Fitting the Bill

Case Study | Sunshine Doctors

An upgrade to athenaOne’s extended revenue cycle management services leads to more comprehensive billing and higher revenues for a family medical practice.

  • ILLO_LocationGlobe-Teal_DGT_2

    Small, family practice in Daleville, Va.

  • Female Dr and male nurse

    4 providers

  • ILLO-laptop_phone_DGT

    Primary and Urgent care

Challenges

  • Heavy billing and coding burdens
  • Out-of-date fee schedules
  • Missed reimbursements
  • Lost revenue opportunities

Solutions

  • athenaOne
  • athenaOne Medical Coding
  • athenaOne Enhanced Claim Resolution
  • athenaOne Authorization Management

Results

  • Thorough coding and billing
  •  Major income improvements
  •  More time to spend on patient care
  •  Strong expansion potential

Dr. Lianna Lawson was missing out on a lot of money. She grew worried that her coding and fee schedules were out of date due to years of poor management by a former employee and an outside vendor.

With a busy family practice in Daleville, Va., Dr. Lawson needed a partner she could trust with the coding and billing demands that can rob practitioners of precious time tending to patients. So she turned to athenahealth, her long standing partner since 2014, and in 2021 added athenaOne Medical Coding, Enhanced Claim Resolution and Authorization Management to get things on track.

“I started realizing that our billing was in dire need of help,” she explained. “I don’t really have time to be looking over my people’s shoulders all the time to make sure that they are getting the work done.”

Soon after upgrading to these services, she discovered that she had previously been losing out on about $50,000 a year in reimbursements during the pandemic years. Now, after consultations with her athenaOne team, she is billing quickly and comprehensively and gaining added revenue.

“That’s been a real big benefit of having athenaOne,” she said, noting that she has been made aware of revenue opportunities “that weren’t in our fee schedule or weren’t in there correctly.”

A ‘cost effective’ way to improve billing and revenue

Dr. Lawson founded her practice, Sunshine Doctors, in 2009 after leaving a large medical group because she felt she had too little time to care for patients. Her practice is deeply family-oriented, providing clinical and acute care, and sees all ages, from infants to the elderly.  

But medical billing and coding became an ongoing headache and time killer due to staff turnover, paperwork and input complexity, and a reliance on her existing services and workflows were not up to the task. She did not like that she was paying for a full-time in-house coding specialist instead of the nursing assistant like she wanted.

She said partnering with athenaOne has given her “more me time back in my day to focus on higher value tasks,” and allowed her “to collect money faster, help me increase my revenue, and scale my business.”

Now, with the “very cost effective” addition of athenaOne’s extended revenue cycle management services, including athenaOne Medical Coding and Enhanced Claim Resolution, she has been able to bring on a new medical professional, something she “could not have done in the financial situation I was in before this change.”

“With athenaOne taking on such a significant amount of the billing,” she said, “our money is flowing in because of more accurate coding and because proper billing has really improved.”

“If your coding is correct and coded to the maximum allowed for your visit,” she added, “then your billing is going to look better.”

Signing up for athenaOne’s full service ‘makes so much sense’

Dr, Lawson, a physician since 1998, says she has been approached by colleagues looking for advice on medical record-keeping and billing services. Some doctors are skeptical, thinking they will save on costs by handling records and billing and coding in-house.

She said she strongly recommends athenaOne’s full suite of records management tools and extended revenue cycle management services, telling colleagues that taking the burden of billing out of house will save them time and money over the long term. She added that the transition to these services was easy and the results immediate.

“I can’t imagine why they would not want to sign on,” she said. “It makes so much sense.” 

Schedule a demo and value assessment to find out if athenaOne is the right fit for you.

These results reflect the experience of one particular organization and are not necessarily what every athenahealth customer should expect.

Sunshine Doctors participates in athenahealth’s Client Advocacy Program. To learn more about the program, please visit athenahealth.com/client-advocate-hub.

Sunshine Doctors was not compensated for participating in this content.