Collection Policies

 

If you want to review the list of patients included in collection placement files before submitting the files to a collection agency, create a non-automated collection policy. Claims eligible for collections based on non-automated collection policies must be reviewed and adjusted to collections on the Collections Worklist page.

1. Display the Collection Policies page: On the Main Menu, click Settings > Billing. In the left menu, under Practice Links — Collections, click Collection Policies.
2. Click Add new.
   Additional fields appear.
3. Name — Enter a name for the collection policy.
4. Automate policy — Select No to create a non-automated policy.
   The Frequency field is grayed out.
5. Action — Select an action for the policy.
• Send to collections — If you select this option, the Default collection agency field appears. Select a default agency from the menu (if agencies are configured). You are not required to select a default agency for non-automated collection policies; you can select the agency on the Collections Worklist page.
  Note: When a balance meets the criteria for a collection policy with the action Send to collections, it cannot qualify for any additional policies with the same action. To ensure that patients are included in the intended collection policy, make sure that the filters in your collection policies do not overlap.
• Adjust off to bad debt — If you select this option, the Custom transaction code field appears. Select a transaction code from the menu. A transaction code is not required, but you can use it for reporting to associate bad debt adjustments with this policy.
• Move from one agency to another — If you select this option, the following fields appear:
  At collection agency for — Enter the number of days since you sent the balance to the first collection agency.
  Transfer from agency — Select the agency from which to transfer balances, then select the agency to which you want to transfer the balance.
  Note: The transfer-from and transfer-to agencies must both be established agencies.
• Move from collections to bad debt — If you select this option, the following fields appear:
  Custom transaction code — Select a transaction code from the menu. A transaction code is not required, but you can use it for reporting to associate bad debt adjustments with this policy.
  At collection agency for — Enter the number of days since you sent the balance to a collection agency.
  Transfer from agency — Select an agency from which to transfer balances.
6. Eligible balance — Enter the minimum balance (smallest amount eligible for the selected action according to this policy) and the maximum balance (largest amount eligible for the selected action according to this policy).
   Note: This balance applies to the patient account as a whole, not to a specific claim or procedure code.

Patients Not on Payment Plans

7. Minimum # days since — Select First statement sent, Date of service, or Balance transferred to patient to specify when to initiate the policy. The default value is 120 days since the balance was transferred to the patient.
   Note: The criteria for both Minimum # days since and Minimum # statements must be met to make an outstanding balance eligible for collections.
8. Minimum # statements — Enter the number of statements athenaOne sends to the patient before you invoke the policy. The default value is 3, based on a 35-day statement cycle.
   Note: Because athenaOne sends a maximum of three statements per charge, we strongly recommend that you not set Minimum # statements to a value greater than 3.

Patients on Payment Plans

9. Minimum # days since — Select First statement sent, Date of service, or Balance transferred to patient to specify when to initiate the policy. The default value is 120 days since the balance was transferred to the patient.
   Note: The criteria for both Minimum # days since and Minimum # overdue payments must be met to make an outstanding balance eligible for collections.
10. Minimum # overdue payments — Enter the number of overdue payments before you invoke the policy. The default value is 3.
    Note: Because athenaOne sends a maximum of three statements per charge, we strongly recommend that you not set Minimum # overdue payments to a value greater than 3.

Patient Criteria

Note: Claims for any patient who is marked as "Deceased" in athenaOne are not included in collection files.

11. Patient's last name starts with — Select one or more letters of the alphabet to apply a policy to a subset of outstanding patient balances based on the first letter of the patient's last name.
    
12. Provider group — Click Selected to choose individual provider groups to attach to the policy, and then select the provider groups to add to the filter.
13. Primary department — Click Selected to choose individual primary patient departments to attach to the policy, and then select the departments to add to the filter. Select None to include patients who have a blank value in the Primary department field. Select Deleted/Inactive to include patients whose primary department is deleted or inactive.
14. Usual provider — Click Selected to choose individual providers based on the previous selections. Select None to include patients who have a blank value in the Usual provider field. Select Deleted/Inactive to include patients whose usual provider is deleted or inactive.
15. Exclusions — You can select one or both of the following exclusions to apply to this collection policy:
    • Patients with manually held statements (see Patient Statements for more information about held patient statements).
    • Patients who made any payment within 30 days, 60 days, or 90 days (choose one of these values).

16. Click Save or Save and Add Another.

 

If you do not want to review the list of patients included in collection placement files before submitting the files to a collection agency, create an automated collection policy. An automated policy performs the same search and status update action as a non-automated policy, but an automated policy also performs a designated action (such as batching claims into COLLECT files) at a specified frequency without your intervention.

Note: We recommend that you first create a non-automated policy, run the Collections Worklist for that policy to confirm that it does what you expect, and then change it to an automated policy.

