Payer Solutions

Robust clinical data exchange for optimal care decisions

Fast, accurate data exchange from day one

Connect to thousands of healthcare providers when you go live with athenaPayer solutions. Our cloud-based, single-instance platform enables near real-time sharing of critical information across the largest open network in healthcare.

  • Care Gaps

    Help providers address open care gaps by surfacing clinical data directly within their workflows.

  • Diagnosis Gaps

    Support diagnosis gap review by surfacing suspected and potential diagnosis information in the moment of care.

  • Health Plan Data Exchange

    Receive clinical information in the form of a CCD whenever a member's encounter is closed.

  • Medical Electronic Prior Authorization

    Connect to athenahealth's network of providers to streamline and automate a full end-to-end prior authorization process.

  • ADT Notifications

    Alert providers about member admission, discharge and transfer activity to help support transitions of care.

  • Quality Program Advancement

    Help providers succeed in your quality programs by leveraging athenahealth to drive improved quality performance. 

  • Provider Network Directory

    Improve the referral process by surfacing provider network designation, cost and quality ratings information in the ordering workflow. 

  • Appointment Notifications

    Receive member appointment activity to help coordinate care and minimize duplicative outreach.

Simplify the authorization process

Medical Electronic Prior Authorization

Learn how athenaPayer’s automated end-to-end prior authorization support can streamline burdensome processes to resolve requests faster.

Spend less time chart-chasing

Health Plan Data Exchange

Hear from our Chief Product Officer Paul Brient about how athenaPayer’s Health Plan Data Exchange can save you time by simplifying access to your members’ clinical data.

A network that drives action

160K+

providers on the athenaOne network.1

25M

total care and diagnosis gaps ingested by third parties.2

50 states

athenaPayer’s care and diagnosis gap solutions touch members in all 50 states.3

136M

CCDs sent to payers annually.4

Awards

Industry recognition for athenaPayer

  • KLAS Point of Light Awards Payer/Provider 2022

    Care and Diagnosis Gaps

    KLAS 2022 Points of Light recognition award for payer/ provider collaboration

  • Emerge Innovation Experience Award Payers

    Care and Diagnosis Gaps

    HIMSS 2024 Winner Circle award for the EMERGE Innovation Experience

  • KLAS Point of Light Awards K2 Collaborative Payer/Provider 2024

    Electronic Prior Authorization

    KLAS 2024 Points of Light recognition award for payer/ provider collaboration

Payer solutions that enable optimal care decisions

athenaPayer

Schedule a demo

1. Based on athenahealth data as of Dec. 2024

2. Based on athenahealth data for 12 months ending Dec. 2024

3. Based on athenahealth data as of Dec. 2024

4. Based on athenahealth data for 12 months ending Dec. 2024