirement that you keep a medical biller on staff. For small practices looking to outsource their medical billing entirely, this is not an option. While athenahealth can handle a significant portion of your billing operation, as well as provide guidance to make in-house coders and billers more efficient, it does not offer a true revenue cycle management outsourcing plan, in which all coding and claim generation would be handled by a third party. Instead, your in-house medical biller must internally code claims before athenahealth steps in to handle submission and denial issues. However, at this point, athenahealth guarantees that your claims will be handled quickly or you will be reimbursed. Still, if you're looking for a full medical billing partner so you can focus on front-office and clinical operations without worrying about claims, be aware that athenahealth only manages part of the process.

Ready to choose your practice management software? Here's a breakdown of our complete coverage:

Editor's note: Are you looking for medical practice management software that can help your office run more efficiently? Fill out the form below for more information from our vendor partners.

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.