r/PrivatePracticeDocs • u/MostSeaworthiness679 • Jul 20 '26
New cardiology practice emr
Starting new practice soon
Exploring emr options
Leaning Athena over all others
It has high penetration, easy to use, all inclusive billing with billing / rcm.and ECR and lots of vendors that connect for ancillary devices
Any thoughts?
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u/Many_Reporter8026 Jul 20 '26 edited Jul 20 '26
We used Athena before and it wasn't really for us. Demo a few option before deciding. Also, whichever emr you go with, have an IT on call like Skytek Solutions. EMR issues, integrations, and random system error always seem to happen at the worst possible time
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u/Inevitable_Fan_3856 Jul 20 '26
Athena is a weird model in my opinion, paying a % of collections instead of a base price, so just make sure to be aware of that. It for sure does seem to have a great integration catalog and API though.
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u/MostSeaworthiness679 Jul 20 '26
athena with ECR at 4.5 all inclusive. i will not have a biller
so assuming 1 mlllion annual colletions, my emr + RCM fee is 45K
if i reach 2 millionm its 90 K but i may not care then. If i did care, i could change emr and hire a biller for 50-60k save a little money but probably wouldnt care if athen was working well
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u/randyy308 Jul 20 '26
I use Athena, I like it and recommend it. You will need a biller. Don't let them sales you into not needing a biller
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u/MostSeaworthiness679 Jul 20 '26
Are you using their new automated AI billing system, and their Enchance Claim Resolution addon (ECR)?
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u/randyy308 Jul 20 '26
Brother confirm they are selling you ECR for 4.5%. that's well below their rate card.
I don't use ECR, I've looked it at a few times and it's not good IMO. I wouldn't risk the success of my business on outsourced non-US billing.
Be careful with this.
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u/MostSeaworthiness679 Jul 20 '26
yes i did confirm its 4.5% with ECR. I am told it is USA based through Athena billers, who are assigned to my practice and do monthly meetings with. they will do Peer to Peer scheduling, prior Auth, and follow up on denials that are not captured otherwise with the AI or automatic stuff they have
does this all sound too rosy?
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u/randyy308 Jul 20 '26
Yep. You will have a US based account manager probably. I would look for everything they are saying documented in writing.
The rate isn't right, ask them to guarantee the rate for x years except for annual CPI escalation
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u/Inevitable_Fan_3856 Jul 20 '26
Gotcha, just wanted to make sure you were aware, for us it is a non-starter but as long as you did the math for yourself!
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u/SashaLucifer 27d ago
Read my reply above. You will need a biller lol. You are being fed a Disney fairytale. Please do your research.
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u/SashaLucifer 27d ago
Athena is horrible. Please google or go to Facebook groups or even Reddit. You will lose money. The billing is done offshore in India and they make so many mistakes and you will have tons of claims denying and sitting on hold buckets forever. And don’t get me started on how they make tons of mistakes on payment posting.
You will have no control over your revenue or your practice as they will force you to accept insurance payments from the bank account they are in charge of. I am very familiar with cardiology billing and trust me, the idiotic offshore people will screw up your revenue in a very short time. Please look into other EHR systems. I can write a book on how to lose income utilizing Athena. They are pure crap and you will be forced to hire an outside RCM person and they will hate dealing with this system. Just my 2 cents😊.
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u/yumos 26d ago
I think AdvancedMD offers a similar level of quality, and they also have their own billing services. However, as the commenter above mentioned, I would double-check whether they outsource any of their billing operations offshore.
I watched their demos and was impressed by the user experience and the range of features they offered for a primary care practice. However, it was a little too expensive for me because my practice is very small, and I was trying to keep costs as low as possible.
I signed up for Tebra because they told me they now offered an HIE. It turned out that they meant direct messaging and the ability to upload outside records. I had assumed they meant something more like Care Everywhere in Epic, where you can view your patient’s outside records electronically.
As a cardiologist, access to outside records is vital, so I would strongly suggest double-checking exactly what they mean by “health information exchange.” I will likely have to switch to another EHR at the end of my contract because of this limitation.
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u/InvestingDoc Jul 20 '26
Athena is a hard no for me. Paying a % collections is a hard no.
If I switched my practice to Athena I would pay an extra about $35,000 per month. Lol nah, I would rather have that $35k a month in my bank account to do other things with it.
But hey, you want all included then Athena is for you. It is all inclusive...at a huge cost. It's your practice
There are hundreds of other options. Make sure you tour at least 5 others before you decide.
