athenahealth Medical Billing and Practice Management Services

Methodology

OVERVIEW

Our goal is to provide users with a brief and simple illustration of a few of the ways that athenahealth, Inc. can help to improve a medical practice's bottom line.

DATA PERIOD AND SCOPE

The data used in this Calculator are based on actual physician activity captured by athenahealth in the course of providing our services, surveys we've taken of vendors, and third-party research published by iData Research Inc. (U.S. Market for Electronic Medical Records, December 2009) and the U.S. Department of Labor, Bureau of Labor Statistics (Occupational Employment and Wages--May 2009, May 2010). The following provides a summary of the data used:

Average Annual Chart Pull Savings: The average annual savings per physician in chart-pull labor costs due to EMR adoption. Source: iData Research (2008)

Average Monthly Collections: The average monthly collections per provider, by specialty. Source: athenahealth data (Q3 2011)

Average Monthly Label Cost: The average price per provider for printed labels used to identify clinical documents faxed to athenahealth during one month. Source: athenahealth data (September 2010), athenahealth vendor survey (October 2010)

Average Monthly Labor Cost: An estimate of the average monthly labor cost per provider for a medical records technician to process a practice’s internal documents for delivery to athenahealth. Source: athenahealth data (September 2010), U.S. Dept. of Labor (Year ended may 2009)

Average Monthly Printer Cost: The average price for a label printer, amortized over a year. Source: athenahealth vendor survey (October 2010)

Average Monthly Visits: The average monthly number of patient visits per provider, by specialty. Source: athenahealth data (Q3 2011)

Medicare Part B Percentage: The average percentage of collections that are received by practices under Medicare Part B, by specialty. Source: athenahealth data (Year to date as of 11/23/2011)

Pre-athena No-show Rate: The average percentage of patients who do not show for appointments for practices that are not live on athenaCommunicator®. Source: athenahealth data (Year ended 8/2011)

Storage & Management Cost Savings: The average annual practice savings in storage space and archive management costs due to EMR adoption, based on the number of practice physicians. Source: iData Research (2008)

ASSUMPTIONS

In developing this Calculator, we relied on our experience with our clients in assuming that a practice will generally have one label printer for every three providers and that a medical records technician will take between one and two minutes to prepare and send an internal document of the practice to athenahealth (documents from third parties are faxed directly to athenahealth without any action required on the part of the practice). We have also assumed that a practice's providers are all eligible ambulatory health care providers and therefore qualify for HITECH Act incentives. CALCULATIONS

The data and assumptions provided above are used to calculate the results in each of the following categories:

Increase Collections: To determine the estimated increase in monthly collections due to use of athenaCollector®, the Average Monthly Collections for a practice of the selected specialty (a per-provider average) is multiplied by the specified number of practice providers to estimate total practice monthly collections. This number is presented to the user during the initial questions as the default, but it, like the other defaults in the Calculator, may be changed by the user. The entered practice monthly collections is then multiplied by the entered percentage increase in collections. 12% is offered as the default for the percentage increase in collections because that is the average increase for our clients, based on a weighted average for athenahealth clients with valid pre-athenahealth benchmark data that had their 15-month anniversary with athenahealth during 2010. /p>

Increase Patient Volume: To determine the estimated increase in patient volume due to use of athenaClinicals®, the Average Monthly Visits for a practice of the selected specialty (a per-provider average) is multiplied by the specified number of practice providers to estimate the practice's total number of monthly visits. This number is presented to the user during the initial questions as the default, but it, like the other defaults in the Calculator, may be changed by the user. The entered number of monthly visits is then multiplied by the entered percentage increase in patient volume to get the estimated number of additional visits each month for the practice. 3.8% is offered as the default for the percentage increase in patient volume, because that is the average increase for our clients, based on a comparison of the average change in patient visits for clients without athenaClinicals with that for clients that had their six-month anniversary on the service during the year ended November 2009.

The estimated number of additional visits each month is then monetized by dividing the entered practice monthly collections by the entered number of monthly visits, which gives average per-visit collections, and then multiplying that by the estimated number of additional visits.

