WATERTOWN, Mass. and LOUISVILLE, Ky., Oct. 19, 2007 (PRIME NEWSWIRE) -- 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."
About Humana
Humana Inc., headquartered in Louisville, Kentucky, is one of the nation's largest publicly traded health benefits companies, with approximately 11.3 million medical members. Humana offers a diversified portfolio of health insurance products and related services -- through traditional and consumer-choice plans -- to employer groups, government-sponsored plans, and individuals.
Over its 46-year history, Humana has consistently seized opportunities to meet changing customer needs. Today, the company is a leader in consumer engagement, providing guidance that leads to lower costs and a better health plan experience throughout its diversified customer portfolio.
More information regarding Humana is available to investors via the Investor Relations page of the company's web site at http://www.humana.com.
About athenahealth
athenahealth is a leading provider of internet-based business services for physician practices. The Company's service offerings are based on proprietary web-native practice management and electronic medical record (EMR) software, a continuously updated payer knowledge-base and integrated back-office service operations. For more information visit www.athenahealth.com or call (888) 652-8200.
This press release contains forward-looking statements which are made pursuant to the safe harbor provisions of Private Securities Litigation Reform Act of 1995, including statements regarding the benefits of the Company's service offerings. These statements are neither promises nor guarantees, and are subject to a variety of risks and uncertainties, many of which are beyond our control, which could cause actual results to differ materially from those contemplated in these forward-looking statements. In particular, the risks and uncertainties include, among other things: the risk that our services offerings will not operate in the manner that we expect, due to design flaws, security breaches or otherwise; potential interruptions or delays in our internet-based services offerings; our reliance upon third parties, such as computer hardware, software, data-hosting and internet infrastructure providers, which reliance may result in failures or disruptions in our service offerings through no fault of our own; errors or omissions included in our payer and clinical intelligence rules engine and database; and the evolving and complex government regulatory compliance environment in which we and our clients operate. Existing and prospective investors are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date hereof. athenahealth, Inc. undertakes no obligation to update or revise the information contained in this press release, whether as a result of new information, future events or circumstances or otherwise. For additional disclosure regarding these and other risks faced by athenahealth, Inc., see the disclosure contained in our public filings with the Securities and Exchange Commission.