You'll unlock our resource library, including all of our whitepapers, for two weeks.
CodeView gives you access to physicians' average reimbursement payments, per procedure—not just for Medicare and Medicaid, but also for commercial payers, extracted from our cloud-based network of more than 38,000 providers. Explore by specialty, and compare national and regional figures against your own.Start Now Methodology and Legal
To be medical care givers' most trusted service, athenahealth eases practices' administrative burden, making it easy to access and share data, freeing up physicians' time so they can focus on patients, and helping them get paid for the care they deliver. Here’s a look at how we do it.
The key to CodeView and other athenahealth insight is the technology and intelligence of our cloud-based network. We continually compile data for more than 38,000 providers, and utilize it to inform the industry and help practices achieve financial health.
In our mission to help make health care work as it should, we deliver our Best in KLAS* cloud-based services by combining three essential health IT elements:
All providers access a single instance of our cloud-based software, continually updated and always available
athenahealth intelligence teams ensure that all clinical and revenue workflows are streamlined and up-to-date
Our service teams work behind the scenes to take on your most onerous administrative tasks, freeing up your staff to focus on patient careWatch an athenahealth demo
Achieve financial health at your practice: Take advantage of athenahealth data, insight and expertise with these useful tips and tools.
When considering payer agreements, be prepared and well-informed with these best-practice tips.Download Your '7 Tips'
You're popup blocker is on. Therefore you need to click the above link in order to view the worksheetClose
Quickly find out how much extra revenue your specific practice could be earning with athenahealth services.Launch Revenue Calculator
How well is your practice performing? See how athenahealth clients are doing, on average, with performance metrics that determine success.Launch via browser Download the app
Looking for a practice management system? Check out the five essential questions you should ask any health IT vendor.See 5 Questions
Selecting the right practice management system is not easy. The ideal offering should boost your overall efficiency, and greatly
ease your staff's administrative burden. How can you assure that experience? Ask any vendor these five essential questions.
Our Best in KLAS practice management solution helps more than 38,000 providers on our cloud-based network get paid more, faster. Find out how your practice can achieve financial health during these times of change, with far less administrative burden.Discover athenaCollector
CodeViewSM uses clean claims data to estimate average contracted rates for select procedure codes across several classes of payers. We employ the following process to produce these estimates:
1. In order to limit the data set to payers for which we have significant and reliable transaction volume, we first remove data from any payer that isn't included in our PayerView® report, which uses a robust vetting process to ensure data quality.
2. We then restrict the data to primary charges on claims billed to primary insurance that did not receive a denial (i.e., they either resulted in a payment or an explanation of benefits that resulted in a transfer to either secondary insurance or the patient).
3. Because mid-level providers are often reimbursed at a different rate, procedure code modifiers can impact reimbursement, and practices located outside of the lower 48 states often see reimbursement that is not comparable to practices elsewhere in the U.S., we remove data to control for these factors.
4. For each payer, the remaining allowable amounts are then analyzed to find the most common amount for each practice/procedure code (this is used to control for anomalies, like the effect of deductibles that have not been satisfied early in the year). If the most common allowable amount is found a material number of times and constitutes the sizeable majority of results for that practice and procedure code, it is assumed that this allowable amount reflects the contracted rate for that practice and procedure code.
5. Using these estimated contracted rates, we calculate the 25th percentile, median, and 75th percentile, for each procedure code, by provider specialty, nationally and in each region of the country, for Private, Medicare B, and Medicaid payers. To comply with Department of Justice guidance, we only display results for private payers if the data behind those results come from at least five payers, no one payer constitutes more than 25% of the charges used in the calculation, all data is at least 90 days old, and the data used in the calculation was taken from multiple practices (Medicare and Medicaid data is obviously not subject to these limitations). Data for each specialty must also be available for at least two regions of the country.
*Practice management (1-10 physicians & 11-75 physicians); ambulatory EHR (1-10 physicians), as reported in the 2012 Best in KLAS Awards report]