User Guide — Posting Workflow

 

Please see the Managing Time-of-Service Money page to learn about the TOS workflow, TOS payment batches, and TOS deposit batches.

 

 

HRA, HSA, and FSA payments are posted to the Primary column. An HRA payment typically covers a deductible amount that was patient responsibility. This employer money is set aside to help with healthcare costs. It comes from the payer, so if a refund is required, the funds should go back to the payer, not the patient. Typically, the EOB should include HRA information that can be used to post accordingly.

 

HSA and FSA funds are deducted from the employee's pay and placed into a special account to help with healthcare costs. These funds come from the payer; however, if a refund is required, the funds may need to be sent back to the patient because this money was deducted from the employee's pay. When an overpayment occurs, review the associated EOB and, if necessary, call the payer or the patient to determine whether the funds can be moved to another outstanding date of service or whether a refund is required.

 

 

 

The first step in posting EOB information is to create the deposit batch. The user who creates the deposit batch should also create the payment batch (see Manage Deposit Batches).

 

Creating a deposit batch

When you create a new deposit batch, enter only the amount of the deposit (as it appears on the bank deposit slip) in the Deposit Amt field. This amount equals the total on the bank deposit slip, even if the deposit includes "non-athena" payments.

 

The next step is to create a set of payment batches that balance to the deposit total (typically, one check and one EOB per batch). athenaOne tracks the out-of-balance amount against payment batch target amounts. You cannot save the deposit batch until the deposit batch amount equals the sum of its payment batch target amounts.

 

See Manage Deposit Batches for the steps to create a deposit batch.

 

Changes to deposit batches are recorded in an audit trail so that the updates and errors are traceable. You can click the show audit history link on the Edit Deposit Batch page to see a detailed record of the changes, including the change date, the username of the person who made the change, and the impact of the action.

 

 

Because payment batches are created at the time that the deposit batch is created, the payment poster must select a payment batch to begin posting.

1. Make sure that you have no payment batches currently assigned to you. You can be assigned to only one payment batch at a time.
2. Display the Payment Batch page: On the Main Menu, click Financials. Under MONEY MANAGEMENT, click Begin/End Payment Batch. The bottom of the Payment Batch page contains a list of payment batches available for posting. (If you already have an open payment batch, you do not see this list. Instead, the payment batch already assigned to you is displayed.)
3. Click the link for the batch that you will be working on.
   The payment batch assignment page appears (the title bar says Payment Batch).
4. Enter the check number, if it is not already listed, and add any notes.
5. Click Assign Payment Batch to assign the batch to yourself.
   Note: As long as the batch is assigned to you, no other user can post into it. (You can unassign yourself or reassign the batch to a different user later, if needed.)

 

After you select a payment batch, you can begin posting.

 

Display the Post Payment page for the patient

The first step, with an EOB in hand, is to display the Post Payment page for the patient listed on the EOB line item. There are two ways to display the Post Payment page. The best option depends on how many claims you plan to post for the patient.

• Use the Find Claim tool to access the Claim Edit page, then click the Post payments/adjustments link at the top of the Claim Edit page.
  The Post Payment page shows you only the open charges for the specific claim that you entered. Use this option if you are not posting multiple claims for the same patient.
• Use the Find patient tool to display the patient Quickview. On the Patient Actions Bar, click Billing, and then click Post Payment.
  The Post Payment page shows you all claims for this patient that have an open balance. This option can produce many line items depending on the patient account. Use this option if you are posting to multiple claims for the same patient.

If you do not have a payment batch open, athenaOne displays these options:

• The Create New Batch button allows you to create a new deposit batch/payment batch pair.
• The Start a New Payment Batch button allows you to create a new payment batch and link it to an existing deposit batch, or to select from a list of already created payment batches.

The Post Transactions page provides guidance on which option to select.

