User Guide — Minimum Service Commitment (MSC)

athenaCollector + athenaClinicals

This page describes the minimum service commitments made by athenahealth to your organization. As part of our co-sourcing partnership with you, we at athenahealth pledge to provide, at the minimum, the levels of service described on this page.

 

We are so confident in our ability to keep athenaOne up and running that we will credit you 1% of your Service Fee for every 0.1% of availability we fall below 99.7% in a month, up to a maximum of 20% of that month's Service Fee when taken in combination with any other credits. athenahealth hours of operation are from 6:00 a.m. to 1:00 a.m., Eastern time, 365 days per year.

 

That doesn't mean that athenaOne isn't available from 1:00 a.m. to 6:00 a.m. In fact, athenaOne is usually available 24/7 except for one Friday every month, when we update the software, and most Mondays, when we perform routine maintenance.

 

If we need to take the system down for maintenance, we will do all work within the 1:00 a.m. to 6:00 a.m. window, and post a notice in the "Service Alert" section of the athenaNetwork home page.

 

Major system maintenance

In case we need to perform major system maintenance, athenahealth reserves the right to take athenaOne offline between 11:00 p.m. Saturday and 8:00 a.m. Sunday, Eastern time, without penalty. We will do that no more than twice per year and no sooner than 90 days since the last time. We will give you at least seven days notice.

 

 

 

 

athenahealth will submit at least 95% of your primary and secondary claims within three business days of their entering DROP status, or we will credit you 2% of that month's invoice for every 1% we fall below 95%. On rare occasions, claims are exempted from this minimum service commitment.

 

athenahealth will automatically submit claim attachments on primary and secondary claim submissions. If the claim is a secondary claim submission, athenahealth will automatically include the primary remittance.

 

Primary institutional claims are sent on paper. We send claims electronically to Medicare A and a few commercial payers.

 

 

 

athenahealth will post at least 95% of payment dollars within four business days after the date of receipt to your athenahealth P.O. box of both the payment dollars and the corresponding remittance. If we fail to meet that standard, we will credit you 2% of that month's invoice for every 1% we fall below 95% in a calendar month.

 

athenahealth will post payments from corporations, but we need an allowable schedule from you if you negotiated a discounted rate.

 

The Non-Participating Providers page is maintained solely by you and must be updated annually.

 

 

 

athenahealth commits to initiate a follow-up contact within 20 business days on at least 95% of the claims that have remained outstanding past our standard waiting period — that is, after an alarm has been triggered. If we fail to meet that standard, we will credit you 2% of that month's invoice for every 1% below 95%.

 

 

 

athenahealth commits to examine and take action on at least 95% of your denials within 10 business days. If we fail to meet that standard, we will credit you 2% of that month's invoice for every 1% we fall below 95%.

 

 

Should we fail to meet these MSCs, athenahealth automatically refunds to your practice a percentage of your monthly service fee. This percentage is determined according to your level of service — athenaCollector, athenaCollector (No Follow-Up), and athenaCollector (No Posting) — and the nature of the events that caused the failure. You can find the details of our MSC pledge in your service contract.

 

Because we cannot log in to Medicare's system as you, you need to notify us if there are denials related to claim formatting.

 

 

 

 

When new enrollment numbers or information are entered in athenaOne, athenahealth will take action to initiate work within five days. If the NPI or provider number information entered in athenaOne does not match the payer's records, athenahealth will send the task back to the Enrollment Worklist for review.

 

For transaction enrollment (EDI, ERA, etc.) based on payer requirements, athenahealth will either send forms to your practice for signature or submit the forms directly on your behalf. athenahealth will monitor the progress of these forms until the payers have processed them.