Reduce No-Shows: To determine the number of additional visits each month due to use of athenaCommunicator, the entered number of monthly visits (as described in Increase Patient Volume) is multiplied by the Pre-athena No-show Rate and then the expected percentage improvement in the no-show rate. 16% is offered as the default for the percentage improvement in the no-show rate, because our clients have seen at least that percentage of improvement, based on a comparison of the highest no-show rate among clients with athenaCommunicator® and the average rate for appointments without the service for the year ending August 2011.

The expected number of additional visits each month is then monetized by the same method set forth in Increase Patient Volume.

Qualification for HITECH Act Incentives: For 2011, the HITECH Act authorizes payments to each Medicare provider equal to the lesser of $18,000 or 75% of that provider's total Medicare payments for the year. To determine a provider's expected total Medicare payments for the year, the entered practice monthly collections is divided by the specified number of providers to obtain a per-provider average. This average and the Medicare Part B Percentage for a practice of the selected specialty are then multiplied and annualized. The lesser of $18,000 or 75% of the average provider's total Medicare payments for the year is then multiplied by the selected number of practice providers to determine the practice's total payments for 2011 under the HITECH Act in regard to Medicare.

Qualification for PQRI: To determine the monthly payment for participation in PQRI, the entered practice monthly collections (as described in Increase Collections) is multiplied by the Medicare Part B Percentage and then by CMS's average PQRS incentive payment rate (which is 1%).

Qualification for e-Rx: To determine the monthly payment for participation in e-Rx, the entered practice monthly collections (as described in Increase Collections) is multiplied by the Medicare Part B Percentage and then by CMS's e-Rx incentive payment rate (which is 1%).

NOTE: If a provider is eligible and opts to receive HITECH incentives, that provider does not qualify for e-Rx incentives per the HITECH Act rules. The Calculator will exclude e-Rx incentives if the user indicates that HITECH Act incentives are to be included.

Document Services Cost Savings: As a rough estimate of the monthly document services cost savings from use of athenaClinicals, the Average Annual Chart Pull Savings (a per-physician average) is multiplied by the specified number of practice providers and then added to the Storage & Management Cost Savings for a practice of the specified number of providers (since the iData Research data underlying this calculation are based on the number of practice physicians, the specified number of practice providers is used as a proxy for purposes of this calculation). This number is then divided by twelve to obtain a monthly average document services cost savings.

In an effort to represent the athenaClinicals cost savings fairly, we then make sure to back out an estimate of the document services expenditures incurred in the use of athenaClinicals. To do this, we subtract the following from the monthly average cost savings: (1) the Average Monthly Printer Cost, multiplied by the specified number of practice providers and then divided by three (i.e., the assumed number of providers per label printer); (2) the Average Monthly Label Cost (a per-provider average), multiplied by the specified number of practice providers; and (3) the Average Monthly Labor Cost (a per-provider average), multiplied by the specified number of practice providers.

As background, the average monthly costs used in this calculation are determined as follows. Average Monthly Printer Cost is based on our market research of the going price of suitable label printers, and the average cost of such printers is then divided by twelve to obtain the monthly expenditure (note that this is only an expense in the first year). Average Monthly Label Cost is based on the average number of bar-code-labeled clinical documents that Athena receives from each athenaClinicals client in a month, multiplied by the average cost of a single label (as determined through our market research). Average Monthly Labor Cost is based on our understanding of the time taken to label a practice's internal clinical document (converted to an hourly fraction), multiplied by the average number of such documents that we receive per month from each athenaClinicals client, and then multiplied by the 2009 median U.S. hourly wage for medical record technicians (i.e., $15.04).

Welcome to the athenahealth Revenue Calculator! Answer 3 quick questions
and see the potential improvements to your practice's bottom line.

How many providers are in your practice?

Next Question

Question 2 of 3

What is your specialty?

Anesthesiology
Cardiology
Dermatology
Emergency Medicine
Endocrinology
Family Practice
Gastroenterology
General Practice
General Surgery
Internal Medicine
Multi Specialty
Nephrology
Neurology
OB/GYN
Occupational Medicine
Ophthalmology
Oncology/Hematology
Orthopedic Surgery
Otolaryngology
Pain Manangement Specialist
Pediatrics
Physical Therapy
Plastic Surgery
Podiatry
Radiology
Rheumatology
Urgent Care
Urology
Vascular Surgery
Other

Back Next Question

Question 3 of 3

What are your average monthly collections?

