User Guide — Card on File
athenaOne for Hospitals & Health Systems
The Card on File feature allows you to put a credit card "on file" and establish preauthorized payment agreements. With Card on File, you can collect outstanding balances automatically, as soon as the insurance company processes the patient's claims. When you create a Card on File agreement for a patient, the patient is automatically charged for balances that are deemed their responsibility by insurance or otherwise. Patients can also make a one-time manual payment towards an upcoming Card on File charge online with an alternate card.
Card on File is optional functionality, and the use of which may be subject to certain state laws or other requirements applicable to your organization. You are solely responsible for ensuring the use of the Card on File feature complies with all such requirements.
Note: You can manage Card on File agreements on the Manage Credit Card Agreements page. On this page, you can manage failed payments; view, print, and cancel existing agreements; view sent email messages; and update invalid email addresses.
To use the Card on File feature, your practice must use the Credit Card Plus service and accept credit card payments in the office. You must have the Credit Card Plus: Payment Processing user role or permission.
You can create a Card on File agreement when you collect payment during an encounter on the Check-in or Checkout page (Patient tab).
Under the Card on File heading:
- Card on File type — Select an option from the menu:
- Card Expiry — Create a Card on File agreement that remains active until the credit card expires.
- One year — Create a one-year Card on File agreement.
- Today's appointment — Create a single-appointment Card on File agreement.
-
Maximum amount — Verify the default amount in this field, or enter a new maximum amount that can be charged to this card under this Card on File agreement.
Note:You can change the default Maximum Amount on the Credit Card Plus Settings page.Users also have the option to make a one-time payment with any card for payment plans that have exceeded their maximum charge balance.
Important: You must enter the cardholder's billing address to enable a Card on File agreement.
- Swipe or insert the credit card. This action automatically populates all the credit card fields.
Note: You can also type the information into the fields if necessary. - Billing address — Select the billing address for the cardholder. You can select the patient or guarantor address on file, or you can add a different address. The address must match the address that is associated with the credit or debit card.
Note: When athenaOne detects a credit card swipe, the address area on the Collect Payment page is automatically hidden. - Verify that all the information is correct.
- Click Collect payment.
- The receipt page appears, showing the Card on File agreement, and the receipt associated with the payments collected. A Card on File heading also appears in the patient's Quickview.
Important: athenahealth highly recommends that you obtain the cardholder's signature, but the "wet" signature is not required.
- Click Print to display a printer-friendly version of the agreement, and then click Print Agreement to print a hard copy of the Card on File agreement.
- You can click Email receipt to provide the cardholder with an electronic copy.
- Have the cardholder sign the agreement.
With Card on File, your practice can:
- Collect future patient balances automatically by credit card, debit card, or HSA/FSA card
- Collect future patient balances for multiple appointments
- Reduce patient statement costs and collection agency fees
- Reduce the time to collect patient balances
- Collect future TOS payments without re-entering card information
With a Card on File one-year agreement, your patients can:
- Pay future balances and copays conveniently
- Make payments automatically using their credit card of choice
- Make a one-time manual payment towards an upcoming Card on File charge online with an alternate card
- Avoid writing checks to pay monthly bills by mail
- Specify a total maximum amount to be charged
- Cancel the contract at any time
- Receive notifications and receipts sent via email
A Card on File agreement can be set up for the following durations.
- A card expiry Card on File agreement covers any charges incurred until the expiration date of the credit card.
- A one-year Card on File agreement covers any charges incurred within a year. Patients can also use the card to pay for time-of-service charges or to make payments over the phone without swiping or inserting the card again.
- A single-appointment Card on File agreement covers any charges incurred for a particular appointment. Users also have the option to make a one-time payment with any card for payment plans that have exceeded their maximum charge balance.
Note: A Card on File agreement does not cover all claims that have a patient balance. If a claim was created before the cardholder signed the Card on File agreement, that claim is not covered by the agreement.
You can create a Card on File agreement when you collect payment during an encounter on the Check-in or Checkout page (Patient tab).
athenahealth highly recommends that you obtain the cardholder's signature in person for the Card on File agreement. However, this "wet" signature is not required.
Important: If you do not obtain the cardholder's signature in person, you must understand the implications of not retaining a signed agreement on file. If a cardholder disputes a charge under the Card on File agreement, you may not have documentation available to respond to the dispute. Although the cardholder is still responsible for the outstanding charges, you may incur fees associated with a chargeback transaction.
