athenahealth

Company: Athenahealth Software system: athenaCollector

Website:
http://athenahealth.com

Description:
athenahealth is a leading provider of Internet-based services for physician practices. athenaCollector is their proprietary web-based physican billing and practice management system that aims at helping their clients ( i.e. physicians) achieve faster reimbursement from payers ( i.e. insurance companies), reduce error reates, increase collections and lower operating costs. The heart of the software is a proprietary database of payer rules, containing over 40 million payer rules permutations, which can be continually updated with new rules continually due to the web-based nature of the software. This rules engine enables athenaHealth officials to effectively and efficiently file claims on behalf of their clients.
Use Cases:
The primary actors in the system are the physicans and the athenaHealth officials. The goal of the physican, the primary actor is to submit his claims to the athenaHealth officials. The physican logs in to the web based athenaCollector software, fills in the claims details and submits his claims. The goal of the athenaHealth officials is to retrieve the claims submitted by the physicans and process the same. The athenaHealth officials retrieve the claims by logging in to the system, and submit the retrieved claim to the rules engine subsystem. the rules engine subsytem processes the claim and provides the most effective way to process the claim as an output after checking for discrepancies and erroneous entries.
Standards:
The use of standards were not explicitly mentioned in the overview page, but secondary readings did suggest that the software uses HL7 standards for communicating healthcare information.