Back Calculate

Please wait...

Retrieving your estimated savings

Get more money and more control for better financial health.

Boost Your Practice's bottom line.

Now that we know a little about you, let us tell you a little about athenahealth and how we can help improve your practice's financial health. Explore any of the opportunities for boosting your financial health on the right to get a more customized view of how our services can improve your bottom line.

The data used in this tool is based on historical data from athenahealth clients as well as third-party research. Give us a call at 888.805.0067 to schedule a meeting to explore the specific ways our services can drive better results for your practice.

Get Started

Increase your collections

With athenaCollector's® patented billing rules database, you benefit from the collective experience of over 35,000 providers. On average 94% of claims get resolved the first time and our clients see an average 35% reduction in days in accounts receivable. We help you secure more revenue by:

Reducing denials from billing errors or rules exchanges
Catching and responding to unexpected changes to payer rules
Helping you qualify for and receive government incentive payments

The result: On average, our clients see a 12% increase in collections.

View A Demo of athenaCollector Next: Increase Patient Volume

Increase your patient appointments.

athenaClinicals® helps you optimize your time with patients by giving you access to all the information required to be efficient at the point of care.

Clinical data and P4P measures are collected outside of the exam stage where possible — improving patient volume and better using your time
Documents related to patients are scanned, categorized, and filed in their electronic chart.
Clinical documentation automatically generates billing information for visits through athenaCollector® integration.

The result: On average, our clients experience a 3.8% increase in patient visits.

View A Demo of athenaClinicals Next: Reduce No Show Rates

Reduce your practice's no-show rate.

athenaCommunicator®, our on-demand, live, and automated patient communication service, streamlines patient interactions outside the exam room, identifying in advance which patients have confirmed their visit and which need to reschedule. Our system:

Frees up valuable staff and physician time
Offers patients convenient phone access to your practice
Gives patients an efficient 24-hour web portal where they can schedule appointments, make payments, and receive test results and health information

The result: On average, our clients see a 16% lower no-show rate.

View A Demo of athenaCommunicator Next: Meaningful Use Incentives

Guaranteed "Meaningful Use" Incentive Dollars

Under the HITECH Act, physicians who meet “meaningful use” EHR requirements are eligible to receive up to $44,000 over 5 years for Medicare. We are so confident in athenaClinicals® that we are guaranteeing our eligible physicians will receive their federal stimulus Medicare payments in year one.*

If you are opted in for Meaningful Use incentives:

You’re eligible to receive payments equal to 75% of Medicare allowable charges up to a maximum of 18k
You can't receive both e-Rx and HITECH incentives

*Visit www.athenahealth.com/BonusFAQ

Learn more about Our Guarantee Next: Qualifications for PQRS Medicare

Get the PQRS incentives you deserve.

Our experts stay on top of Physician Quality Reporting System (PQRS), and other Pay-for-Performance and government incentive programs to ensure you bank the revenue you're eligible to receive.

Thanks to our cloud-based rules database, we're able to make available the latest industry requirements and government incentives to our entire network, making it easy for you to participate and stay up to date.

The Revenue Calculator only includes additional PQRS Medicare Payments. However, for many of our practices, we are able to help them qualify for and obtain reimbursements from many other P4P programs.

Learn How to Boost Your Financial Health Next: Qualification for e-Rx

Get the e-Rx incentives you deserve.

With our cloud-based rules database and SureScripts certification, we're able to give providers the functionality they need to report successful use of qualifying e-prescribing measures, allowing you to participate in the federal e-Prescribing Incentive Program (e-Rx).

We make it easier for a practice to earn an e-Rx incentive payment equal to 1% of its total estimated Medicare Part B Physician Fee Schedule allowed charges specified by CMS.

Watch a quick Overview of athenaClinicals Next: Save on Paperwork

Save time and money on paperwork.

Our data shows that every full-time practitioner handles about 1,150 pieces of documentation per month. That adds up to significant staff time and costs for your practice. At athenahealth, we take on the bulk of your practice’s paperwork, saving you money and freeing up staff to focus on more value-add work.

