Features and services

When you submit an eligible order, our Authorization Rules Engine immediately checks it against continuously updated payer requirements to determine if medical authorization is needed. When it is, our authorization specialists communicate directly with payers to submit documentation, follow up on status, and manage the authorization to completion. Our service can complete this entire process with zero additional client work over 95% of the time.

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    Fully integrated solution

    There’s no additional vendor, application, or data to manage. Our service is fully integrated into your clinical workflow and launches when you place an eligible order.

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    Authorization Rules Engine

    Save the time and frustration of researching updates and tracking changes across payers. Our rules engine is continuously updated with the latest payer requirements and closely monitored for accuracy.

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    Urgent authorizations

    Get same or next-day authorizations for situations requiring immediate care. Same-day authorizations are initiated within 2 hours of receipt, and 94% of urgent authorizations are completed within 48-hours.

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    Authorization Tracker dashboard

    Have complete visibility of the authorization process and the status of your medical authorizations at any time. View details of individual authorizations and communicate with our specialists as needed.

See how athenaOne® Authorization Management works

As soon as you hit ‘submit’ on an eligible order, our service takes the work off your plate by automatically determining if medical authorization is necessary. Our team obtains required authorizations on your behalf, saving you valuable time and effort.

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Free to focus on patient care

Cookeville Regional Medical Group’s staff (CRMG) struggled with a paper-based authorization process that consumed a lot of time. Even worse, authorizations typically took seven to ten days, which could delay patient care. By implementing athenahealth’s Authorization Management service, CRMG reduced the completion time for most authorizations to 48 hours. They were also able to decrease the number of employees working on authorizations by 60%.

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Reduced staff pressure means better patient care

The Griffin Faculty Physicians (GFP) staff were spending a collective average of 650 hours a month on the phone seeking medical authorizations. It was putting a strain on staff across the organization as well as impacting the patient experience. After adding the Authorization Management Service, GFP reclaimed all 650 hours of staff time, reducing the risk of after-hours work and allowing for a better patient experience.

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    Percentage of authorizations completed with zero client work.*

    *Based on athenaNet data as of Q1 2020

    “Some of our staff would be on the phone for probably a good half hour, even more, just to get an authorization for an MRI."

     

    – Joanna Vagueiro, Sr.Electronic Medical Records Coordinator,Griffin Faculty Physicians