athenaOne Reviews & Pricing

Key Features

Medical Billing

• Medical Coding: Access certified coding support for accurate ICD-10-CM and CPT coding, ensuring alignment with current coding standards. Benefit from automated coding suggestions and alerts for potential code mismatches, reducing coding errors.
• Claims Resolution: Manage denied and rejected claims with tools that offer real-time claim status tracking and detailed feedback on claim issues. Receive automated alerts and guidance for correcting errors, allowing faster re-submission and reducing denial rates.
• Insurance Verification: Automate patient eligibility verification before appointments to ensure coverage and minimize denied claims. Receive alerts for potential eligibility issues, enabling front-office staff to resolve discrepancies early.
• Billing Rules Engine: Automatically flag and correct potential issues in coding, documentation and claim formatting, increasing first-pass acceptance rates. Continuously update rules to stay aligned with payer requirements and industry regulations, minimizing rework.
• Telehealth Billing: Use special codes that tell insurance companies this is a virtual visit, so they know exactly how to pay. Automatically add these codes when creating bills so that they match what insurance needs. Add a “place of service” code that shows the visit happened online, not in a clinic or office. Make sure bills reflect that the service was remote, so insurance pays correctly.
• Authorization Management: Initiate same or next-day authorizations for urgent situations requiring immediate care, with a two-hour initiation window for same-day requests. Track and manage prior authorizations directly within the billing system. Automate follow-ups for pending authorizations to get necessary approvals before you provide the services.
• Dashboard: Access financial performance metrics like days in accounts receivable, total receivables and unpaid claims. Track claim statuses from submission to payment in one centralized view.
• Reporting: Use customizable reporting tools to analyze practice financials, claim performance and payer trends. Generate detailed reports on revenue metrics including payer performance, patient collections and claim aging for strategic planning.
• Patient Portal: Let patients view medical histories, sign documents, pay bills, manage appointments and more using mobile devices. Physicians can communicate with patients through messaging, notes or even video calls.

Electronic Health Records

• Documentation: Use customizable templates and macros to speed up documentation, tailoring forms to fit specific specialties or individual provider preferences. Access pre-encounter preparation tools to review patient histories, lab results and any relevant details, preparing effectively for patient appointments.
• Voice Powered Services: Use voice commands for retrieving patient information and documenting encounters, reducing manual input and improving efficiency.
• Population Health: Combine clinical, financial and payer data to build a comprehensive view of patient populations, identifying health trends and potential risk factors. Use care management tools to pinpoint care gaps, monitor chronic conditions and coordinate patient care across various settings and providers.
• Interoperability: Share information easily with other healthcare providers, labs and pharmacies, making sure everyone has the same up-to-date information about a patient. Combine data from different sources so doctors can see everything they need to know in one place.

Want Numbers? Let’s Take a Look at the Data

• Peachtree Orthopedics saw a 240% increase in time-of-service collections, a 22% reduction in denial rate and a 37% reduction in charge entry lag.
• SCP Health observed a 67% reduction in eligibility-related denials and saved $6,000 per month in payment posting-related costs.
• Spine Colarado PC noticed a 99.5% authorization success rate and 100% visibility in the authorization process.
• Georgia Hand, Shoulder & Elbow saw $1.5M average increase in collections per year over the first four years and 92.9% of claims accepted on the first submission.
• Premier Inpatient Partners observed a 15% revenue increase and 90% clean claims rate.

Limitations

• The initial setup and implementation phase can be time-consuming and resource-intensive.
• Certain users find the system's customization capabilities insufficient for tailoring workflows to their practice's specific needs.

Suite Support

Case Study Source Links:

• Peachtree Orthopedics
• SCP Health
• Spine Colorado PC
• Georgia Hand, Shoulder & Elbow
• Premier Inpatient Partners