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Infants and Children

Pediatric Practice Freed Up to Give Back to Diverse Community


Infants and Children, a nine-physical pediatric practice with a mission to become part of the fabric of its diverse community, was struggling not only to get paid, but also with patients showing up for appointments. With athenahealth, the practice was able to reduce DAR from 90+ to just 16 days on average, and greatly reduced no-shows and balanced out busy seasons with automated reminders.



  • Located in West Palm Beach, FL
  • 9 Physicians
  • 1 Nurse Practitioner
  • 2 locations
  • 30,000-40,000 patient visits


  • Patients not complying with care or showing up for appointments
  • Bills sitting in days in accounts receivable (DAR) for 90+ days
  • Administrative burden overwhelming staff capacity



  • Office visits increase significantly without growth in patient base
  • DAR reduced by 33.51% despite five fewer billers*
  • Greater practice efficiency generates more revenue even with a shorter work week
For 50 years, Infants and Children, a nine-physician pediatric practice, has been part of the ethnically and economically diverse West Palm Beach community. It’s the kind of community where getting involved is important.

By partnering with athenahealth—who are handling administrative work such as billing, claims, and patient outreach—the practice has become more efficient, having more time to carry out their original mission of becoming part of the fabric of the community, and not just another pediatric practice.

With the right partner and services by their side, Infants and Children kicked its philanthropy into high gear by starting the “Healthy Mothers, Healthy Babies” pregnancy program for expectant mothers, providing free care to homeless families, and serving on the board of the West Palm Beach public library, among other activities.

Dr. Ronald Romear, originally from Trinidad and the practice’s first African-American partner, has been practicing at Infants and Children for 20 of the practice’s 50 years and has seen the clientele evolve. “The practice has had to learn the food, the ethnicity, and the social mores of Haitian-Americans, Cuban-Americans, and Central-Americans, as well as the entire Caribbean, along with all we should know about being American,” he says.

These are people who expect respect and a personal touch. “We made sure that we were sensitive to the needs of all our patients,” says Dr. Romear, “and did not provide different levels of care based on patients’ ability to pay.”
Overcoming operational struggles, low visibility

To provide this kind of service, the practice needed to be financially sound, a struggle prior to working with athenahealth. As Lori Fischer, Infant and Children’s office manager, describes it, “We had eight full-time billers here and our days in accounts receivable was well over 90 days. It was not good at all. We were collecting at a very low percentage rate. We [also] had a server for our software and when the server went down, we couldn’t function.”

Dr. Romear adds that they didn’t know where revenue was coming from, and how much revenue was being lost from no-shows and patients not coming in on time for essential preventative care, like vaccinations and annual well visits. The practice would have long, slow periods and then sudden overwhelming rushes, such as when high school students needed physicals for college applications.
Cloud-based services enable new practice efficiencies

When Infants and Children moved to athenahealth, all this changed. Using athenaCollector, athenahealth’s practice management service, enabled the practice to trim its billing staff from eight employees to three while still reducing its DAR 33.51%—to just 16 days on average. athenaCollector also made sense of the larger financial picture, providing insight into revenue sources and performance.

“athena has given [providers] visibility and transparency within their practice,” says Fischer. “It’s been really terrific for them to be able to see exactly where they’re at, to be able to pull specific reports about how much they’re collecting for newborns at the hospital...[or] from a specific insurance company. And how they’re doing individually as well… they can compare their progress to other doctors in the state of Florida or the rest of the country. And they enjoy doing that.”

athenaCommunicator equipped the practice with a suite of patient communication services to make them more efficient and effective. The services reduced no-shows by reminding patients of appointments, and increased collections by reminding patients of payments due. The practice also uses athenahealth’s live operator service after business hours to make appointments and field patient calls. And an online patient portal, branded as the practice’s, allows patients to schedule their own appointments, and ask providers clinical questions and get prompt responses, reducing time-consuming callbacks.

athenaCommunicator also helped solve the problem of overwhelming busy periods punctuated by slow periods. By automatically sending out targeted messages to large groups of patients about time-sensitive services (such as flu shots and school physicals), the practice balanced out its scheduling and workload and avoided overwhelming rushes for such services.

All of these efficiencies enabled Infants and Children to reduce its work week from seven days to five-and-a-half days and still take in more revenue, faster, than ever before.
Serving the community bonds practice and patients

Infants and Children also put athenaCommunicator to an unusual use—to great effect. “When I came here 20 years ago,” says Dr. Romear, “there was a culture that you had to give back. You had to be a part of the fabric of the community.” Practice providers and staff do that in a variety of ways in West Palm Beach, including free clinics, but they also do regular service work in Haiti, “just a 1 hour and 50 minute plane ride” away, Dr. Romear points out.

When the practice wanted to ask patients to help support the work in Haiti, they used athenaCommunicator. They put the word out that they were looking for: canned goods, non-perishables, blankets, soaps, etc. The request got an overwhelming response, and has led to patients’ ongoing support of the mission. The practice also uses athenaCommunicator to keep patients apprised of how their donations are being used in Haiti.

Doing community work sets Infants and Children apart from other pediatric practices. “The philanthropy that Infants and Children does has helped our patients see that we’re part of their day-to-day lives,” says Dr. Romear. “We’re not just here waiting for when they’re sick.” It also raises the practice’s profile in West Palm Beach. “It’s a very competitive area. There are several pediatric groups here. But there are not several pediatric groups that are doing what we do. And so, it’s a win-win for us.”

© March 2014
* Our clients see an average 8% increase in collections and 29% decrease in days in accounts receivable. These figures are based on a weighted average for athenahealth clients with valid pre-athenahealth benchmark data that had their 15-month anniversary with athenahealth through 9/30/2012.

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