athenahealth (ATHN)
VCA Stocks: B2B Software and Services -> Healthcare Software -> Medical Office Software
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145.58
$5,441,780,400
$5,600,880,400
$595,000,000
9.15
107.84

athenahealth, Inc. (athenahealth) is a business services company, which provides ongoing billing, clinical-related, and other related services to its customers.

The Company provides these services with the use of athenaNet, an Internet-based practice management application. The Company’s customers consist of medical group practices ranging in size throughout the United States of America. Its cloud-based services are packaged as four integrated offerings: athenaCollector for revenue cycle management, athenaClinicals for clinical cycle management, athenaCommunicator for patient cycle management, and athenaCoordinator for referral cycle management. On October 31, 2011, the Company acquired Proxsys LLC. In March 2013, the Company completed the acquisition Of Epocrates. In May 2013, athenahealth Inc acquired The Arsenal on the Charles.

The software offered through athenaNet is conduit through, which the Company exchange information among clients, payers, and its staff of experts. It works with clients, payers, and other partners to codify rules associated with reimbursement, clinical quality measures, and other factors related to its clients’ performance. Its service offerings are based on its cloud-based software, a continually updated database of rules, and integrated back-office service operations.

athenaCollector and Anodyne Analytics

The Company’s offering, athenaCollector, is its revenue cycle management service. It automates and manages billing-related functions for medical practices and includes a practice management platform. athenaCollector assists its clients with the proper handling of claims and billing processes to help manage reimbursement. Complementing athenaCollector is its business intelligence offering, Anodyne Analytics, which provides physicians and practice managers with detailed insight into practice performance. Through athenaNet, athenaCollector utilizes the Internet to connect medical practices to its Rules Engine and service operations team. athenaCollector is a complete practice management system, which includes scheduling, payment processing, and a workflow dashboard. The system is used by its clients and its services team to track claims requiring edits in real-time before they are sent to the payer, claims requiring work, which have come back from the payer unpaid, and claims that are being held up due to administrative steps required by the individual client. It also includes a full set of reporting tools in athenaNet, so that users can track their ongoing performance and benchmark it against other practices.

athenahealth service operations enable the service teams, which collaborate with client staff to achieve transactions. Its service operations consist of both knowledgeable staff and technological infrastructure used to execute the key steps associated with proper handling of physician claims and clinical data management. The service operations team interact with physicians, providers, and clinicians at all of the key steps in the revenue cycle, including coordinating with payers to ensure, which client providers are properly set up for billing; checking the eligibility of scheduled patients electronically; submitting claims to payers directly or through intermediaries, whether electronically or through printed claim forms; obtaining confirmation of claim receipt from payers, either electronically or through phone calls; receiving and processing checks and remittance information from payers and documenting the result of payers’ responses; evaluating denied claims and determining the approach to appealing or resubmitting claims to obtain payment; billing patients for balances that are due; compiling and delivering management reporting about the performance of clients at both the account level and the provider level; transmitting key clinical data to the revenue cycle workflow to eliminate the need for code re-entry and to permit assembly of all key data elements, and providing client support to manage issues, address questions, identify training needs, and communicate trends.

athenaClinicals

athenaClinicals is the Company's electronic health record (HER) service, which automates and manages medical-record-management-related functions for practices. It assists medical groups with the proper handling of physician documentation, orders, and related inbound and outbound communications to ensure, which orders are carried out quickly and accurately. Through athenaNet, athenaClinicals displays clinical measures, by office location related to the drivers of care delivery, on a workflow dashboard, including lab results requiring review, patient referral requests, prescription requests, and family history of previous exams. athenaNet provides comprehensive reporting on a range of clinical results, including distribution of different procedure codes (leveling), incidence of different diagnoses, timeliness of turn around by lab companies and other intermediaries, and other key performance indicators.

Clinical intermediaries, such as laboratories and pharmacy networks require specific formats and data elements, as well. athenaRules is designed to access medication formularies, identify potential medication errors, such as drug-to-drug interactions or allergy reactions, and identify the specific clinical activities, which are required to adhere to Pay-for-Performance programs, including Medicare incentive payments. Its service operations capture inbound paper documents, convert them to electronic format, attach them to the appropriate patient chart, and classify them according to type and associate results with the original order where applicable. In addition, even if the physician creates an order in the EHR, the intended recipient may not accept orders electronically it reduces the electronically generated order to paper for delivery on behalf of the practice. It also performs Pay-for-Performance program identification and enrollment tasks on behalf of practices so that they can participate without up-front research and effort.

athenaCommunicator

athenaCommunicator includes ReminderCall and other automated patient messaging services, live operator services, and a patient portal. athenaCommunicator allows practices to manage many patient communication tasks electronically, including use of automated reminder calls with criteria and opt-out functionality; creation of a self-service patient portal for registration, appointment requests, bill payments, and general communication; automatic generation of e-mails to patients, and patient education tools. The automated phone calls are multi- purpose and may include appointment reminders, outbound campaigns, and follow-up on outstanding balances while prompting patients to make payments by mail, telephone, or online through its systems. athenaCommunicator allows practices to build a set of communication rules with their patients. They can set patient or group-specific communication preferences, which automatically tailor communications to the timing and mode of delivery, including phone call, e-mail, or patient portal. These communication rules allow each patient to receive a personalized experience, including delivery of messages with branding and using the Caller identity of the practice. As part of the athenaCommunicator service, it provides live operators who field these calls on behalf of practices, including redirected automated calls for appointment scheduling, patient payments, and message-taking. It also prints and mails paper statements to patients on behalf of the practice to assist with patient payment collection.

athenaCoordinator

athenaCoordinator allows providers, through an online portal, to electronically prepare and send a clean order for a referral and a patient can arrive at his or her appointment with another physician, or at a hospital or lab, with information already entered and verified. This information can include the order details, the patient’s insurance eligibility, any necessary pre-certification, information the receiving provider needs to fulfill and bill the order, and details on any prior authorizations that are needed. For the initial care giver, athenaCoordinator reduces time spent managing outbound orders and can provide visibility to patient status after the referring visit. athenahealth’s Rules Engine automatically determines a patient’s insurance eligibility after a referring provider enters an order through the Web-based portal. athenahealth back-office operations verify insurance and benefits with payers, secure pre-certification, handle patient registration, collect self-pay from the patient, and electronically deliver the order to the receiving provider in advance of the patient visit.

The Company competes with Allscripts-Misys Healthcare Solutions, Inc. eClinicalWorks, LLC, GE Healthcare, Greenway Medical Technologies, Inc., Quality Systems, Inc., Sage Software Healthcare, Inc., Siemens Medical Solutions USA, Inc., United Healthcare, Inc. and McKesson Corp.

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