Approve Insurance Refunds

athenaCollector

athenaOne for Hospitals & Health Systems

This page allows you to generate the Issue Refunds Worklist, which you can use to approve insurance refunds. The worklist appears in the Task Bar.

 

On the Main Menu, click Financials. Under REFUNDS, click Approve Insurance Refunds

 

 

  1. Display the Approve Insurance Refunds page: On the Main Menu, click Financials. Under REFUNDS, click Approve Insurance Refunds.
  2. Select one or more options from the filter menus provided.
  3. Enter or select a date range (optional) for the refund request date.
  4. Click Generate Worklist to generate the Issue Refunds Worklist in the Task Bar.
    • Click Printable Report to display a detailed report at the bottom of the page.
    • Click Download CSV to download a detailed Excel report to your PC.

Note: If your practice uses a multi-step process for issuing refunds (i.e., the billing manager reviews the accounts and approves refunds, but checks are issued separately), athenahealth recommends that you generate a printed or .csv list to track the approval and check-writing process, then use the worklist to apply the refunds. This process ensures that the transaction post dates of the refunds match the issue dates of the checks.

 

If your practice approves refunds by entering the check amount on the Issue Insurance Refund page while leaving the check number blank, the resulting transactions are populated in the Refund Checks In Process worklist.

 

 

 

The Issue Refunds Worklist provides a single place to find all requests for insurance refunds. Claims appear on this list if they are in MGRHOLD status and have an active kick code of SENDREFUND or SENDREFUNDINTEREST. When athenahealth posts for your practice, we use these codes for paid claims that are later denied. We also use code REFUND when researching claims that have received a refund request letter.

 

Items on the Worklist are linked to the Issue Insurance Refund page. This page shows the affected charges with their transaction histories, and provides fields for recording payment amounts and check numbers.

 

You can also generate a printable report that shows a detailed breakdown of charges and the total outstanding amount for each claim on the worklist. This report includes columns for:

  • Date requested
  • Refund requested
  • Service — the service date, department, rendering provider, and supervising provider
  • Patient — the patient name, patient ID number, and policy number
  • CHARGES

You can also generate the report as an Excel (.csv) file for download to your PC.

 

 

Filter Fields to generate worklist and report
Payor

Select the payers who are due the refund, or select "any" to show refunds for all payers. You can select more than one payer.
Providers

Select the billed providers associated with the refund, or select "any" to show refunds for all providers. You can select more than one provider.

Service department

Select the departments of service associated with the refund, or select "any" to show refunds for all departments. You can select more than one department.
Date requested

Enter or select a date range for the refund request date.

Column Headings for Printable and CSV Report
Claim ID

The claim ID associated with the refund.
Payor

The payer who is due the refund.
Refund requested

The refund was requested.
Providergroup If your practice has provider groups, select the provider groups associated with the refund, or select "any" to show refunds for all provider groups. You can select more than one provider groups.
Service

The service date, service department, rendering provider's username, and supervising provider's username.
Patient

The patient name, patient ID number, and policy number associated with the refund.
CHARGES

The charges for each procedure on the claim.

The Total outstanding is the amount of the refund due.

 

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