Small Practices Win Big With athenahealth
We’re thrilled about the growing numbers of small practices joining athenahealth. They represent all kinds of specialties – including Family Practice, Orthopedic Surgery, Obstetrics/Gynecology, Pediatrics, and Cardiology, just to name a few.
In this issue, we check in with two small practices that have recently opened their doors and joined the athenahealth family. We wanted to know how athenahealth has helped them – and if there were any surprises along the way.
To start, we asked why these practices chose athenahealth in the first place.
“We didn’t bother looking at other companies”
Trudy L. Tieman, Practice Administrator for the single-provider practice of Diveris Orthopedics and Sports Medicine, PC, in Merrillville, IN was impressed with the comprehensiveness and ease of using athenahealth’s services. “I love the wide variety of features provided with athenaCollectorSM, especially since we’re a small practice,” said Tieman. “It takes a lot of work off our hands, like scrubbing claims and doing other corrections to claims before they get sent out. The functionality far exceeds that of other billing software.”
Diveris Orthopedics and Sports Medicine opened its doors in December 2005 and went live with athenahealth in February 2006. How did they find athenahealth so quickly? “Dr. Diveris heard about athenahealth and we decided to demo athenaCollector,” said Tieman. “I’ve been in practice administration for over 20 years and knew about other systems, but after we saw athenaCollector we didn’t even bother looking at other companies.”
“I knew I wanted athenahealth”
It was a similar story with Dr. Marc Leibole of Eye Care and Laser Surgery of Newton-Wellesley in Newton, MA. “The hospital I used to work with found two billing vendors and we interviewed both,” said Dr. Leibole. “When they chose the other vendor, I saw how many problems there were. They didn’t train the staff and were hard to reach on the phone. So when I opened the doors to my own practice in November of 2007, I knew I wanted athenahealth.”
Dr. Leibole said one of the biggest advantages of athenahealth is its rules engine, which he said has already saved him time and money. His claims get paid quicker and he has more cash to put in the bank. athenahealth’s Rules Engine contains the largest real-time database of payer rules in the country, enabling us to immediately spot claims with incorrect codes, incomplete information, and other inaccuracies, helping clients submit cleaner claims.
“It can’t be this easy...”
Once they went live with athenahealth, there was one surprise for Tieman. “I was surprised it all worked,” said Tieman. “We had been using an old system, and then nothing, so we were starting from scratch with no data. The implementation went so smoothly I remember thinking, ‘It can’t be this easy...’.”
Both practices were initially concerned about using the athenahealth system. Tieman worried she wasn’t ready to handle all the features of athenaCollector right away. But as soon as the practice went live, she and her staff found athenaCollector easy to use – even for staff members who were not computer savvy.
Dr. Leibole said his staff didn’t have medical billing backgrounds – so they needed some time to understand the terminology and details of submitting claims. “The implementation went exactly as I expected,” said Dr. Leibole. “athenahealth’s system is very straightforward. There are always instructions for what to do next. If you just follow the instructions you’ll figure it out. Our staff got comfortable very quickly.”
Small practice, big savings
Tieman estimates that athenaCollector has saved her practice from hiring an extra 2.5 employees. That’s big savings for a small practice. Another timesaver: athenahealth’s ability to place automatic alarms on claims she needs to follow up on. That means no more time-consuming scheduling of follow-up phone calls. She also appreciates the function that tracks “payment mismatch,” or when payment doesn’t match the submitted claim. “It’s amazing what athenaCollector can track for me. I immediately see which payers need to get an appeal letter – which I fire out automatically – and then I always get paid for those claims,” said Tieman.
Dr. Leibole said he would have to hire at least 1.5 full time employees if he weren’t with athenahealth – one to handle billing and one to answer phone calls from patients who have questions about denied claims. “Thankfully, with athenahealth we are getting fewer denied claims and fewer calls from patients about billing,” he said.
Any especially fun features of athenaCollector? “Live Benchmarking,” said Tieman.
Live Benchmarking provides clients with a quick pulse check of their practice compared to others in their region and specialty on key metrics such as the average number of days between the date of service and the date the charge is entered, and the percentage of open self-pay balances that are older than 90 days. At the end of each quarter, athenahealth looks at an aggregate score of these metrics to determine the top three practices in each region and specialty.
“I check every day to make sure we’re number one, two or three,” said Tieman. Both practices also check the hold buckets every day to see what claims need to be followed up on. “Sometimes I can resolve issues immediately,” said Tieman. “Some I refer to the department where they originated. It’s a useful training opportunity for staff to see what issues regularly come up and how we resolve them. That way we prevent problems in the future and save even more time.”
Tools for business decisions
As for the big picture of running the practice, Tieman says athenaCollector has proven invaluable. With all kinds of point-and-click reports available (including customized reports that athenahealth developed with the practice), she can quickly check metrics like staff productivity.
“It’s particularly helpful to use the productivity and performance statistics when conducting staff assessments and as a quick pulse check during our monthly staff meetings. We ask ourselves how we can improve, and how we can make progress in specified areas.” For example, her team now requests Worker’s Compensation insurance information from patients’ case managers before each appointment so patients are “ready to go” as soon as they walk in the door. “This has saved us from tracking down information after the patient leaves and helps us get paid faster.”
Tieman also uses athenaCollector reports to check things like accounts receivable (AR) by payer. “We can analyze contracts and see what payers contribute to what percent of our revenue. When the time comes, we can decide whether or not to continue with a payer based on this information.”
Dr. Leibole expects that once he is up and running for a few more months, he will use the reports frequently. “I look forward to benchmarking my practice with other Ophthalmology practices in the region and the country,” he said. “I’m also going to pinpoint measurable criteria for improvement, and we’ll base our employee bonuses on that.” He is also running reports looking at specific diagnoses to determine the best way to bill for certain services and further reduce denials.
“I always get solutions”
“I’m amazed by athenahealth’s culture and the level of the staff’s enthusiasm for what they’re doing,” said Tieman. “Everyone is so upbeat. Most importantly, I always get solutions. If a client support staff person doesn’t know how to resolve a particular issue, they investigate it and call me back with a solution.” Every week, Tieman has a conference call with her Account Manager, which is also helpful. “I make a list before each call,” Tieman said. “And afterwards everything is taken care of.”
Dr. Leibole said he is comfortable with a vast majority of client support staff members at athenahealth. “With the other billing company, you could never reach a live person and sometimes they wouldn’t even call you back,” he said. “Now I never have to wait to reach a live person who can help.”
Preparing for the future
“athenahealth is a progressive company,” said Dr. Leibole. “They help me prepare for the future.” For example, Dr. Leibole said he appreciates being able to easily participate in the physician quality reporting initiative (PQRI). “Medicare is now grading us based on how we treat certain patients. If we meet the criteria we get a bonus at the end of the year,” he said. “I know other doctors who can’t do this because their billing systems make it too difficult. But athenahealth has built PQRI right into the system. I can participate in PQRI without any trouble.”
Tieman states, “athenahealth’s evolution as a company has been focused on listening to clients. Other companies give you their services and that’s it. athenahealth listens to its clients and will leverage their input to innovate their service offerings. Feature and functionality updates to athenaCollector are released about every seven weeks – they’re always making improvements.”
“I’m extremely happy,” said Dr. Leibole. “athenahealth has been so helpful to me, especially as a small practice starting from scratch.”