athenahealth Billing Services

For practices already on athenahealth who are deciding who should run the billing. We work inside your system - and since athenahealth sells billing too, this page says plainly how the two differ.

What does not change

What we run inside your athenahealth

Claims from your existing documentation

We work from what your providers already complete. Nothing is submitted before the note supports it.

Eligibility confirmed before the visit

Coverage is checked ahead of the appointment, so a lapsed policy becomes a phone call rather than a denial three weeks later.

Denials worked, with the cause recorded

Every denial gets a reason logged. Recurring ones get fixed at the source rather than arriving again next month.

Payments checked against the remittance

What the payer said they paid, compared with what actually landed. Underpayments are otherwise a slow, invisible loss.

Aged A/R worked in age order

Oldest first, because those claims are closest to a filing deadline and about to become worthless.

How the switch works

  1. We review your recent claims

    Before anything changes, a sample of what you have been submitting shows where money is going and what to correct first.

  2. Access, not migration

    You give us user access to the athenahealth you already have. No data moves and nothing is in transit.

  3. We confirm enrolment before submitting

    A meaningful share of billing problems are really enrolment problems. We check each provider is properly enrolled with the payers you bill.

  4. New claims start immediately

    Current work comes to us straight away so nothing stalls during the change.

  5. Then the backlog

    Whatever is left outstanding gets worked, largest and oldest first.

What your staff still do

Where practices like yours lose money

athenahealth sells billing too, so compare like for like

This is the real decision for most practices on this system. Both options are legitimate. What separates them is not the software - you keep that either way - but who works your denials and how visible that work is to you.

Ask both of us the same four questions

Who specifically works my account and how many other practices do they carry? How quickly is a denial picked up? Do I get told the reasons my claims are denied, or only what was collected? What happens to my A/R if I leave?

A percentage of collections is not the whole cost

Compare what is included. Credentialing, eligibility checks, patient statements and A/R follow-up are sometimes bundled and sometimes billed separately. The headline rate is the easy part to compare and the least informative.

Switching billing is not switching systems

Practices often delay changing biller because they assume it means changing software. It does not. You keep athenahealth; only who logs into it changes.

Questions we get asked

Do we have to leave athenahealth?
No. We work inside the athenahealth you already have. Moving you off it would mean retraining your staff for our convenience, which is not a good reason.
Why use you instead of athenahealth’s own billing service?
Both are real options and we would rather you chose well than quickly. The differences worth testing are denial handling, how many practices your account manager carries, and what reporting you actually see. Ask us and ask them the same questions, then compare the answers.
What access do you need?
User access to your athenahealth with billing permissions, plus the payer portals you are enrolled with. Your practice stays the account owner throughout.
How long does the switch take?
It depends on how quickly access and enrolment details come together, which is usually the slowest part and mostly sits with your side and your previous biller.
What does it cost?
Billing is 4-8% of collections depending on volume and specialty. Credentialing is charged per application, per provider. Every rate is published on our pricing page.

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