athenista spotlight: Meet Kim LaFontana
You can thank this athenista and her team when your claims get paid the first time around and your payers start cooperating! Once known as "Vampira" in a past job, she is now our Vice President for Performance Management. Meet Kim LaFontana, this month's featured athenista.
athenaPulse: Tell us about your position at athenahealth.
Kim LaFontana: I am the Vice President for Performance Management, which means that I am responsible for finding new and creative ways to continually help improve our clients' collection rate and collection timeliness. Our department has responsibility for athenahealth's Payer Outreach (working with payers to make things work better), Denials Analysis, and Rules building functions.
aP: What do you do in a typical day at work?
KL: Lots of phone calls and meetings with payers and my teams, talking to clients to learn what they are experiencing, working with my colleagues in other departments, some travel to meet with payers and clients. Right now one of the things I am focused on with payers is determining what tools they are making available to help our clients with all the new high-deductible plans out there - how much to collect from the patient at the time of service.
aP: What do you help clients accomplish?
KL: We are using athenahealth's extraordinary set of claims data to figure out how payers pay claims, and write rules to help our clients navigate through payer policies successfully. No other company in the U.S. is doing what we are doing. We often know more about a given payer's policies than they do themselves!
aP: What was the most challenging project you worked on at athenahealth?
KL: We created athenahealth's Denial Analysis program in 2002 when we realized that we could write great rules by analyzing trends and patterns in the data rather than just individual claims. Our first "DA" was Minna Chan who is still here and is now the Team Lead, in addition to 10 more DAs who are totally dedicated to finding and solving the toughest billing problems. They have improved athenahealth's 'first pass resolved rate' from 65% a few years ago to almost 90% today, and we aren't giving up on that last 10%!
aP: If someone gave you a million dollars, how would you spend it?
KL: I'd fix up the drafty 100-year-old house we just bought in Melrose, a suburb about 10 miles north of Boston.
aP: What was your first job?
KL: I worked in a hospital as a phlebotomist - collecting blood! - on the night shift while I was in college. Patients called me Vampira.
aP: Your favorite athenahealth moment?
KL: I love the last day of the User Conference - everyone is exhausted and has just spent three days with our clients bonding, learning, sharing information, having fun and reminding ourselves why we work so hard every day all year.
aP: Your favorite payer moment?
KL: My favorite moment in working with payers came last year when a large national payer asked us to work with them to help providers need to make fewer phone calls - we were thrilled. When we started to look through the data it became apparent quickly how big bureaucratic payers can't connect the dots - they were sending thousands of EOBs that said: "Claim Denied - Please Call for Rationale" at the same time they were running a project to reduce phone calls!
aP: Favorite way to unwind after work?
KL: Rush straight home and feed dinner to my sweet little daughter Abigail, who at 8 months old is thoroughly enjoying mushy peas and applesauce.