 

Note: If new monies are being posted to athenaOne for the first time and those monies have not yet been recorded as a deposit in athenaOne, athenahealth recommends that you create a deposit batch with a deposit amount equal to the amount of the monies being processed. A payment batch is then created within the deposit batch with a target amount equal to the payments to be posted. Your payment batches must equal the total deposit amount.

 

Using the Start a New Payment Batch option

1. Click Start a New Payment Batch.
   athenaOne displays the Payment Batch page.
2. Follow the usual steps to begin a new payment batch.

Using the Create New Batch option

1. Click Create New Batch.
   athenaOne displays the Prepare Deposit Batch page.
2. Deposit Date — Enter the date on which the funds were deposited.
   Note: This date can be found on your deposit slip.
3. Bank Account — Select the bank account where the funds were deposited. If this batch is for zero dollars, you can select UNKNOWN.
4. Deposit Amt — Enter the deposit amount from your deposit slip.
5. Bank Deposit Type — Select the appropriate bank deposit type from the menu.
6. Checks Deposited By Site? — Select Yes or No, depending on whether your practice deposited the money.

Under the Enter Payment Batches heading

7. Target Amount — Enter the total amount of the payments to be posted. This amount should equal the amount of the deposit recorded in the previous steps. However, if you have multiple payment batches, the sum of all payment batches will equal the deposit total.
8. Route — This field defaults to Manual.
   
9. Paper — Select No.
   
   
10. Check # — Enter the check number.
11. Notes — Add any notes (if applicable).
12. Click outside the payment batch line.
    A new Seq # line appears.
13. To create additional batches, enter the target amount and other information in the new line.
14. Click Save to save the batch.
    The Payment Batch assignment page appears.
15. Click the Assign Payment Batch button to assign the payment batch to yourself.
    The Payment Batch page appears with all the batch details. This batch is now assigned to you (the Opened By field displays your username).
    
16. Click the Continue button.
    The Post Payment page appears for manual posting. This page displays the open charges for the patient.
    

Payment Batch Status Summary on the Post Payment page

The Payment Batch Status Summary appears when you process an open payment batch and displays your progress in completing and balancing the payment batch.

Note: The Payment Batch Status Summary appears at the top of the Post Payment, Void Transaction, and Find Unpostables pages.

 

The Payment Batch Status Summary displays the target amount of the payment batch in process and the relationship of that target to any activity posted to date in that batch:

• Target Amount — This field displays the target amount for the payment batch.
• Current Payments — This field displays the sum of all payment-related transactions recorded.
• Current Unpostables — This field displays the sum of all unpostables recorded.
• Out-of-Balance — This field displays the difference between the target amount and the activity amount. This field must be $0 to close the payment batch.

To post a payment, follow the instructions on the Post Payment page.

 

Recording unpostables

An unpostable is an amount of money that cannot be posted to athenaOne. For example, posters may encounter a payment that was not accompanied by a patient statement and for which athenahealth cannot locate the patient. An unpostable can also represent funds that are for services from your legacy system, or that are otherwise unidentifiable. Posters may also encounter entire checks that are not for healthcare services (for example, a tax refund), but that were included in your deposit. Unpostables account for these discrepancies and ensure that all money in your deposit batch is fully accounted for.

 

athenahealth recommends that you record unpostables when you post a payment batch. Recording unpostables makes it easier to reconcile accounts at month-end. Payment posters can record the reasons for any discrepancies against the original deposit amount.

 

To add an unpostable to a payment batch

1. Display the Post Payment page.
2. Click the add unpostable link that appears in the Payment Batch Status Summary.
3. Enter the amount of the discrepancy, the type, and any notes. If you have additional information, please enter the details to help in the resolution of the record.
   The amount of your unpostable counts toward your Payment Batch Target, just as a payment does.

If your practice chooses not to use the athenaOne unpostables functionality

Your practice may choose not to use the athenaOne unpostables functionality. In this case, you must edit your deposit batch and payment batch amounts to reduce the target amount by the amount of unposted payments. This reduction for unpostables balances your batch and allows you to close it.

