Quick Reference — To view and edit patient consented amount at Charge Entry or Claim Edit

 

This functionality is available if the No Surprises Act Consent feature has been enabled for your practice. For reference, see the User Guide — athenaOne Support for Compliance with No Surprise Billing Legislation.

 

 

If a patient’s Out-of-Network Billing consented amount was entered in the appointment AND a signed consent form was attached, you’ll see that amount in the No Surprises Act Consent Service Type Add-On.

 

Note: On the Claim: Charge Entry tab, Service Type Add-Ons are located between the Illness/Injury section and the Charges section. They allow your practice to provide additional information that is not typically submitted on claims to health insurance payers.

 

Service Type Add-Ons — Select No Surprises Act Consent.

 

 

Note: If no signed consent form was uploaded, the cost estimate will NOT carry over to the consented amount in Charge Entry, as it is assumed that the patient did not consent to paying Out-of-Network rates.

 

If a patient’s consented amount is missing at Charge Entry or Claim Edit: you can check the patient’s appointment to see if a signed consent form was attached, and then enter the consented amount.

  1. Check the patient’s appointment to see if a signed No Surprises Act Consent form was attached.

  2. Consented amount ($) — Enter the consented amount.

  3. Continue with your Charge Entry workflow.

You can attach a signed patient consent form in Claim Edit if needed.

  1. On the Claim Edit page, under Attachments, click Add attachments.
  2. Click Add New Attachment. The Add New Attachment view appears.
    • Type — Select No Surprises Act Consent.
    • File — Click Choose file and navigate to the signed consent form on your computer.
    • Notes — Enter a note if needed.


  3. Click Add Attachment. athenaOne saves the attachment to the claim.
  4. athenahealth submits the signed patient consent form as a claim attachment along with the claim that goes to the Payer.

Note: If you entered a consented amount but you do not attach a signed consent form to the claim using the No Surprises Act Consent attachment type, a rule (Rule ID: 19709) fires, holding the claim.

  • Claim Note: "Patient consent for the No Surprises Act has not yet been attached to the claim. If the patient consented, then attach the signed consent form to this claim. If not, then remove the consented amount from the No Surprises Act Consent service type add-on."

  • The claim is not submitted to the payer until the signed No Surprises Act Consent form is attached.