User Guide — Pay for Performance Service
The athenahealth pay for performance service is designed to assist your athenaClinicals practice with participation in a wide variety of pay for performance programs.
Step-by-step instructions
To enroll a new provider in a pay for performance program
- Make sure that the provider has been added to athenaOne on the Users page. (On the Main
Menu, click Settings
> User. In the left menu, under Practice Links — Users, click Users.) - Add the provider to the Providers page. (On the Main
Menu, click Settings > Billing. In the left menu, under Practice Links — Providers, click Providers.)
- On the Providers page, verify that this provider can create encounters; that is, the Encounters option on this page must be selected.
- Add the provider's NPI to athenaOne. (On the Main
Menu, click Settings > Billing. In the left menu, under Practice Links — Enrollment and Numbers, click NPIs and Other Numbers.)
- Contact the CSC by selecting Support > Create Case or Call in the Main Menu.
The case classification page appears. - Click the Quality Management category.
The Quality Management subcategories appear. - Click Quality Program Enrollment and then click Create Online Case.
The case creation page appears. - Specify the following information:
- Provider to enroll
- Program that the provider is currently enrolled in
- Program that the provider should be enrolled in
- Any specific measures that should be tracked for that provider (if applicable)
- Click Create Online Case.
A case confirmation page appears with the case number.
To change the pay for performance program that a provider is enrolled in
- Before you submit a case to change the P4P program for a provider:
- Verify that the provider can create encounters; that is, the Encounters option on the Providers page must be selected.
- Verify that the provider's NPI is still listed in athenaOne. (On the Main
Menu, click Settings > Billing. In the left menu, under Practice Links — Enrollment and Numbers, click NPIs and Other Numbers.)
- Contact the CSC by selecting Support > Create Case or Call in the Main Menu.
The case classification page appears. - Click the Quality Management category.
The Quality Management subcategories appear. - Click Quality Program Enrollment and then click Create Online Case.
The case creation page appears. - Specify the following information:
- Program that the provider is currently enrolled in
- Program that the provider needs to be enrolled in
- Click Create Online Case.
A case confirmation page appears with the case number.
Work with our Clinical Intelligence team
We invite your practice to work with the athenahealth Clinical Intelligence team to enroll providers with the appropriate P4P programs in your practice's region.
- We automate and assist in the data collection required for pay for performance programs.
- We provide reporting so that you can monitor your performance in the program.
- We make data submission easier.
- We notify you about programs that your practice may be eligible for.
Our Clinical Intelligence team would like to hear from you regarding P4P programs in which you are enrolled or may wish to participate in. You can contact the CSC by selecting Support > Create Case or Call in the Main Menu.
Terms & Conditions Agreement
If you are not yet enrolled in a quality management program, a Terms and Conditions agreement will appear for participating providers when you first log in following your enrollment in a P4P program.
This agreement concerns the submission of clinical data to a third party related to pay for performance service program and measures:
- This agreement allows us to submit clinical data from athenaClinicals on your behalf to third parties for the pay for performance programs that you are enrolled in. The accuracy of the data is the responsibility of the practice.
- Although athenahealth will assist you with the pay for performance programs, there is no guarantee of payment from the programs.
- Your practice must still adhere to state and local laws regarding consent and privacy.
If this agreement appears and you are not interested in taking advantage of our pay for performance service, please contact us at P4P@athenahealth.com or contact the CSC by selecting Support > Create Case or Call in the Main Menu so that we can disable the Terms and Conditions agreement for you.