To change the parameters of an existing Card on File agreement, you should cancel the agreement and create a new agreement, including a new signature if possible.
You cannot establish a single-appointment contract if a Card on File agreement already exists, but you can establish an automated payment plan when a Card on File agreement exists.
If a claim is added to an automated payment plan and a Card on File agreement exists, the claim balance (patient) will be paid via the payment plan, and the Card on File agreement will not be used.
The patient is notified by email of pending charges 5 calendar days before the charges occur. Patients can click the Pay now with any card link in the email if they want to pay with an alternate card.
Patients will receive an email notification again when the credit card is charged along with a receipt in a separate email.
Note: For more information, see Manage Credit Card Agreements.
For a detailed view of the billing details available to patients, review this release note from Fall 2021.
Patients receive a link in their upcoming auto-charge notification emails, directing them to a detailed breakdown of their bill.
When a patient receives an upcoming charge notification email, they can click a link to enter the two-factor authentication entrance point to CoF autopay. This page shows the associated phone numbers from Quickview if the CoF owner is a patient or a guarantor.
If the CoF owner is not the patient or guarantor, the notification emails don’t include the bill summary link, to prevent unauthorized individuals from accessing bill-related patient information. The CoF agreement details section handles both One Year and Single Appointment contracts.
What if a patient opens the notification email after they’re charged?
In this case, the amount due displays $0 if the card has been successfully charged. The language in bill summary also reflects the recent payment.
What if the claim amount to be charged exceeds the available balance on the patient’s card?
In this case, the bill summary displays the amount that is about to be charged on the card. The remaining balance is sent to the patient in statements. They also have the option to make a one-time payment with an alternate card if needed.
If your practice uses the athenaCommunicator Patient Portal and Credit Card Plus, your patients can see a complete history of credit card payments made to your practice on their Patient Portal. Electronic payment receipts appear on the Payment History page of the Patient Portal (click View receipt to display the receipt). Receipts remain on the Patient Portal indefinitely, so patients can refer back to their receipts at any time. For more information, see To display a patient's credit card payment history on the Patient Portal.
Note: Receipts for cash payments do not appear on the Patient Portal.
A patient cannot be charged more than the maximum amount on the Card on File agreement. If the charge amount exceeds the limit, the patient is sent a statement for the remaining balance. Patients also have the option to make a one-time payment with an alternate card if needed.
Cards are charged at approximately 6:00 a.m., 5 days after the pending charge notification. (Exception: If the patient has an unapplied balance, the charge notification is sent after the money is applied to the claim.)
If a patient requests that you hold a charge, you can hold the charge by putting the associated claim in hold status.
Note: Charge-level information is PHI, so it is not included in the email notifications.
A one-year Card on File agreement should not be confused with a payment plan established using the Credit Card Plus (CCP) feature.
- A CCP payment plan is used to pay for past charges. It involves a regular monthly charge of an agreed-upon amount, until the patient balance is paid in full.
-
A Card on File agreement is used to pay for current and future charges. It involves preauthorized payments for the full patient balance amount.
Using the Report Builder, you can report on Card on File and Credit Card Plus payment plans. For example, you can build a report to understand past e-payment activity.
When you select the Transaction Activity type on the Choose Report Type tab of the Report Builder, you can use the following display columns and filters in the E-Payment Contract section:
- E-Payment Contract Class Name — Name of the E-Payment contract class
- E-Payment Contract Created — Date that the E-Payment contract was created
- E-Payment Contract Created By — Username of the E-Payment contract creator
- E-Payment Contract Department — Department in which the E-Payment contract was created
- E-Payment Contract Expiration Date — Date that the E-Payment contract expired
- E-Payment Contract ID — ID of the E-Payment contract
- E-Payment Contract Maximum Amount — Maximum payment amount that a user can submit
- E-Payment Contract Minimum Amount — Minimum payment amount that a user can submit
- E-Payment Contract Signed — Date that the E-Payment contract was signed
- E-Payment Contract Start Date — Date that the E-Payment contract started
- E-Payment Contract Status — Status of the E-Payment contract
When you select the Transaction Activity type on the Choose Report Type tab of the Report Builder, you can use the following display columns and filters in the Measures section:
- Count of E-Payment Contracts (#) — Number of existing E-Payment contracts
- Sum of E-Payment Contract Available Balance ($) — Available balance of remaining E-Payment contracts
- Sum of E-Payment Contract Balance ($) — Total balance of E-Payments made