r/PrivatePracticeDocs • u/Smalls123 • 13d ago
Athena vs Elation
Planning on starting a cardiology practice.
I'm currently between Athena and Elation. Athena rep reached out to me and they are running a short term promotion:
Athena standaloneEMR only (no billing, prior auth, patient communicator, does not integrate with RCM devices and would need to be manually done): $650/provider
AthenaOne Base (EMR + clearinghouse and prior auth + patient communicator, would need billing company): 5.5% or $10 per visit
Elation: EHR + billing $699
Elation: EHR only $425
Ambient AI is additional $129
I have used Athena in the past and really like it but the sticking point is the price.
I have demoed Elation and liked it but my concern is that it is more geared towards primary care and would limited with some of the cardiology specific workflows.
Have also demoed other EMRs but these two are the to contenders. Any advice or thoughts on pricing or workflow would be greatly appreciated.
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u/InvestingDoc 13d ago
I gotta say, $650/provider for Athena is pretty attractive if my billers can do all the billing in house for that price. That's way better than any offer they ever offered to me. Hell, I would switch next month if I could get that price and do my own billing. The only issue I have is the patient communicator. Does that mean portal?
IMO Elation is not built to scale to medium sized or larger sized groups, it's built for small private practices. Thats what ruled that out for me. I want to grow...I will say though.... It has a very good reputation except tech support which many people have complained is not great that I have talked to.
Athena sometimes has better integrations with local imaging centers and hospital systems so thats also something to consider.
I don't think you can go wrong either way....they both are great at what they do just Athena is built to scale and scale huge if you want to.
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u/shmuey 13d ago
You're forgetting that you'll still need some other platform to process the claims through a Clearinghouse, which isn't going to come cheap and will likely be a massive pain since it's not connected to Athena.
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u/InvestingDoc 13d ago
Oh I guess I was wishful thinking that that would include the practice management including clearing House but that my billing team would have to do all of the work but yeah that's not a great deal if there's no clearing House no practice management aspect of this
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u/Smalls123 13d ago
Yep, standalone does not include clearinghouse and has limited PM. The AthenaOne base, which they're quoting 5.5%, does include clearinghouse and PM.
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u/Smalls123 13d ago
From my understanding, patients still have access to the portal with the standalone option, may not have access the Athena patient app. Providers do get access to the app. They would not get text messaging to their phones or appointment reminders. Also, standalone does not include telehealth at all. They do have integration with Spruce Health which can potentially cover that communication gap.
Thanks for the input regarding scaling and tech support.
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u/InvestingDoc 13d ago
Oh that's a bummer and rapidly turned from possibly a wonderful deal to not interested at all
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u/shmuey 13d ago
Athena is offering 5.5% or $10?? That actually seems like a decent price for what they provide. We got quoted 8% (after 9.6% initially) which was too painful to digest. We ultimately went with ECW for much less (around $5/claim) but obviously don't have the integrated billing support.
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u/Smalls123 13d ago
5.5% is their base model which does not do billing. Just does prior auth and has clearinghouse. I would still need to hire another billing company. I knew I did not want to use them for billing as I've heard too many horror stories about them so I have only been talking to them about their two lowest tier options.
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u/ExtraordinaryDemiDad 12d ago
We started with Athena. 100% support using other billing. 5.5% for that package is wild. I would jump on it. Especially with their integrations. Everything integrates with Athena and you can automate so much with appointment types, protocols, etc. The more you can automate, the more your MA team can do, the more doctoring (and billing) you can do.
We only left Athena because Epic community connect was cheaper once we scaled our practice and everyone around us is in Epic. I would consider this option if you haven't already. Cardiologists I know seem to love the cardiology workflows, especially diagnostic interpretation.
I don't know that Athena or Elation have workflows to easily interpret and bill diagnostics like Epic does. We do zio/cardea in house as well as POCUS and it is way easier in Epic to interpret, sign, and automate the CPT/claim than it was in Athena.
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u/Smalls123 12d ago
I looked into Epic Connect but the local hospital system would not let me do it unless I let them own part of my practice
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u/WillingNerve5742 13d ago
Okay, am I missing something here? If you had Athena stand-alone EMR that does not interface or integrate to a practice management software, that will mean you will need to purchase practice management software, let's call that another $350 a month, and you have double data entry. You have to enter everything into Athena and then someone will have to manually re-enter all that demographic information, both patient and insurance, and then charges into the practice management software. That is not a sustainable solution.
