Two medical groups – Spine Colorado and Cookeville Regional Medical Group – realize a success rate of up to 99.5% using athenahealth’s integrated service; clinicians and office staff get considerable time back to devote to patients and other priorities
athenahealth, a leading provider of network-enabled software and services for medical groups and health systems nationwide, today announced that Spine Colorado, a nationally acclaimed spine practice specializing in the diagnosis and treatment of back and neck problems, and Cookeville Regional Medical Group (CRMG), one of Tennessee’s leading healthcare providers, have realized significant results using athenahealth’s authorization management solution.
By streamlining the entire authorization process, the fully integrated service has empowered the medical groups to reallocate up to 60% of the full-time employees working on authorizations to focus on higher-value matters, including improving patient and staff experiences.
athenaOne Authorization Management, which is continually updated to changing payer requirements, alleviates time-consuming administrative tasks such as maintaining medical authorization requirements and coordinating with payers to pre-approve imaging services, procedures, surgeries, medications, and primary care physician-to-specialist referrals. It is a value-added service available to practices using athenaOne, athenahealth’s cloud-based suite of electronic medical record, revenue cycle management, and patient engagement services.
Spine Colorado recently implemented Authorization Management to address challenges associated with the authorization process, such as employee workload and lack of visibility into progress. Now, instead of relying on staff to spend time manually tracking down payer information, the service automatically begins processing pre-certifications as soon as a clinician enters an order into athenaOne. By addressing authorizations for Spine Colorado efficiently and accurately, Authorization Management has saved the practice approximately 40 hours per week that are now rededicated toward improving the patient experience.
"Prior to adopting athenahealth’s solution, we lacked comprehensive oversight into the authorization process. Now that we’ve made the switch and are using the automated service, we have gained 100% visibility into the status of medical authorizations managed by athenahealth’s team, which has been critical in our organization’s commitment to transparency," said Christopher Scott, MS, CMPE, CEO of Spine Colorado. "Whether it’s Authorization Management, athenaCommunicator, or athenaTelehealth, we know that we can trust athenahealth to help us remove technological barriers, stay current with changing payer rules, and focus on providing excellent care."
CRMG faced a different set of challenges that led them to implement Authorization Management to support more than 12 medical and surgical specialties, as well as pre-authorize hundreds of visits and procedures daily. Due to a paper-based authorization process, the medical group previously experienced delays in patient care of seven to 10 days, spent too much time on follow-ups to ensure authorization success, and had difficulty monitoring the progress of authorizations. Since adopting Authorization Management, CRMG’s average time to obtain authorizations has been reduced by a week and the group is now able to schedule patient appointments and procedures within 48 hours. The organization has also been able to redeploy 60% of its full-time employees working on authorizations.
"Creating a significantly more efficient authorization management process was important to our organization so we could reduce pressure on staff and allow them to spend less time handling administrative work, while increasing time focused on patient care," said Monica Morrison, director of practice operations, CRMG. "As with all athenahealth services, the company’s in-system tool for authorization management is seamless to use, allows complete visibility into the status of authorizations, and has proven effective in allowing us to focus on delivering high-quality patient care in a timely manner."
According to the 2019 AMA Prior Authorization Physician Survey results reflecting responses from 1,000 practicing primary care and specialist physicians, practices spend an average of almost two business days each week completing prior authorizations (PAs). Additionally, for those patients whose treatment requires PA, 91% of physicians report the process delays timely access to necessary care. Authorization Management renders a determination as to whether an authorization is required with zero additional client work more than 95% of the time, thereby reducing burden on staff and costs associated with PA management. Further, for same or next-day orders, the athenahealth service aims to initiate contact with the payer within two hours to quickly begin the authorization workflow, giving physicians peace of mind that there is a focus on urgency so they can provide timelier patient care.
"Following a year of uncertainty for many healthcare organizations, we are more determined than ever to help practices improve their processes and generate efficiencies so they can reallocate their time and resources to what matters most: caring for their patients," said Bret Connor, chief customer officer, athenahealth. "Authorization Management helps many organizations like Spine Colorado and CRMG not only reduce delays in patient care, but also foster higher productivity and save valuable time and money."
To read more about Spine Colorado and CRMG’s results using Authorization Management, please visit: https://www.athenahealth.com/case-studies.
To learn more about Authorization Management, please visit: https://www.athenahealth.com/prior-authorization.
About athenahealth, Inc.
athenahealth partners with medical organizations across the country to drive clinical and financial results. Our vision is to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all, and we are pursuing this through our medical record, revenue cycle, patient engagement, and care coordination service offerings. Our expert teams build modern technology on an open, connected ecosystem, yielding insights that make a difference for our customers and their patients. For more information, please visit www.athenahealth.com.
About Spine Colorado
Spine Colorado is a highly acclaimed, regional spine center for the treatment of back and neck problems across the Four Corners area. Spine Colorado includes two fellowship trained spine surgeons working alongside two physical medicine and rehabilitation physicians, physician assistants and nurses who are committed to utilizing the most advanced diagnostic technology and evaluating techniques. In addition, Spine Colorado physicians and staff work collaboratively with neuropsychologists, specialized spine physical therapists, registered dieticians, and medical massage therapists to uncover the best possible treatment and outcomes in patient care.
About Cookeville Regional Medical Group
Cookeville Regional Medical Group is a multi-specialty group consisting of primary care and specialty physicians dedicated to caring for families. With over 200 physicians on its active and courtesy medical staffs, CRMG is part of Cookeville Regional Health System, a robust health care system that also consists of Cookeville Regional Medical Center and The Foundation at Cookeville Regional. The sum of our parts makes us a leading provider of high-quality health care services to the people of Tennessee.
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