1. Display the Collection Policies page: On the Main Menu, click Settings > Billing. In the left menu, under Practice Links — Collections, click Collection Policies.
2. Click Add new.
   Additional fields appear.
3. Name — Enter a name for the collection policy.
4. Automate policy — Select Yes to automate the policy.
   Note: Click the info icon to display more information about automated policies.Frequency — Select how often to run the policy:
   • Twice weekly (every Wednesday and Sunday)
   • Weekly (every Sunday)
   • Monthly (on the first Sunday)
   • Monthly (custom)
5. Day of the month — If you select Monthly (custom) from the Frequency menu, select the day of the month that the policy should run.
6. Action — Select an action for the policy:
• Send to collections —If you select this option, the Default collection agency field appears. Select a default agency from the menu (if agencies are configured).
  Note: When a balance meets the criteria for a collection policy with the action Send to collections, it cannot qualify for any additional policies with the same action. To ensure that patients are included in the intended collection policy, make sure that the filters in your collection policies do not overlap.
• Adjust off to bad debt — If you select this option, the Custom transaction code field appears. Select a transaction code from the menu. A transaction code is not required, but you can use it for reporting to associate bad debt adjustments with this policy.
• Move from one agency to another — If you select this option, the following fields appear:
  At collection agency for — Enter the number of days since you sent the balance to the first collection agency.
  Transfer from agency — Select the agency from which to transfer balances, then select the agency to which you want to transfer the balance.
  Note: The transfer-from and transfer-to agencies must both be established agencies.
• Move from collections to bad debt — If you select this option, the following fields appear:
  Custom transaction code — Select a transaction code from the menu. A transaction code is not required, but you can use it for reporting to associate bad debt adjustments with this policy.
  At collection agency for — Enter the number of days since you sent the balance to a collection agency.
  Transfer from agency — Select an agency from which to transfer balances.
7. Eligible balance — Enter the minimum balance (smallest amount eligible for the selected action according to this policy) and the maximum balance (largest amount eligible for the selected action according to this policy).
   Note: This balance applies to the patient account as a whole, not to a specific claim or procedure code.

Patients Not on Payment Plans

8. Minimum # days since — Select First statement sent, Date of service, or Balance transferred to patient to specify when to initiate the policy. The default value is 120 days since the balance was transferred to the patient.
   Note: The criteria for both Minimum # days since and Minimum # statements must be met to make an outstanding balance eligible for collections.
9. Minimum # statements — Enter the number of statements athenaOne sends to the patient before you invoke the policy. The default value is 3, based on a 35-day statement cycle.
   Note: Because athenaOne sends a maximum of three statements per charge, we strongly recommend that you not set Minimum # statements to a value greater than 3.

Patients on Payment Plans

10. Minimum # days since — Select First statement sent, Date of service, or Balance transferred to patient to specify when to initiate the policy. The default value is 120 days since the balance was transferred to the patient.
    Note: The criteria for both Minimum # days since and Minimum # overdue payments must be met to make an outstanding balance eligible for collections.
11. Minimum # overdue payments — Enter the number of overdue payments before you invoke the policy. The default value is 3.
    Note: Because athenaOne sends a maximum of three statements per charge, we strongly recommend that you not set Minimum # overdue payments to a value greater than 3.

Patient Criteria

Note: Claims for any patient who is marked as "Deceased" in athenaOne are not included in collection files.

12. Patient's last name starts with — Select one or more letters of the alphabet to apply a policy to a subset of outstanding patient balances based on the first letter of the patient's last name.
    
13. Provider group — Click Selected to choose individual provider groups to attach to the policy, and then select the provider groups to add to the filter.
14. Primary department — Click Selected to choose individual primary patient departments to attach to the policy, and then select the departments to add to the filter. Select None to include patients who have a blank value in the Primary department field. Select Deleted/Inactive to include patients whose primary department is deleted or inactive.
15. Usual provider — Click Selected to choose individual providers based on the previous selections. Select None to include patients who have a blank value in the Usual provider field. Select Deleted/Inactive to include patients whose usual provider is deleted or inactive.
16. Exclusions — You can select one or both of the following exclusions to apply to this collection policy:
    • Patients with manually held statements (see Patient Statements for more information about held patient statements).
    • Patients who made any payment within 30 days, 60 days, or 90 days (choose one of these values).
17. Click Save or Save and Add Another.

 

When you create a collection policy, the policy is automatically assigned a priority based on the order it was created in (you can see the priority of each policy in the Existing Collection Policies table). If a claim qualifies for multiple collection policies, the policy with the lowest priority number is executed. For example, if two policies apply to a claim and one policy has a priority of 1 and the other policy has a priority of 2, the policy with the priority of 1 is executed. You can rearrange the priorities of your policies.

1. Display the Collection Policies page: On the Main Menu, click Settings > Billing. In the left menu, under Practice Links — Collections, click Collection Policies.
2. Click Edit priority above the list of collection policies.
   The Collection Policy Priority page appears.
3. Drag and drop policies so that the priorities are listed in the order that you want.
4. Click Save.