ATHENAHEALTH AND HUMANA LAUNCH FIRST FULLY-INTEGRATED NATIONAL ALL-PAYER PLATFORM FOR REAL-TIME ADJUDICATIO
WATERTOWN, Mass. and LOUISVILLE, Ky. (October 19, 2007) – (PrimeNewswire via COMTEX News Network) — athenahealth, Inc. (Nasdaq:ATHN), a leading provider of internet-based business services for physician practices, today announced that it has developed and launched the first fully-integrated all-payer platform that is designed to enable its entire national client base to perform real-time adjudication (RTA) of medical claims at the point-of-service for participating payers. athenahealth was able to achieve this major milestone through co-development efforts with Humana Inc.(NYSE:HUM), one of the nation’s largest publicly traded health benefits companies with more than 480,000 physicians and Availity, LLC, a leading provider of healthcare transactions.
As part of the new program, physician practices leveraging athenahealth’s on-demand national network are now able to more accurately collect patient-owed portions of claims at the time of the office visit in real-time. This functionality has become increasingly important with growing patient responsibility due to the consumer-directed health care movement. athenahealth’s RTA functionality enables physicians and their staff to submit a claim at the time of service, receive a fully adjudicated claim response from the payer within seconds and collect the appropriate payment for services that qualify for real-time claim adjudication before the patient leaves the office.
“With the help of a leader like Humana, we are thrilled to bring this new real-time adjudication functionality and all-payer platform to the thousands of physicians that make up our national network,” said Jonathan Bush, Chairman and CEO of athenahealth. “Through our PayerView(tm) Rankings initiative we are uniquely positioned to see emerging trends, like growing patient responsibility due to the consumer-directed healthcare movement, and then work with payers like Humana to help simplify the claims payment process. Our new all-payer RTA platform is one of several areas we are aggressively pursuing to help furnish providers with relevant information at the time of service which can dramatically improve their bottom line.”
“Our partnership with athenahealth clearly demonstrates Humana’s continued commitment to innovations that reduce complexity in the health care system,” said Bruce Perkins, Humana’s Senior Vice President of National Contracting. “Investing in resources like real-time claim adjudication will have a dramatic impact on the industry by streamlining administration efficiencies and increasing the timeliness and accuracy of claims payment.”
athenahealth and Humana announced their RTA partnership in 2006 and piloted the new program in three states over the past year, now making it generally available to athenahealth’s entire national client base. As a result of its extensive work with Humana, athenahealth plans to leverage the platform that it has built to be used with any payer that chooses to participate and meets certain technological requirements to link to the athenaNet(r) system, athenahealth’s centrally-hosted practice management and EMR service platform, enabling athenahealth clients to seek to collect patient-owed portions of claims in real-time.
“Physicians across the country, and especially here in Ohio, are increasingly concerned about the impact that consumer-directed health care plans and high-deductible health plans will have on their ability to collect timely payment from their patients,” said Carol W. Mullinax, Senior Director of the Ohio State Medical Association, which has over 20,000 physician members and has endorsed athenahealth’s services to its membership since 2001. “We are thrilled that athenahealth has launched this new RTA all-payer platform as they have been a great partner in empowering our member physicians to run more effective medical practices and navigate an increasingly complex reimbursement environment. As usual, athenahealth is ahead of the curve in developing solutions for the problems physicians face today.”
“As high-deductible health plans continue to increase over the next few years, medical groups will grow increasingly frustrated if they have to perform RTA differently for each payer,” said Usman Mirza, CEO of The San Antonio Orthopaedic Group, a pilot site for the athenahealth and Humana RTA initiative. “One of the core reasons we use athenahealth is their ability to stay ahead of emerging industry trends like consumerism and work on our behalf with payers so we can continue to drive operational improvement and concentrate on delivering better patient care.”
Source: ATHENAHEALTH
