Healthcare Innovation Journal

athenahealth announced that on November 10, 2009, the U.S. Patent and Trademark Office has issued athenahealth a patent entitled, ‘Practice Management and Billing Automation System’ (U.S. Patent No. 7,617,116) for its athenaNet rules engine that is part of the Company’s revenue cycle management service, athenaCollector.

The patented athenahealth technology is, briefly described, 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. A complete description of the patented technology is available through the website of the U.S. Patent and Trademark Office.

“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. 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,” said Jonathan Bush, athenahealth’s Chairman and CEO. “We are thrilled to have been granted a U.S. patent on our athenaNet rules engine as it has always been a key source of competitive differentiation and our client service results. While this differentiation has always been valuable to us, it has been defended primarily by our superior execution. 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. In turn, the athenaCollector revenue cycle management service is designed to enforce medical office workflow in conjunction with these rules. The web-based service functions as a proactive utility that guides medical practice staff away from making billing mistakes that may adversely impact the practice’s operational performance.