Refund Request Letter Type
A Refund Request Letter remittance record represents a request from Medicare for the return of full or partial payment from the practice, for funds paid in error. Medicare refund request letters are opened in the athenahealth queue as part of our matching logic for readjudication. You should not need to take any action on these letters.
General resolution guidance
Please do not change a Refund Request Letter to another remittance record type or close it; such changes affect the PCN matching logic that automatically links the Refund Request Letter to Readjudication Notice and Provider Takeback remittance records.
To update a Refund Request Letter remittance record
If a Refund Request Letter does not have a payer control number (PCN) or if we cannot identify a matching record for the Refund Request Letter remittance record, the record is moved to the practice queue for further review.
To indicate that a Readjudication Notice record exists
athenahealth identifies and matches Refund Request Letter remittance records to Readjudication Notice remittance records; we then move the records to the practice for review. After you review the records and verify that the records match, update the status of the Refund Request Letter remittance record to Resolved Refund Request Letter - Balancing Record Identified.
- Display the Find Unpostables page: On the Main Menu, click Financials. Under PAYMENTS, click Unpostables. In the left menu, under UNPOSTABLE REMITTANCE, click Find Unpostables.
- Unpostable status — Select OPEN.
- Responsible party — Select Practice.
- Unpostable type — Select Refund Request Letter.
- Click Generate
Worklist.
The Unpostables Worklist appears in the Task Bar.
Display the unpostable record
- From the worklist in the Task Bar, click the Refund Request Letter bar to expand the worklist.
- Click the linked unpostable
ID number for the remittance record/unpostable in the worklist.
The Remittance Record page appears in the Workspace.
In the Status section
- Under Select an action to resolve or reassign record, select the Update status and reassign record option.
- Update status — Select Resolved Refund Request Letter - Balancing Record Identified.
- Click Submit.
To indicate that payer resolution is in process
athenahealth may move a Refund Request Letter remittance record to the practice for review when payer resolution is in process. After you review the remittance record, contact the payer. If the payer will send additional information or resolve the issue, update the status of the Refund Request Letter remittance record to Contacted Payer - Resolution in Process. The record is placed into a pending status. After additional information is received, the record is matched to a balancing record.
- Display the Find Unpostables page: On the Main Menu, click Financials. Under PAYMENTS, click Unpostables. In the left menu, under UNPOSTABLE REMITTANCE, click Find Unpostables.
- Unpostable status — Select OPEN.
- Responsible party — Select Practice.
- Unpostable type — Select Refund Request Letter.
- Click Generate
Worklist.
The Unpostables Worklist appears in the Task Bar.
Display the unpostable record
- From the worklist in the Task Bar, click the Refund Request Letter bar to expand the worklist.
- Click the linked unpostable
ID number for the remittance record/unpostable in the worklist.
The Remittance Record page appears in the Workspace.
In the Status section
- Under Select an action to resolve or reassign record, select the Update status and reassign record option.
- Update status — Select Contacted Payer - Resolution in Process.
- Click Submit.
To indicate that a refund was sent to the payer
If you refunded the payer and no remittance record matched this Refund Request Letter remittance record, update the status of the Refund Request Letter remittance record to Refunded Payer and add a note with the refund check information and submission date.
- Display the Find Unpostables page: On the Main Menu, click Financials. Under PAYMENTS, click Unpostables. In the left menu, under UNPOSTABLE REMITTANCE, click Find Unpostables.
- Unpostable status — Select OPEN.
- Responsible party — Select Practice.
- Unpostable type — Select Refund Request Letter.
- Click Generate
Worklist.
The Unpostables Worklist appears in the Task Bar.
Display the unpostable record
- From the worklist in the Task Bar, click the Refund Request Letter bar to expand the worklist.
- Click the linked unpostable
ID number for the remittance record/unpostable in the worklist.
The Remittance Record page appears in the Workspace.
In the Status section
- Under Select an action to resolve or reassign record, select the Update status and reassign record option.
- Update status — Select Refunded Payer.
- Note — Enter a note about this refund, including the check number and the date you submitted the check.
- Click Submit.
To indicate that a Refund Request Letter remittance record is for a non-athenaOne claim
If the Refund Request Letter remittance record is for a non-athenaOne claim, update the status of the Refund Request Letter remittance record to Posted to Foreign System.
- Display the Find Unpostables page: On the Main Menu, click Financials. Under PAYMENTS, click Unpostables. In the left menu, under UNPOSTABLE REMITTANCE, click Find Unpostables.
- Unpostable status — Select OPEN.
- Responsible party — Select Practice.
- Unpostable type — Select Refund Request Letter.
- Click Generate
Worklist.
The Unpostables Worklist appears in the Task Bar.
Display the unpostable record
- From the worklist in the Task Bar, click the Refund Request Letter bar to expand the worklist.
- Click the linked unpostable
ID number for the remittance record/unpostable in the worklist.
The Remittance Record page appears in the Workspace.
In the Status section
- Under Select an action to resolve or reassign record, select the Update status and reassign record option.
- Update status — Select Posted to Foreign System.
- Click Submit.