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Revenue cycle management overview

Secure full payment, faster

We help accelerate payment before the exam even begins. Patient eligibility is confirmed pre-visit through a curated database of tens of thousands of insurance packages. As we make more connections across the healthcare continuum, we ensure that more and more referred patients arrive with critical patient data, expediting scheduling, treatment, and payment. And the patient's obligation is clear and available at the point of service.

We combine the power of our network with work done at scale to help you get paid more, faster. Thanks to our unique billing rules engine, continuously updated based on the experiences of our network of 80,000 providers, our clients see a 94% first pass claim resolution rate. We establish and maintain connections to payers to expedite your payments. Our revenue cycle management service also includes embedded financial transaction support, such as credit card processing and dedicated bank lockbox accounts.

Because athenahealth aligns our success with yours, we give you the reporting and visibility you need to make sure your health system is performing at its peak. In addition, our teams of experts review key performance metrics and proactively notify you if performance is not consistent with targets. Our business model is to get paid for results, so when you do well, we do well. 


Reduce administrative drag and cost

Leave your low-value work to us. athenahealth leverages scale and automation to drive efficiencies at your health system. Our revenue cycle management service includes handling all of your outbound claims and inbound remittance and payments, both electronic and on paper. We proactively address claim appeals and manage denials on your behalf. And by continually expanding our billing services, we're taking administrative tasks off your hands. We make your claims our business, so your business can move faster.


Stay current on industry change

The typical 18- to 24-month software development cycle can't keep pace with regulatory and reimbursement changes. We can. At athenahealth, your health system benefits from the latest knowledge on payer requirements and opportunities, thanks to our provider network and our expert research teams. In addition to giving you visibility into performance across your network, we also provide performance coaching and guidance on best practices based on top-performing medical groups and health systems.


40M billing rules in our  patented rules engine

 

94% of claims resolved upon first submission

 

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Our cloud-based services include:

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Electronic Health Records

Our award-winning Electronic Health Records (EHR) service gives providers greater control, so they can focus on what they do best.



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Revenue Cycle Management

Providers on our medical billing and practice management service get paid more, faster, with less work.



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Population Health

Patient communication services that reduce no-shows by 8% and keep providers better connected to our patients.



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Patient Access & Care Coordination

A complete end-to-end service for seamless care coordination across the continuum, no matter where patients seek care.



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Epocrates®

Clinical intelligence from the most trusted mobile medical reference is embedded inside our EHR workflow.



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