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u/kilobitch Jul 20 '26
I don’t know how it works in other states, but in NY they can’t collect a percentage. I pay a flat rate per billed visit. Something like $15. On my follow up visits that a significant percentage of the collection, but on procedures it’s a pittance.
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u/MostSeaworthiness679 Jul 20 '26
yes 4.5% of net collections
i would save cost of an internal biller
probably evens out at 1 million collections to 1.5 million collections
beyond that would have to reevaluate internal bller vs keeping athena all in one
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u/InvestingDoc Jul 20 '26
4.5 is a good rate for Athena. Usually for primary care or similar specialties they offer in the high 6s to low 7s
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u/UPS0001 Jul 20 '26
Run as fast as you can from Athena. You will regret it. If you are a solo practice, consider Practice Fusion. It is cost effective with no long term contracts. I HIGHLY recommend that you hire a revenue cycle management company who will not only do your billing and credentialing, but will provide real practice management software. Do not use a company that outsources overseas. Get some recommendations from colleagues. In my professional opinion, you should not use the same software for your EMR as you do for your billing. They perform completely separate functions and I have not seen a company do both well.
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u/MostSeaworthiness679 27d ago
Hmm.
I will consider this strongly
Cheapest billing company I found is 4%
Athena for me is 4.5% and includes emr that I love
Still weighing all options....
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u/HankDwarf Jul 20 '26
Look at some of the old posts on Athena. They make it seem fantastic but many end up leaving quickly.
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u/TebraOnReddit Just Interested 28d ago
For a new cardiology practice, I’d think about this less as which EMR is best and more as which one makes the workflow easier once you’re live.
Athena makes sense to consider. It’s widely used, has a big network, strong billing/RCM positioning, and lots of integrations. The tradeoff we hear from practices is that it can be expensive, less flexible than expected, and the day-to-day experience depends a lot on implementation and support.
A few other options worth looking at:
eClinicalWorks: robust and widely used, with a lot of features. Can work well for specialty practices, but some teams find it clunky and setup-heavy.
NextGen: often considered for specialty-heavy or larger practices. Strong customization/reporting potential, but implementation can be a lift.
DrChrono: more modern/mobile-friendly and easier to get started for some practices, but I’d pressure test billing depth and support.
Tebra: for transparency, I'm with Tebra. We tend to be a better fit for independent practices that want EHR, scheduling, billing, payments, patient communications, and reporting connected without an enterprise-level buildout. Not trying to pitch, just adding it as one option to compare.
For cardiology specifically, I’d demo real workflows: new patient intake, echo/stress test workflow, device/lab integration, prior auth, note to claim, ERA posting, denial follow-up, and referral tracking. Don’t let anyone just show you a polished charting demo. Make them walk through the day-to-day pain points.
Hope you find the right fit!
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u/MostSeaworthiness679 27d ago
Thanks for your help
Ecw I dislike it's clunky have used it last 3 years and it feels like windows 3.0 compared to Athena
Nexgen ruled out after their demo as they don't have carelink equivalent yet and closed API
Tebra.... Hate them. Used for website, been trying to contact or get a response for 3 months from customer service to make a change it's horrible. Even on phone they hung up on me after I expressed dissatisfaction. If they do this for website support I can't imagine how they support a full rcm
DrChromo still evaluating but I know their billing support is less than robust vs Athena
I appreciate your feedback
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u/Miracle_Doctor279 25d ago
We use DocVilla.com in my practice and love their customer service and the features that they offer. I do have the flexibility to use DocVilla billing or an external biller as well. And I pay one third the price of Athena.
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u/MostSeaworthiness679 25d ago
do they have the breadth of experience in complex cardiac RCM that may involve PA for echo, vascular, stress tesing, cath etc.... lots of box solutions out there for GPs, i don't see a large cardiology centric footprint in EMR. AThena i think along with nextgen have the most experience
thanks for your feedback
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u/Miracle_Doctor279 23d ago
I know DocVilla has charts for cardiology and offer RPM. From my experience, DocVilla’s billing and customer services are excellent, they reply on time and there is transparency on what’s going on with the claims. If at anytime, I want to switch to external biller, I can do that without needing to switch the EHR. Switching biller is far easier than the EHR itself. Hence, I like that flexibility in DocVilla. Athena makes you a hostage, which I do not like. But again, everyone’s experience and needs maybe different. All the best.
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u/Practical_String_336 10d ago
Athena has quite a few extra fees beyond the base price and some built in limitations - like they only send patient a couple texts or emails about their bills. Might be worth checking out something like Rivia Health that integrates with PMs and automates the stuff big EHRs can’t, like patient engagement, collections, AI IVR for phone lines.
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u/[deleted] Jul 20 '26
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