athenaOne® Enhanced Claim Resolution Performance Dashboard

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This dashboard is available to customers who have contracted with athenahealth for the athenaOne® Enhanced Claim Resolution service.

 

The athenaOne® Enhanced Claim Resolution Performance Dashboard provides transparency into the work being done, the effectiveness of this work, and the impact it has on your practice​.

 

  • On the Main Menu, click Reports. Then click athenaOne Enhanced Claim Resolution Performance.
    The dashboard appears in a new tab.
  • On the Main Menu, click Reports > Insights Dashboards. The Insights Dashboards landing page appears in a new browser tab. In the menu bar, hover over Less Work and then click athenaOne® Enhanced Claim Resolution.

 

 

  • This dashboard is available to customers who have contracted with athenahealth for the athenaOne® Enhanced Claim Resolution service.
  • To access the athenaOne Enhanced Claim Resolution Performance dashboard, you must have the Messaging, user, and practice pages role/permission.

 

 

The athenaOne® Enhanced Claim Resolution Performance Dashboard provides transparency into key performance indicators. related to the athenaOne® Enhanced Claim Resolution service, including:

  • Amount of work done by athenahealth independently

  • Amount of work where the athenahealth team needed your practice's assistance

  • How effective the claim work is at securing a payment or transfer to the next responsible party

  • Average work times between receiving the claim rule hold or denial and billing it out

Note: Currently, the dashboard is available only to existing customers who were already using athenaOne and then later added the Enhanced Claim Resolution service. In a future release, we will consider making the dashboard available to customers who have the service as part of their athenaOne onboarding.

 

 

Dashboard metrics are refreshed daily. The latest dashboard refresh date appears on each dashboard.

 

For more information about the athenaOne Enhanced Claim Resolution service, see the following in the Success Community:

For more information about Insights Dashboards, see the Insights Dashboards article in O-help.

 

 

The athenaOne Enhanced Claim Resolution Performance Dashboard includes the following sections:

  • Filters
  • Performance at a glance
  • Metrics charts and graphs
  • Left panel with highlighted metrics and links to focused dashboard views
  • Insights

 

Tip: Click the image to see an expanded view

 

 

Using the filter fields, you can filter data on the dashboard, by:

  • Department

  • Supervising Provider

  • Supervising Provider Specialty

  • Payer (IRC)

To display the filter fields on the dashboard, click Filters at the top right of the dashboard.

  • Click any filter field to display the filter options. Select the filters that you want from the list and click Apply. The filtered results appear immediately on the dashboard.
  • Click Clear all to remove all filters that were previously selected.

 

 

 

Key metrics at the top of the dashboard show how athenaOne Enhanced Claim Resolution is working on your behalf.

 

Metric Description
Service-Eligible Claims

Total claim rule holds and denials within the scope of the service, including:

  • Claims worked by athenahealth
  • Claims that your practice worked from athenahealth's worklist
  • New work that athenahealth couldn't take on because of missing documentation or open encounters
athena Resolved Claims billed or closed by athenahealth (independently or with your practice's assistance)
athena Worked Independently: Effective Submission Rate

The percent of claims that received a payment, a capitation adjustment, or a transfer to the next responsible party, for claims that athenahealth billed without needing assistance from your practice.

The Effective Submission Rate metric takes around 3 months to mature, so the data shown is for dates 3 months or older (current month minus 3 months).
athena Worked Independently: Time to Claim Submission (Days) Average business days between athenahealth receiving the claim and then billing it out, for claims that athenahealth billed without needing assistance from your practice

 

 

 

Charts and graphs of your organization's performance over time help you visualize the data and compare performance between the current period (day/week/month) and previous periods.

 

Some charts also show a baseline for comparing the service performance to your practice’s previous performance average across the three months before the service start date.

 

Metric Description
Work Distribution Trends (Resolved Claims)

Billed or closed claims in the service's scope and who completed the work:

  • Work by athenahealth's team (on their own or with assistance from your practice)
  • Work by your practice (including claims originally assigned to athenahealth)
Effective Submission Rate

Percentage of billed claims that achieved one of the following successful outcomes:

  • A payment
  • A capitated adjustment
  • A transfer to the next responsible party

The Effective Submission Rate metric takes around 3 months to mature, so the data shown is for dates 3 months or older (current month minus 3 months).
First Pass Effective Submission Rate

Claims that achieved a successful outcome on the first try:

  • The claim's first submission (for claim holds work)
  • The claim's first resubmission (for denials)
Time to Claim Submission

Average time between the claim being sent to athenahealth or your practice and the claim's submission (for claim holds work) or resubmission (for denials).

Calculated in average business days.

 

 

To export data from a table or chart:

  • Click the export icon — located at the top right of each table and chart — to download the data to a CSV file.

 

 

 

The breakdown table displays the detailed data for the Work Distribution Trends.

 

Choose a different view of the breakdown details by selecting from the menus:

  • Work Category
  • Month Billed/Closed
  • View By

Tip:

  • Hover over the information icon to read each metric definition.
  • Click the sort icon to sort by a specific column

 

 

 

Click an area of performance in the left panel to view focused dashboards to help you understand the drivers for that performance indicator:

  • Reduce requests for practice input

Each additional dashboard has similar sections as the main dashboard

 

 

 

Clicking the Insights button on the right side of the page provides information about Enhanced Claim Resolution, links to resources, and descriptions of dashboard metrics.

 

 

 

 

 

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