Everyone in your practice is probably familiar with the feelings that come with having to deal with denied claims. Frustration, to be sure. Maybe even powerlessness or a sense of resignation at being exposed to so many problems you can’t control.
Now imagine something very different. Imagine a team of experts and thousands of other practices working on your behalf, finding billing problems and fixing them before they reach your practice. When you’re connected to our proprietary database of billing and clinical rules, this is exactly what happens.
Our rules database puts the experience and knowledge of all our clients to work for each of our clients. Here’s how it works:
Everyday our clients submit thousands of claims through our web-based software. Our billing experts monitor these submissions and look for claim denial trends. As soon as they spot one, they fix the incorrect payer code that’s causing the trend and add a rule to our database. From this moment forward, no athenahealth client will confront the problem again. Scale this process up by tens of thousands of rules and you get a system where you’re far more likely to get your claims paid the first time around – and it gets smarter every day.
In addition to preventing claim denials, the rules database also keeps you up-to-date on clinical guidelines, protocols and pay-for performance program requirements. It automatically provides drug interaction and allergy alerts right at the point of care. And it will be easier to track that you’ve captured the data required for HITECH Act and P4P incentives as they are implemented.
There’s no software to upgrade. All the information in the rules database is updated daily by us and becomes a part of your workflow without you having to do a thing.
In a healthcare system that sometimes seems designed to keep your practice off balance, the rules database harnesses the experiences and strength of all our practices to help set things straight. It protects each practice from billing problems, gets each practice paid faster and more fully, and gives you the time (and timely information) you need to do what matters most – provide better care.
athenahealth, there is a better way.
How our Rules Engine Works Imagine a team of experts and thousands of other practices working on your behalf, finding medical billing problems and fixing them before they...