 

 

The Payment Batch Status Summary displays your progress towards completing and balancing the payment batch. When the Out-of-Balance amount in the Payment Batch Status Summary is $0, you can close the payment batch using the Close this payment batch button.

Note: If you do not see the Close this payment batch button, the batch is out of balance and needs to be corrected.

 

To close the payment batch:

1. Click the Close this payment batch button in the Payment Batch Status Summary (you can also click the edit payment batch link).
   The Edit Payment Batch page appears.
2. Click Close This Payment Batch at the bottom of the page.
   After you close the payment batch, you can open another payment batch for posting.
   

You can also display the Edit Payment Batch page as follows: On the Main Menu, click Financials. Under MONEY MANAGEMENT, click Begin/End Payment Batch. Click Close This Payment Batch to close the payment batch.

 

Closing the deposit batch

When all the payment batches in a deposit batch are closed, the deposit batch closes automatically. You do not need to take any action to close the deposit batch.

 

Adding a payment batch to a closed deposit batch

You may need to add a payment batch to a closed deposit batch when you create a correction batch for a previously posted claim/record. To add a payment batch to a closed deposit batch, you must reopen the deposit batch.

1. Display the Manage Deposit Batches page: On the Main Menu, click Financials. Under MONEY MANAGEMENT, click Deposit Batches.
2. Use the filters to locate the deposit batch, then click the view/update link to update the batch.
   The Edit Deposit Batch page appears.
3. Click the Re-open button at the bottom of the page.
   A confirmation message appears.
4. Click OK.
   The batch is now available for editing.
   Note: If your deposit batch is more than 6 months old, another message alerts you about the age of the deposit. Click OK to continue.
5. Add payment batches as needed. Unless the new payment batch Target Amount total is $0, athenaOne requires you to update the deposit batch total to reflect the additional amount. For example, if you add a payment batch for $25.00, you need to add $25.00 to the current deposit amount.

 

From the Manage Deposit Batches page, you can click the view/update link for a deposit batch to display the Edit Deposit Batch page. This page shows you the deposit batch details, including the list of parent/child payment batches, with the target amount, current unpostable amounts, and current payments for each payment batch.

 

If you need to change the deposit batch target amount, you must create new payment batches to balance the batch totals. For example, if you increase the deposit total by $25.00, you need to create a payment batch for $25.00. The Edit Deposit Batch page includes a show audit history link that you can use to monitor all changes made to the original deposit batch.

 

Correcting previously posted information

"Corrections posting" refers to a set of posting activities that have no net impact on the cash balance of the practice. The following scenario provides an example of a corrections posting.

1. A payment poster creates an unpostable because the CPT code on the charge was voided and the payment poster cannot identify it.
2. The charge is later identified.
3. The poster posts the payment and voids the unpostable.
4. The total cash balance of the practice does not change.

In this example, funds are transferred from one area of the ledger (unpostables) to another (service payments) so that you can account for both sides of these transfers and, therefore, they can be reconciled at month-end.

 

Converting payments to unpostables

You can pair a payment void with an unpostable. For example, if you post a payment to a charge, then discover that the payment is a legacy payment (which should not have been posted), you can first void the payment, then create an unpostable for the same amount.

1. Display the Claim Edit page for the claim.
2. Click the Void this transaction link to void the payment.
   athenaOne prompts you to select one of these options: Create Correction Batch or Create a New Batch.
3. Click Create Correction Batch.
   This option allows the payment batch to be reopened in the original deposit batch and allows for a more accurate reconciliation process.
4. On the Payment Batch page, enter any notes in the Notes field, and then click Continue.
   The Void Transaction page appears. This page displays the transaction amount, the post date, and the payment batch number.
5. Click Void This Transaction. (If you clicked this button in error, click Cancel.)
   The Claim Edit page appears.
6. On the Claim Edit page, click Post payments/adjustments at the top of the page.
   The Post Payment page appears.
   Note: The Payment Batch Status Summary at the top of the page indicates that your batch is out of balance by the amount that you just voided.
7. Under the Payment Batch Status Summary, click add unpostable.
   The Add Unpostable page appears.
8. Amount — Enter the amount that was originally posted.
9. Type — Select No matching charge/patient from the menu.
10. Note — Enter a note explaining the remittance record/unpostable.
11. Click Save.
    The payment batch is now balanced and can be closed.

