ATHENAHEALTH HELPS MASSACHUSETTS MEDICAL PROVIDERS AVERT INSURANCE CLAIM DENIALS WORTH NEARLY $100 MILLION IN 2006

Watertown, Mass. (January 30, 2007) – athenahealth, Inc., the premier provider of web-based services, knowledge, and software for medical practices, today announced that in 2006 its system caught claims errors that would have resulted in health insurance claim denials totaling close to $100 million for Massachusetts medical providers. This figure is one of a series of new financial milestones athenahealth achieved for its Massachusetts physician practice clients in 2006. athenahealth attributes these results to its growing Massachusetts client base, and the ever-increasing effectiveness of its on-demand service as more medical practices contribute to the powerful network effect created by the company’s unique payer rules-engine and web-based practice management system, athenaNet®.

New 2006 milestones announced today include:

athenahealth assisted medical providers in Massachusetts in averting more than $98.9 million in health insurance claim denials in 2006, more than doubling the approximately $40 million in averted claim denials for Massachusetts medical providers in 2005.
Currently more than 1,500 medical providers in over 140 medical practices throughout Massachusetts are using athenahealth to streamline their practice management, clinical workflow, and billing and collection needs.
athenahealth has collected more than $576 million for medical practices in Massachusetts in 2006.
“The landscape for physician practices is becoming increasingly more complex. New trends within the marketplace such as pay-for-performance and consumer-directed health care are making traditional practice management systems obsolete. These market dynamics are requiring medical providers to leverage a new on-demand service like athenahealth to maximize their revenue and streamline their practice management,” said Jonathan Bush, chairman and chief executive officer of athenahealth. “Medical groups deal with a tangled web of insurance rules that dictate the format and content guidelines for submitting claims. With athenahealth, physicians participate in a network and share intelligence. As the network grows, so does the intelligence of the service because payer rules are added to the database on a daily basis resulting in increased revenue and efficiency.”

Physician practices across the country continue to experience financial stagnation due to the use of traditional software-based practice management systems that erode productivity and profitability. These systems are not suited to apply new protocols from specific payers to the practice’s billing process, nor are they able to calculate the payment responsibilities in advance for patients with new high-deductible plans. Without these capabilities, practices are losing revenue by failing to meet reimbursement requirements and in the administrative costs of collecting payments from patients long after the day of care delivery.

As part of athenahealth’s practice management offering, its revenue cycle management solution applies an industry-unique combination of intuitive software, billing intelligence, and results-oriented services. The company’s on-demand service provides continually updated payer-specific coding rules to help providers optimize reimbursement. Through the system, medical practices are also alerted to relevant payer rules that need to be considered to ensure proper documentation and efficient billing processes. Today, athenaNet has over 40 million permutations of payer reimbursement rules.

“Our claim volume with athenahealth has been relatively stable over the last few years, but the savings we have achieved continues to escalate,” said Peter E. Masucci, MD, a one-physician practice in Everett, Massachusetts. “Every month athenahealth’s service gets better at squeezing out additional revenue for my business, and when you combine that with the constant parade of new management tools and best practices they provide, it makes athenahealth the clear choice for practice management and EMR services for all medical practice types in Massachusetts.”

In 2006, athenahealth, along with Physicians Practice Magazine, launched the first annual PayerView Rankings that analyzed claim performance data from thousands of medical providers using athenahealth’s athenaNet® system database to rank national, regional, and government payers according to specific measures of financial and administrative performance and medical policy complexity. The complete PayerView Rankings, including Massachusetts-based health insurers are available in interactive form at www.athenaPayerView.com.

Source: ATHENAHEALTH