Supporting growth: PartnerMD Leverages athenaOne® Medical Coding

PartnerMD is a leader in concierge medicine that has been on an ambitious growth trajectory, with a goal to roughly triple in size over the next six years.

Medical coding is one aspect of the organization’s operations that needed to be addressed to support this strong growth. As an athenaOne® customer since 2014, PartnerMD choose to build on its success with athenahealth and chose athenaOne® Medical Coding to support their operations staff and establish a more scalable approach to growth. This partnership has enabled PartnerMD to grow without needing to add staff to its two-person billing team.

Identifying the need for a scalable coding process capable of driving growth

PartnerMD operates using a concierge model, with patients paying an annual membership fee to join the practice. It’s been a successful model for the organization, which continues to add physicians and grow membership.

PartnerMD’s Chief Operating Officer, Jack Bretcher, knew the organization needed to make some strategic operational changes to support planned growth in a scalable way. One of these key areas for optimization was medical coding.

At that time, using an in-house approach to medical coding, PartnerMD could only handle so much volume of work before needing to add additional full-time staff. However, the practice’s experience trying to hire and retain medical coders made them wary of embracing this approach during rapid growth. Considering what they knew about staffing medical coders, the team realized an in-house approach put them at risk.

“It is really bad. We have had people that are scheduled for interviews who don’t show up for interviews, and we have had people that accept the job and then don’t show up to work,” said Bretcher. “We’ve had people who went out for lunch and then texted that they’re not coming back. So staffing is very tough if we’re tying our success to being able to find and retain people to code.”

Furthermore, the in-house model was fundamentally unscalable, and would not support the ambitious growth the practice was working toward. The only way to make it work would be to continue to hire.

“If you look at doing it yourself, it’s kind of like quantum steps—you’re able to handle this volume of work with this number of people, but then you have to add another FTE to add more volume. So, as we were looking at continuing to grow, we realized we wanted to decouple that cost. We wanted to be able to continue to add doctors and take on more claims without having to add additional people,” said Bretcher. “We’ve been able to remove that step function in terms of cost and growth in a lot of areas.”

In addition to scalability, the team also knew that any process changes would need to also improve the accuracy of their coding and billing, a special concern due to its concierge model. Since patients already paid an annual fee to participate in the practice, any billing inaccuracies and overcharges caused extra strain and distracted from the practice’s primary goal—delivering excellent, patient-centric care.

“Patient experiences are paramount for us. Any stubbed toes on the billing side shows up very unfavorably for us because patients pay just to be a member of the practice. If we mess billing up, we look really stupid, and it builds a perception that all we’re in it for is the money,” said Bretcher.

The team at PartnerMD decided to explore other operational models for medical coding in hopes of finding a better way.

Fully integrated coding services and support, streamlined processes and communication

As an athenahealth customer since 2014, PartnerMD’s success with athenaOne® encouraged the team to look into the medical coding services offered through athenaOne®. The goal was to remove responsibilities for medical coding from the two-person billing team and enable that team to focus on higher value work.

“We have a fairly small billing team. We have two people who do medical billing, so allowing them to work at a higher level is really important for us,” said Bretcher.

After brief pilot programs with athenaOne® coding services and those of another vendor, the team selected athenaOne® Medical Coding.

One important factor in the decision was PartnerMD’s desire to collaborate within a single platform, rather than introducing an additional vendor and technology tool. athenaOne® Medical Coding is fully integrated into the core platform, so there are no additional applications or data that needs to be managed.

“Where athenahealth really excelled […] was the workflow from a communications perspective. Having athena coders integrated into athenaOne® and having all that communication inside of the platform really made the difference,” said Bretcher.

Customer service was another deciding factor in PartnerMD’s decision to use athenaOne® Medical Coding. PartnerMD has a unique model, and the organization faces unique challenges (just like every healthcare organization). They knew they needed a partner who would work to understand their practice, and tailor support accordingly.

“I think the most important thing is that athena has a really strong team behind the scenes and they realize that they’re serving a lot of customers and all of the customers are different,” said Bretcher.

For Jack Bretcher, the relationship with athenahealth is collaborative, and not just in terms of day-to-day medical coding tasks. athenahealth is more than simply a vendor or platform provider—as an operational partner, PartnerMD’s strategic planning now incorporates athenaOne’s ever-growing capabilities and platform services.

“Understanding where athena is going and how that impacts our vision is critical for me,” said Bretcher.