User Guide — Posting $0 Transfers
This page describes how and why you accomplish a $0 transfer.
User access and permissions
To post $0 transfers, you must have the "Create zero-dollar transfer" user permission, which is included in the Payment Poster and Practice Superuser roles.
Posting logic
athenaOne posting logic allows a transfer action without an associated dollar amount. When you receive a secondary payment based on a different allowable from the primary, the balance discrepancy is indicated in the secondary payer column on the claim.
In other words, athenaOne posting logic allows for a $0 transfer from primary to secondary in cases where the secondary has paid and, subsequently,
- The primary adjudicates and indicates no secondary or patient responsibility.
- The prior primary remittance indicated no secondary responsibility.
To keep the secondary payment posted in the correct transfer type and to indicate this overpayment on the secondary, you must make a transfer of $0 to the secondary and then post payment against it.
Posting scenarios
Posting scenario 1 — Primary paid and then refunded
The primary payer paid and transferred $39.42 to the secondary, indicated in a crossover. Then the primary payer was refunded their full amount and you voided the transfer-to-secondary.
When the secondary payment arrives, you create a $0 transfer to the secondary and post the $39.42 payment against that, correctly representing the secondary as overpaid (by that payment amount) and the primary as underpaid, by the full billed amount. You can see this on the Claim Edit page (for the transaction).
Posting scenario 2 — Payment not yet received
No payment was received from the primary payer. You make a standard (non-$0) transfer to the secondary and post it there. You can see this on the Claim Edit page (for the transaction).
Posting scenario 3 — Primary paid and then readjudicated
The primary payer had paid and transferred $44.00 to the secondary, which paid that amount. Then the primary payer readjudicated the claim, indicating that they would now pay the full billed amount.
When the primary readjudicates and athenaOne must void and repost the secondary payment, athenaOne reposts it with a $0 transfer-to-secondary, such that the claim ends up fully paid in the primary and overpaid (by $44.00) in the secondary. It is then your responsibility to make a refund to the secondary as necessary.
The claim is CLOSED in primary and MGRHOLD in secondary due to the overpayment. You can see this on the Claim Edit page (for the transaction).
Posting scenario 4 — Primary denied the full, secondary pays partial
The primary payer has denied the full balance as GLOBAL, but then the secondary pays $5.00.
You make a $0 transfer from primary to secondary, such that the claim ends up fully paid in the primary and overpaid (by $5.00) in the secondary. You must make a refund to the secondary as necessary.
The claim is CLOSED in primary and MGRHOLD in secondary due to the overpayment. You can see this on the Claim Edit page (for the transaction).
Workflow example
- John Smith, a provider at Seven Hills Medical Group, wants to refund a payment from a secondary payer on claim 1234V5678 as a result of the primary's readjudication.
- On the Claim Edit page, John voids the copay transfer and payment in the secondary payer column on the claim, which moves the transferred balance to the primary payer column as an outstanding amount.
- He then clicks the Post payments/adjustments link on the Claim Edit page and views the charge details for the primary payer.
- In the Other Transfer field, John selects 3. OTHER, enters $0.00, and clicks Save.
The Claim Edit page now shows a positive outstanding payment balance, a $0.00 TRANSFEROUT in the primary payer column, and a $0.0 TRANSFERIN in the secondary payer column. - John clicks the Post payments/adjustments link on the Claim Edit page and views the charge details for the secondary payer.
- He selects the secondary insurance with the $0.00, reposts the voided payment amount, and clicks Save. The Overpaid Warning message appears.
- John clicks OK.
On the Claim Edit page, the claim now shows an overpayment in the secondary payer column in the amount of the full secondary payment. - John refunds the payer using the Manage Refunds page.