I wish I had focused this thread to Athena's Billing software and service. Its been side-tracked a little bit on their EMR business which is okay, but wasn't the intent of the thread.
From what I've concluded in my searching, Athena's Billing Engine and patient aging follow-up is top notch. Best of Breed.
Sadly they were not available in Utah when I started my practice.
I use to think an integrated EMR/PMS from the same company was best. I'm having different thoughts now. When the PMS and revenue results are this good, its hard to ignore it over another system.
A user of Athena Billing service writes in another thread:
AggieDoc
"My AR is now the lowest it has ever been.... All I know, is that this company knows how to get us paid! "
http://www.emrupdate.com/forums/t/15581.aspx?PageIndex=2
FPDoc,
"I use to think an integrated EMR/PMS from the same company was best. I'm having different thoughts now. When the PMS and revenue results are this good, its hard to ignore it over another system. "
Layne, are you thinking perhaps best of breed is a better choice?
Matt, I've realized the importance of good billing software and people doing the billing. Wether that is in-office billing or a billing service. Even doing it in-office, it really is a pain. Athena takes the painful parts out of the equation. They do all the phone call follow-ups to insurance companies. Its like a combined inoffice/billing service combo. Because a doctors A/R is the most important part of his or her practice, I believe one should look for the very best solutions.
So in that regard, choosing the best of breed PMS (Athena) thusly gives the doctor open room to go out and choose the best of breed EMR for their purpose. In your case, when someone reviews Medtuity, they are focused on what you do best, EMR that does not come with an after thought PMS add-on. The last few years there has been an increased desire by physicians to have PMS/EMR combined from the same company. So many EMRs are doing just that, finding an add-on PMS so they can market the wares better. I once agreed with that. But after realizing the importance of A/R and collection management and how Athena excels in that space, I'm forced to change my opinion. Go for the best of breed PMS first, then go out and find an EMR that fits your situation. What some may consider a best of breed EMR may not actually fit a practices profile. Go for what fits the practice best.
If one chooses Athena PMS, you still have office staff that types in the claims. That's the easy part. Athena does all the problematic follow-up that offices hate to do. Sure there are other billing services out there, but they don't have a rules engine to keep track of how the insurance mafia keeps changing their internal rules to deny claims. Only Athena does that. 97% yearly renewal rate means that their 13,000 physicians like the results they get.
I’m in the process of evaluating Athena due to internal & external problems collecting insurance payments. I have a very good practice management system and have recommended it to colleagues. It does much more than Athena’s system and is much more intuitive. It has billing rules to scrub claims during input and to help new employees understand the nuances of insurance coding. From a software standpoint, Athena is not even in the same league. I don’t have a problem submitting clean claims. Wrong ID numbers is the extent of my clean claim problem. Where I have a problem and Athena presents a solution is service.
My practice does a horrible job in following up on claims. This is something software cannot do. The super majority of my claims problem is “We did no receive your claim”. I get this for paper and electronic claims. Only a human can badger the insurance company in this respect. I have a hard time watching $15.00/hr personnel sit on hold chasing down this information. As best as I can gather, Athena will follow-up on these claims and at least notify us of the problem. It appears that they do not automatically resubmit these claims. In the whole scheme of things, what Athena provides is a service to follow-up on insurance claims and provides a basic practice management software and scheduler. I have been through a demo and the software is basic. It can’t find patients by first name only. I agree that the color is horrible and there are several other features that I would loose by changing systems.
It really boils down to whether the 4-6% of gross is worth more than the headaches of employing a full time person to handle this and the cost of dealing with the hassles of another software vendor. Athena does not follow-up on patient bills, but it will send bills. Therefore, there still needs to be a part time billing person.
It is really hard to figure which way to go, but I am crunching the numbers. My suspicion is that with 13,000 other practices going this route, it looks good for Athena. Since I also dispense glasses as a cash and carry product and Athena would also want to take a percentage of this gross with no work on there part (yes I could separate this out, but it would require running two billing systems) it might not be feasible for my type of practice.