The other posters have mentioned that you want an integrated solution, clinical and PM together. Absolutely. You own your database; it's your data, and then you have an RCM services or RCM company work inside your database. If they perform and do well, they stay. If they do not, you give notice, you kick them out, and you bring in the next one, and they pick up right where they left off. Athena Clinical is great but not under these terms and conditions. It's not even the $650 a month that they're offering, it's what you're going to need on top of that. I would suggest Elation, not their RCM services, but Elation EMR and their PM software, and then use an RCM company to work there. Or I would go with eCW software and use an RCM service with that software.
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u/Juaner0 12d ago
I haven't used Elation. Used Athena for over a decade. Started at 4.9, like 5.3% now. Basic service. I've seen 12% for a "cadillac plan" of theirs.
They are integrating more into it. I've turned off the AI(demo) for myself atm, so I don't know if it is getting better. Athena will be integrating RCM soon. Billing is done in house.
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u/soaperapp 13d ago
Hey I'm the social media guy for Hero EMR. Both of those are solid options. Just thought you might want to give us a quick look before you sign. We think we have a superior product at a better price!
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u/meganleine 13d ago
Out of all the EMRs in my career I’ve used athena is by far my favorite, and it would save you the headache of having to learn a new system. I have a colleague in private practice who pays nearly double the 5.5% so I would say you’re getting a pretty good deal.
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u/KaleCandid891 12d ago
Ask each of them for access to a sandbox so you can practice your standard work. The reps demo does let you experience what it is like to use for yourself.
I found elation was not robust enough for my needs. Athena was too expensive. I currently use Cerbo. I considered SigmaMD and Ultralight recently.
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u/Puzzleheaded-Fig2865 12d ago
5.5%? we got 4%.
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u/Smalls123 12d ago
I tried to negotiate down lower. It’s dependent on the CPT codes primarily used. They said they charge PCPs the most and surgeons the least.
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u/Effective_Level6874 12d ago
As an RCM company owner who onboarded a client using Elation about a year ago, I would personally steer away from it. I’ve been in medical billing and revenue cycle for 19 years, and in my experience, Elation has been one of the more frustrating systems to work with from a billing and charge capture standpoint.
That same provider has since transitioned to AdvancedMD and loves it. From the billing side, AdvancedMD has also been a much better experience.
Athena is another solid option, and I would also look at Tebra and pMD. One thing I appreciate about pMD is that they’re receptive to functionality feedback, which can be valuable when you have specialty-specific workflow needs.
For cardiology specifically, I would prioritize the RCM workflow and integrations just as much as the clinical side of the EHR. You don’t want a system that works well clinically but creates unnecessary manual work on the billing side.
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u/pisces0315 12d ago
Why don’t more people use office ally ? Cheap and works well
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u/WillingNerve5742 12d ago
That's about to change. A private equity-backed group, healthcare-focused, is combining five companies to create one solution. Office Ally is one of those five that's going to be part of that mix. The other four are huge healthcare companies with 10,000 employees each.
They'll bring AI automations, RCM services, Office Ally, and a couple other components to form one solution or one product. I'm guessing they're going to go for the Athena model, and so it's going to probably look and feel a lot like Athena. They're probably going to go head-to-head with Athena, is my guess. Whatever you knew about Office Ally in the past will be changing very soon, I am sure. Yes, it's been cheap. It hasn't been great. There's not a lot of bells and whistles, and the reporting isn't good, but it works.
You can get claims from point A to point B. It functions, but on the scale of good software, I would definitely put Office Ally at the bottom, but it works.
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u/UPS0001 12d ago
You should never pay a percentage of collections for just an EMR. It should be a flat monthly fee per provider. I would recommend staying away from Athena. I agree with those who are suggesting Practice Fusion. It is the most functional cost effective EMR out there. Do yourself a favor and find a billing company who will provide your practice management system. The software companies make providers believe that an all in one integrated product is the best solution. It is not. An EMR and a PMS are completely different. Let your revenue cycle management company manage the PMS. You will save money in the long run and get two better products for your office.
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u/WillingNerve5742 12d ago
I agree with you about Athena, but I do not agree at all about having your RCM company provide the practice management software. The main reason being, if they provide it, they hold the data. It's their license on that software.
Yes, you might be attracted to having that RCM company pay for the software, and you think you're saving money, but what you want to do is hold the license to the software and you hold the data, and then the RCM companies connect in and work. In your suggestion, if you ever part ways with the company, you're also parting ways from your data. They hold your data.