 

You may need to void a payment for a number of reasons (see Voids for a detailed explanation of how athenaOne handles voids). Common scenarios include:

• NSF checks
• Transfer of a patient balance to the patient's secondary insurance
• Payment that was posted to the incorrect charge

See the Patient Activity or Patient Statements page for more information.

 

If you identify an incorrectly posted claim, follow this procedure.

1. Find the payment on the Claim Edit page.
2. Click Void this transaction.
   The Void Transaction page appears.
3. Click Create Correction Batch.
4. On the Payment Batch page, enter any notes in the Notes field, and then click Continue.
   The Void Transaction page appears.
5. Click Void This Transaction.
   The Claim Edit page appears.
   Note: If you clicked this button in error, click Cancel.
6. On the Claim Edit page, click Post payments/adjustments at the top of the page.
   The Post Payment page appears.
   Note: The Payment Batch Status Summary at the top of the page indicates that your batch is out of balance by the amount that you just voided.
7. Post the payment against the correct charge as you normally would.
8. Click Save.
9. Click Close payment batch.

Zero-dollar and non-zero-dollar payment batches

To open a new, non-zero-dollar payment batch, you must select an existing deposit batch or create a new deposit batch. If you change the amount of a zero-­dollar payment batch, you must assign it to a deposit batch whose total includes your payment batch. The sum of all payment batches in a deposit batch must equal the deposit total. In this way, all posting activity is tied to a specific deposit batch.

 

 

Occasionally, you need to correct deposit amount errors.

1. Display the Manage Deposit Batches page: On the Main Menu, click Financials. Under MONEY MANAGEMENT, click Deposit Batches.
2. Locate your deposit batch in the list, then click the view/update link.
   The Edit Deposit Batch page appears.
3. If the batch is closed, click the Re-open button at the bottom of the page.
   A confirmation message appears.
4. Click OK.
   The batch is now available for editing.
   Note: If your deposit batch is more than 6 months old, another message alerts you about the age of the deposit. Click OK to continue.
5. Change the deposit amount.
   The amount will now be out of balance.
6. Under the Enter New Payment Batches heading, create a new payment batch in the same amount that your deposit batch is now out of balance.
1. Target Amount — Enter the amount in this field.
2. Click Save.
   The deposit amount is now balanced.
7. If the deposit date warning appears, click OK.
8. Click the update/view link next to the new payment batch ID.
9. Click the assign to username button and then click Save.
   The batch is now ready to process.
10. Post the payment or unpostable needed to balance and close your batch.

 

With athenaMailbox, athenahealth waits to confirm deposit for the remittance before posting. However, athenahealth automatically posts EFT deposits for a lockbox account.

 

athenahealth follows this process:

• athenahealth will search for U.S. Bank payments based on check number and P.O. box or EFT payment number.
• If athenahealth is unable to locate the deposit, we will contact the payer for information about when and how the payment was issued to determine why the payment does not appear in our list of U.S. Bank payments and whether we need to allow for additional processing time.
• athenahealth sends unpostable remittance created for Non-U.S. Bank / CHK to your practice, so that deposit can be confirmed.

 

By default, with a non-athenahealth lockbox service, athenahealth auto posts (auto-open) all lockbox customer money on the pay date.

• Pay date can often be used as a deposit date when payments are automatically posted.
• One-time credit cards (also called "virtual credit cards") are excluded from auto-posting.