I ran a quick scenario where the benchmark for a FTE is to generate $150,000 per year. The low is about $100,000/yr to a high of $200,000/yr. This comes to about $9,000 for Athena vs $27,000 for an employee. This looks good for a job market that has high wages. Not as good for a job market with low wages. $10/hr = 20,800 $13/hr = 27,040 $15/hr = 31,200
Contrarian: I’m in the process of evaluating Athena due to internal & external problems collecting insurance payments. I have a very good practice management system and have recommended it to colleagues. It does much more than Athena’s system and is much more intuitive. It has billing rules to scrub claims during input and to help new employees understand the nuances of insurance coding. From a software standpoint, Athena is not even in the same league. I don’t have a problem submitting clean claims. Wrong ID numbers is the extent of my clean claim problem. Where I have a problem and Athena presents a solution is service. My practice does a horrible job in following up on claims. This is something software cannot do. The super majority of my claims problem is “We did no receive your claim”. I get this for paper and electronic claims. Only a human can badger the insurance company in this respect. I have a hard time watching $15.00/hr personnel sit on hold chasing down this information. As best as I can gather, Athena will follow-up on these claims and at least notify us of the problem. It appears that they do not automatically resubmit these claims. In the whole scheme of things, what Athena provides is a service to follow-up on insurance claims and provides a basic practice management software and scheduler. I have been through a demo and the software is basic. It can’t find patients by first name only. I agree that the color is horrible and there are several other features that I would loose by changing systems. It really boils down to whether the 4-6% of gross is worth more than the headaches of employing a full time person to handle this and the cost of dealing with the hassles of another software vendor. Athena does not follow-up on patient bills, but it will send bills. Therefore, there still needs to be a part time billing person. It is really hard to figure which way to go, but I am crunching the numbers. My suspicion is that with 13,000 other practices going this route, it looks good for Athena. Since I also dispense glasses as a cash and carry product and Athena would also want to take a percentage of this gross with no work on there part (yes I could separate this out, but it would require running two billing systems) it might not be feasible for my type of practice. I ran a quick scenario where the benchmark for a FTE is to generate $150,000 per year. The low is about $100,000/yr to a high of $200,000/yr. This comes to about $9,000 for Athena vs $27,000 for an employee. This looks good for a job market that has high wages. Not as good for a job market with low wages. $10/hr = 20,800 $13/hr = 27,040 $15/hr = 31,200
If you instead added GreenFlag Recovery / Transworld Systems to your process using your existing PMS software how does that compare?
It looks like the collections company will cause the insurance companies and patients to call you ! At least as described per http://www.emrupdate.com/forums/p/15406/86381.aspx
What added value would Athena provide ?
caultonpos: If you instead added GreenFlag Recovery / Transworld Systems to your process using your existing PMS software how does that compare? It looks like the collections company will cause the insurance companies and patients to call you ! At least as described per http://www.emrupdate.com/forums/p/15406/86381.aspx What added value would Athena provide ?
Athena does A/R phone calls to the insurance companies way before GreenFlag would be involved. I use GreenFlag as a last resort.
Does your current billing system do this? Say you get a check for a claim submitted to United on average by day 37. If no check is received by day 37, the biller calls the insurance company on day 38 asking where the money is. Its at that time the biller might find out the insurance wants a copy of visit notes. Does your biller do that on ever single claim submitted day in and day out? Athena does. They find and resolve problems with claims early in the procees. Athena does all that. They are the ones who sit on the phone on hold for 15 minutes (or longer) when calling insurance companies all day. They are on the phone for you all day long calling insurance companies finding out why no check has been received early in the process. By day 60 most of all A/R is completed. As a last resort beyond 60 days, GreenFlag is initiated using Athena's Software.
If a line item is denied, Athena finds out why and the claim gets resubmited. Rules are then built to make sure the reason for the first denial won't happen again. They also keep track if your insurance payers are being honest in the amount of money they are paying you per your contract.
I agree with FP Doctor. GreenFlag Profit Recovery is for Patient Balances and Insurance Claims that are DELINQUENT. A a billing service like Athena is utilized for primary billing and collections as opposed to recovery of slow paying patient balances and insurance claims. Unfortunately, regardless of the EMR, PMS, Billing Service, or Internal Staff......you will likely have delinquent patient balances and insurance claims that require 3rd party intervention. That's when you submit accounts to GreenFlag by Transworld Systems.
GreenFlag Profit Recovery byTransworld Systems is a Web Based Fixed Fee collection service that serves over 20000 medical professionals nationwide. Our Fixed Fee Averages $10.00 per account!
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Hello, does Athena (the PMS portion) interphase with any other EMRs?
J. Odutola
Hello Dr. Odutola,
Although we have our own clinical solution, if a practice chooses to use another vendor’s EMR with our revenue solution we are more than happy to interface with it. The one caveat is that athena typically can only work with emr vendors that support HL7 transactions. The only company I am aware of that has had problems with HL7 transaction is amazing charts which I have been told only uses X-Link for their interface engine.
Hope this helps!
Tom Natt Northeast Sales athenahealth 888.652.8200 ext. 1237 tnatt@athenahealth.com www.athenahealth.com
Disclaimer- I work for athenahealth, the views expressed are my own and do not represent the thoughts or opinions of athenahealth.
Tom,
Where is your HL7 interface with EMRs documented?
Graham http://www.synapsedirect.com/ Synapse - the EMR for smart users
The front office would enter the patients demographics into athenaNet (the software component of our solution), and schedule the appointment. athenaNet would then send an HL7 message to the EMR to create the patient in that system and add it to the scheduler of the EMR (if it has one). Once the patient arrives for their appointment, the front office would check the patient in using athenaNet and it would send a HL7 message to the EMR opening the encounter for the physician. Once the physician finishes his encounter the charges (if he/she is using an EMR for charge capture) can be sent back into athenaNet via HL7 to create the claim.
That make sense? It's pretty seamless.
I understood that Athena was a browser based solution. So, how does the browser generate the HL7 message and send it to the EMR?
We use a secure SSL tunnel to setup a direct connection between the server based EMR and our remote application.
I can get a more technical answer if you like, just let me know.
-Tom
Yes please.