We scan and categorize incoming faxes
We match clinical documents to existing patients and orders
We maintain electronic connections to your pharmacies, labs, and hospitals
We alert you to documents that require attention via your athenaClinicals Inbox

View A Demo of athenaClinicals

Boost Your Financial Health: Click on an item below to explore details.
Increase Collections by:
Increase Patient Volume by:
Reduce No-Show Rates by:
Meaningful Use Incentives:: Yes
No
Qualifications for PQRS Medicare:: Yes
No
Qualification for e-Rx: Yes
No
Save on Paperwork:Yes: NOT EDITABLE

YOUR PRACTICE

Providers in your practice:

Practice Specialty:

Avg. mo. collections:

Need to make a change or planning for the future?

Regardless of what the future holds for your practice, athenahealth grows with you. And that's only one of the benefits of being a web-based solution. With no hardware, licensing fees, maintenance or upgrading required, you'll have the freedom to grow at your own pace — worry free!

Return to Results

Let's Talk Results, Click or Call 888.805.0067

To see the details behind the Revenue Calculator, view our methodology.

Use of the Revenue Calculator is subject to the following conditions and limitations.

The information provided by the Revenue Calculator is based on historical data from a limited set of medical practices, average industry cost data published by others, and user responses to a few select questions. Due to the inherent limitations of the data that modeling tools such as the Revenue Calculator must use, any information that they provide is offered for illustrative purposes only and cannot be expected or relied upon to project future results.

IMPORTANT: athenahealth, Inc. makes no representations, warranties, or guarantees regarding any information provided by the Revenue Calculator or the results obtained from its use or the use of any product or service and shall not be responsible or liable for any errors or omissions in that information or the results obtained from any such use.

The information provided by the Revenue Calculator does not constitute advice of any kind and should be viewed critically; users should obtain any additional information necessary to make an informed decision as to the selection of any product or service. Changes may be periodically made to the data on which the Revenue Calculator is based; these changes may or may not be incorporated into any new version of the tool, and results provided by the tool may vary with each use and over time.

To improve the ease of use of the Revenue Calculator, any data or settings you submit will be retrievable on your computer for fourteen days through the use of a "cookie"; for more information on how information you enter when using our website may be used, please see our Privacy Policy, which is available below. If you have obtained information reportedly provided by the Revenue Calculator from a source other than athenahealth.com, please be aware that such electronic information can easily be altered subsequent to its original distribution.

Please click here to view athenahealth's Privacy Policy

Here are the results you requested. Your practice of providers, with a monthly patient load of and in collections, could potentially be adding to your bottom line with athenahealth.

YOUR SAVINGS

Increase collection rates With athenaCollector's® patented billing rules database you benefit from the collective experience of more than 31,000 providers, allowing billing errors to be flagged and fixed before they become problems. As a result, on average 94% of claims get resolved the first time — so you get paid quicker.

Increase patient volume Your practice's revenue depends on being efficient and effective in managing your time with patients. athenaClinicals® helps manage practice workflow and helps to optimize physician time by boosting efficiency throughout the patient visit. It puts patient information, prescriptions, and clinical documents at physicians' fingertips.

Reduce no-show rates athenaCommunicator®, our on-demand, live, and automated patient communication service streamlines patient interactions outside the exam room, identifying in advance which patients plan to keep their appointments, and which need to be rescheduled.

Guaranteed HITECH Act Incentives We are so confident that athenaClinicals will meet meaningful use requirements that we're guaranteeing our eligible physicians will receive their federal stimulus Medicare payments in year one — and we're putting our money on the line to back it up.

PQRS Thanks to our cloud-based rules database, we're able to incorporate the latest industry requirements and government incentives into our network as soon as they are available, making it easy for you to participate and bank new incentive dollars.

eRx e-prescribing reduces work and is included at no additional cost with. Thanks to our cloud-based rules database and SureScripts certification, you're able to stay on top of PQRS, Pay-for-Performance, HITECH Act and other government e-prescribing incentives for which you're eligible.

Yes

Save on Paperwork On average, athenahealth data shows that every full-time practitioner in a practice handles about 1,150 pieces of documentation per month. athenaCollector and athenaClinicals allows your clinical staff to focus on generating revenue and better patient outcomes versus pulling charts and reviewing, routing and filing documents.