Medical Billing Support for Practices on athenahealth

Billing for athenahealth practices, inside the system you already use

If your practice already runs on athenahealth, you do not need new software to get better billing. Our athenahealth billing services put certified billing professionals to work inside your existing athenahealth account, under the user access you grant. Charges, claims, payments and notes stay in your own system, so your providers and staff can see every claim and every follow-up action at any time.

There is no installation and no data migration. The workflow your team knows for scheduling and documentation stays exactly as it is. We simply take on the billing side: reviewing charges, working the claim queues, posting payments, chasing denials and keeping AR current. A Business Associate Agreement is signed before anyone on our team accesses your system.

How claims move through athenahealth with a billing team on them

Claims in athenahealth pass through scrubber edits, claim holding queues and the platform's clearinghouse connection before they reach the payer. Our work starts before that: every encounter is checked against the signed note for coding and modifier accuracy, and charges are reconciled to the schedule so no completed visit is left unbilled. Claims that hit scrubber edits or rejection worklists are fixed the same day, not left sitting in a queue.

Once submitted, we watch acknowledgment reports for rejections. A rejected claim never entered the payer's system, so the fix is to correct the data and resubmit as a new claim. We also track claim status through adjudication and run regular checks on claims that pass the payer's normal processing time without a response. Our claims management service describes this process in full.

ERA and payment posting in athenahealth

Electronic remittance advice arrives in the system and posts automatically in many cases, but automatic posting is not the same as correct posting. Our team reviews ERA payments line by line, compares each payment against the expected contracted rate, and flags underpayments instead of writing them off. Denied and adjusted lines are routed to denial follow-up the same day they post.

Posted totals are reconciled to bank deposits so nothing slips between the remittance and the ledger. If your practice has manual payments, paper EOBs or patient payments to post, those are handled in the same workflow. See the main EHR & PM systems page for how the work stays inside your account.

Denial follow-up and aging AR

Denied claims are worked from the system's denial worklists by code and by payer, with a note on each claim recording what was done and when. We read the CARC and remark codes, decide whether the fix is a corrected claim, a reopening request or an appeal, and act before the payer's appeal deadline. The common denial codes, from authorization denials to medical necessity, are handled the same way every time so the backlog does not grow.

AR is worked by age and by dollar amount, and monthly reporting shows days in AR, denial rate and collections against your contracted rates. Our denial management team owns this part of the cycle end to end.

Eligibility and prior authorization checks

Most denials start at the front desk, not in the billing office. We check eligibility and benefits before visits using your system's eligibility tools or the payer portal, and we confirm authorization requirements for services your payers flag. Authorization numbers, approved units and dates are recorded on the patient account so claims go out with the right reference attached.

For services that need prior approval, the authorization is requested and tracked before the visit, with extensions requested before the approval runs out. If your practice bills services that commonly require authorization, our prior authorization support covers that workflow.

Credentialing, reporting and the monthly review

Claims only pay when the rendering provider is enrolled with the payer, so credentialing runs alongside billing for practices that add providers or locations. We track payer enrollment status by payer and flag any provider or location that is not ready to bill before claims go out.

Each month your account contact walks you through a plain-language report: collections, denial rate, AR aging and what changed since last month. To understand pricing before you start, see our pricing page, or begin with a free billing assessment where we review your claims, denials and AR and explain what we found.

Trademark note

athenahealth is a trademark of its owner. Fastora is not affiliated with, endorsed by or a certified partner of athenahealth. The name is used only to describe the system a billing team can work inside under the user access the practice grants.