athenahealth is an all-in-one EHR and practice-management platform with its own built-in billing service, athenaCollector. NatRevMD is a managed RCM partner that plugs into whatever EHR you already run, including athenahealth. The short version: athenahealth bundles software and billing under one bill; NatRevMD is a dedicated team that owns your revenue cycle end to end, with a senior person, not a queue, handling anything complicated.
| Dimension | athenahealth | NatRevMD |
|---|---|---|
| Product category | EHR + practice management with a built-in billing service (athenaCollector) | Managed RCM partner that integrates with your existing EHR, including athenahealth |
| Bottom line | athenahealth is software you (mostly) run, with billing folded in; NatRevMD is a team you hand the whole revenue cycle to. | |
| Pricing model | Percentage of collections, publicly reported around 3–8% depending on practice size and negotiated terms | Percentage of net collections |
| Who submits claims and works denials | athena's billing staff submit claims and post payments from your documentation | A dedicated NatRevMD team, with specialty-specific staff for complex cases like OB/GYN surgical billing |
| Complex denial handling | Denials requiring judgment calls typically land in a "hold bucket" that routes back to your practice, or to a second billing team you hire to clear it | Every claim is touched every 21–30 days or sooner; unresolved issues escalate to a senior lead, tracked outside of email |
| Financial reconciliation | Payment posting handled within athenaCollector | Bank reconciliation built into the process, so what's reported matches what actually hit your account |
athenahealth's all-in-one pricing feels efficient until a denial needs real judgment. Because athena's own team typically routes those into a hold bucket for the practice to manage, many practices end up paying athena's fee and then hiring a biller or a second billing company to clear the backlog — effectively paying twice for the parts of billing that actually determine how much you collect. NatRevMD has taken over billing for several practices that were previously running on athenahealth's and eClinicalWorks' built-in billing teams; in each case, the software wasn't the gap. The complex, judgment-call work simply had nowhere consistent to go.
For most independent practices, yes. athenahealth keeps your EHR, scheduling, and billing on one bill, but complex denials default back to your practice unless you already have staff ready to chase them — so the "one bill" simplicity often costs more once you factor in that extra headcount. NatRevMD plugs into the EHR you already have and puts a dedicated team, not a shared queue, on the complicated claims. The exception is a practice that genuinely already has in-house staff dedicated to working denials — for them, athenahealth's bundle can make sense.
athenaCollector is billing software and staff bundled into the athenahealth EHR. NatRevMD is a standalone managed billing partner: a dedicated team handles coding review, claim submission, denial appeals, and patient statements, and plugs into whatever EHR you use.
NatRevMD works with most EHR and practice-management systems. If you're evaluating a change to how your billing is handled, talk to our team about your specific setup.
Both price as a percentage of collections, so the comparison depends on your volume and negotiated rate with each. The bigger cost difference usually shows up downstream: whether complex denials get resolved as part of the fee, or require additional staff or a second vendor to clear.
Practices that want a single integrated system for EHR, scheduling, and billing, and that have the staff or bandwidth to manage complex denials that land back in their queue.
With NatRevMD, those claims escalate to a senior team member and get tracked in a shared system until resolved, on a 21-to-30-day touch cycle. That's the specific gap practices most often ask us to close when they're moving off an EHR-bundled billing team.
The free metric audit takes a few minutes to request. We'll look at your denial rate, your AR over 90 days, and your underpayments, and give you the real number.
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