Full steam ahead
1-location outpatient clinic
- Manual claim and denial resolution process was burdensome
- Frustration due to time spent on payer phone calls
- Time diverted from higher-level, revenue-generating work
- Expanding the practice model efficiently
- athenaOne Enhanced Claim Resolution™
- Up to 80% weekly reduction in biller time spent on payer phone calls
- 11.6% Full Spectrum patient collections increase since using Enhanced Claim Resolution
- 25 percentage-point time-of-service collections increase
- Increased patient portal adoption to 87%
- Enhanced patient experience
- Efficient opening of second on-site practice, Identity Health Clinic
Time of service collections jumped by 25 percentage points in one quarter at Full Spectrum Health, which biller December Douglas says is just one improvement at the practice thanks to using athenaOne Enhanced Claim Resolution. She and practice owner Dr. Tracey Wiese were so satisfied with athenaOne – and focused on efforts to expand the business – that they decided to use the service. Enhanced Claim Resolution’s certified, integrated coding and billing talent works on behalf of Full Spectrum to process complex claim issues, call payers, and resolve denials.
Douglas’ day-to-day has greatly improved due to a drastic reduction in time spent on the phone with payers — up to 80 percent weekly, she says. But she also notes other downstream effects as strong as the current that attracts fly fishermen to the practice’s Alaska location. Front desk staff have far less insurance-related dialogue, which means they can focus on several other initiatives. Patient engagement dialogue has yielded an 87% portal registration rate. Staff have made progress on patient payment plans, adding patient credit cards on file within athenaOne, and can focus on co-pay collection at check-in.
Getting paid at the time of service is a strategic goal for Full Spectrum Health, which recently opened Identity Health Clinic on-site to fill a void in Anchorage for gender- and sexuality-affirming healthcare. But in order to expand services, consistent cash flow was essential – as were efficiencies when it came to scaling without adding staff. Douglas and owner Dr. Tracey Wiese decided to enroll in Enhanced Claim Resolution. It’s a decision that Douglas thinks is qualitatively and quantitatively invaluable, she said. Since using the service, Douglas can focus her attention on higher-level work, including internal auditing versus spot-checking claims to improve the clean-claims rate. “If we didn’t use Enhanced Claim Resolution, I would probably be working 50 hours a week instead of 30. Projects would be put on the back burner, or they would be done during non-work hours,” said Douglas.
Besides having time for internal auditing, Douglas can now contribute to answering patients’ insurance questions – and even though she works remotely from Arizona, she can tag-team with the on-site staff via patient portal messaging. Getting patients answers to their questions easily and in a timely fashion enhances their experience, Douglas says. It’s also helped to enhance Full Spectrum’s patient collections rate by 11.6 percent since the practice started using Enhanced Claim Resolution.
Communication and transparency are essential for contractors like Douglas, who can’t simply walk to a colleague’s desk to chat. Before adopting athenaOne, Full Spectrum staff managed billing issues via a spreadsheet. Now, the whole Full Spectrum team can communicate using integrated patient cases in their EHR. And although Enhanced Claim Resolution is resolving 87 percent of the work taken on for Full Spectrum without additional input, any questions Douglas has are typically answered thoroughly and quickly, she said. athenahealth training documentation also helped bring her up to speed, which was essential because she works 2,600 miles away. “The onboarding training modules and videos are irreplaceable. They are invaluable, as far as putting a price on them,” said Douglas, whose contracting requires her to work within several medical records systems. “athenahealth is, by far, the greatest system I have ever worked with. If it was up to me, I would never use another system.”
athenahealth is, by far, the greatest system I have ever worked with. If it was up to me, I would never use another system.
*These results reflect the experience of one particular organization and are not necessarily what every athenahealth customer should expect.