The athenahealth medical billing solution is completely rules based and learns with every denial. In case of a denial, the system works with administrators to create a new rule to ensure that particular denial does not occur again. The result is an improving curve on payments. athenahealth medical billing is a cloud-based solution that offers a range of backend services that handle all time-consuming tasks to keep the practice working efficiently on revenue generation and collection. The rules engine within athenahealth checks each claim carefully against a very large number of rules to ensure the claim has the least possible chance of denial.
A key to the effectiveness of athenahealth billing is its willingness to learn. The solution already incorporates 40 million rules used by different payers to handle claims. By checking every claim against this rules database, athenahealth ensures the lowest possible probability of a claim getting denied. New rules are added on a daily basis, and the 130 million claims submitted annually through athenahealth billing are mined for data about denial trends. As a result, reimbursement ratios increase regularly and medical practices using the athenahealth solution see continuous improvements in the financial health of their practices.
The company claims that their networked, artificial intelligence-supported system results in 32% faster payment and 6% increase in revenue. About 94% of all claims are cleared within the first iteration.
The backend processes are reportedly so good that on October 1, 2015, when the transition occurred from ICD - 9 codes to ICD - 10 codes, clients using athenahealth billing did not see any drop in their collections due to the change.
Besides offering great solutions, the company also coaches its clients in improving their workflow practices. The athenahealth medical billing team will benchmark and track processes used by clinics and can provide guidance on where improvements are possible. A number of analytical services are made available to subscribers free of cost to help them become more efficient. Since the company has a client base of 72,000 medical practices, it is able to tell its clients where they stand in relation to their peers.