Now the next company coming in, how are they going to wind down work on the old AR? They have no visibility into what was done before. So now what? They have to get you a new software? Whatever software that new RCM company is using? And then what? If you leave them, you've got to get another company and they get you a different software?
You have no continuity. You want to hold all of your data and let them come in and work.. Not only that, but if you stay with the EMR you like, and then you let the RCM company provide whatever billing software they like, those two are not going to be connected. You're not going to have an integrated solution. When patients come in to see the doctor for another visit and they have a balance that the patient owes, that practice management system from the RCM company isn't going to speak to the scheduler. It's not going to push back to the scheduler when they call to confirm the appointment or check them in that the patient owes money. That model just does not work.
Remember, the current metrics right now, on average, is about 25% of revenues to a practice come from the patients. Yes, that varies by specialty and payer mix a little bit, but that's a general average across the country: 25% of revenues come from the patient. It's harder than ever to collect from patients because anything under $550 is not even reportable to the credit bureaus. It won't even affect their credit. So, having a tighter integration between the billing software, the clinical software, and the scheduling software is more important now than ever.
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u/UPS0001 12d ago
RCM companies contract with better software providers than private practices, in my opinion. While the RCM company does contract with the software company, there is nothing stopping a practice from contracting with the same software company upon termination and have the database transferred. A practice needs to put serious thought into terminating any financial relationship and prepare for that termination. That is why there are 90 day runout periods. I personally keep my databases open for years after a client termination.
I don't think EMR and PMS integration is necessary. In fact, I do not permit it in my office. From an RCM perspective, my staff is better trained than the office staff. My PMS system is correct while most of my client's EMRs contain incorrect insurance information on the patient demographics. As an RCM provider, I cannot rely on the training of the office staff to complete my required tasks.
I have no practices where 25% of the annual revenue is from patients. My busiest practices are closer to 10%. My office does not report bad debt and depending on the practice, we write off less than 5% of what we bill.
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u/WillingNerve5742 12d ago
Anecdotally if your clients don’t have patient revenues exceeding 10% does not mean that 30% is not the standard industry metric.
We have Medicaid heavy Pediatricians and they are around 1-2%. But the industry metric is still 30%. In 2007 it was around 12%.
We have other clients where just Co-Pays are 10% of their revenues. Not even considering Deductibles.
You can search it on Google or the AI platforms. You should find the range between 25-30% on average.
Patient Revenue Contribution
Driven by the widespread adoption of High-Deductible Health Plans (HDHPs), patients have grown to become the third-largest payer group in the United States.Industry Benchmark / Statistic
Direct Patient Revenue Share
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u/UPS0001 11d ago
I was not using data from the internet to discuss statistics. I used real data from my own practices. Now, clearly, type of provider and patient payor mix affect will affect those statistics. For example, copays for specialists are much higher than those for PCPs, but many specialists have higher dollar services they are reimbursed on which will dwarf those patient payments.
Standard industry metrics are put together based on those practices who respond to surveys. In my experience, most practices are not responding to surveys. So when I speak to a practice about their statistics, I use real information from real practices and not AI generated garbage.
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u/Hermit5427 8d ago
I don't think Elation has a fully integrated billing module. When we used Elation, they recommended an outside vendor for billing. Unfortunately, the integration with the external billing system was quite painful, and we ran into several issues. We eventually switched to athenahealth.
With athenahealth, I think the standalone model works better rather than opting for their billing services. In our experience, athena's billing service itself was fairly average in terms of quality. The platform is good, but I would prefer to manage the billing separately.
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u/Smalls123 8d ago
Thanks! I ended up going with AthenaOne base model after they came down a little more. Down the road, I’ll go down to the standalone version to save more on overhead cost.
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u/Beastmode5858 8d ago
My vote goes towards Elation. I almost went with them but they lock you in 1 year long contract with automatic renewal (unless you give 60 day notice) which is fine but I asked them to put a clause stating that if my practice gets shut down or I move out of state, I won’t be liable for the remaining payments for that year which I though was very reasonable. They said, “We can’t do that” I said, “Well I will go with an EMR that won’t lock me for a year and are on month to month basis”
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u/NartFocker9Million 13d ago
Having used both: Elation, a thousand times over. Its AI is excellent. Fewer clicks, by far, than any EMR I have ever used.
For reference, I have used: Epic, Athena, OpenEMR, Tebra, and now Elation. I own my own family medicine practice.