athenahealth's rules engine scores a patent

By Bernie Monegain
10:38 AM

athenahealth, which provides Internet-based business services to physician practices, has received a patent for its practice management and billing system.

The U.S. Patent and Trademark Office issued the patent on Nov. 10 for the Watertown, Mass.-based comnpany's athenaNet rules engine, which is part of the company's athenaCollector revenue cycle management service.

Company officials describe the patented technology as a method for managing a medical practice's insurance claims by storing and modifying claim rules based on ongoing interactions with claim messages received from payers on submitted claims, enabling the system to automatically produce cleaner and more accurate claims.

"Early on we designed athenaNet to act as a national utility that was able to harness billing and medical practice operational data working with a global rules engine to drive improved financial and operational results across our national physician network," said Jonathan Bush, athenahealth's chairman and CEO. "It is athenahealth's unique ability to leverage this Web-based system and our analyst and service teams to reverse engineer, codify and drive payer and proprietary billing intelligence directly into medical practice workflow that results in our clients experiencing significant financial improvement."

Bush said athenaNet has been a key source of competitive differentiation.

"While this differentiation has always been valuable to us, it has been defended primarily by our superior execution," he said. "With this patent being issued, we will now have a stronger legal basis for defending this advantage in the marketplace."

As part of the athenaNet rules engine, athenahealth has built and continuously updates a proprietary knowledge base of payer reimbursement process rules, Bush said. In turn, athenaCollector is designed to enforce medical office workflow in conjunction with these rules.
 

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