Route to Foreign System Type
A Route to Foreign System record represents payment and remittance information received for claims that have been identified as non-athena.
You can use the Download Non-athena Remittance tab on the Manage Remittance page to review these remittance records.
- If you determine that this payment belongs in athenaOne, identify the correct patient or charge that the remittance record should be posted to. Using the Find Matching Charge tool, route the remittance to athenahealth with the matching charge.
- If, during your review of the remittance record, you find that the payment does not belong to your account, use the event Refund Required to place the record in a pend status, and then refund the record.
Depending on your practice settings, these records can be created in a closed status or an open status. If your records require manual closure, review the record and the associated remittance, record the information in your foreign system, and close the record.
Note: athenaOne automatically closes Route to Foreign System (RTFS) non-athena remittances which have been downloaded or marked as No Action Required.
You can use the Download Non-athena Remittance tab on the Manage Remittance page to review these remittance records.
Non-athena remittance records can be downloaded to foreign (non-athenaOne) systems in several different formats:
- ANSI 835 (raw ERA data file, if electronic remittance was received)
- PDF (copy of the paper EOB, if paper remittance was received)
- CSV (same as the "Download CSV" option available on the Find Unpostables page)
- MREP (PDF of the Medicare Replicated EOB)
- REOB (PDF of the athena Replicated EOB)
You can open a non-athena record from the Download Non-athena Remittance tab or the Find Unpostables page.
athenahealth recommends that all your non-athena remittance records (Route to Foreign System records) be automatically closed upon creation. This athenahealth best practice eliminates the unnecessary work of closing these records manually. You can still reopen a closed record; for example, you may need to mark a record as Refund Required. If this option is not enabled in your practice, you can contact the CSC to request it.
Note: athenaOne automatically closes Route to Foreign System (RTFS) non-athena remittances which have been downloaded or marked as No Action Required.
You must have the Billing Admin: Download Non-Athena Remittance user permission to access this tab. This permission is included in the Billing Admin role.
- Display the Download Non-athena Remittance tab on a regular basis (daily or weekly) to review the non-athena remittance that has been received.
- Use the dashboard section to drill down into the Batches cell for the time period of interest (for example, Last Business Day or Last Seven Days).
- From the resulting report list, click preview EOB to review the remittance details and determine what action is necessary for each batch.
- If no further action in athenaOne or a secondary billing system is necessary, click n/a to mark the batch as reviewed but "No Action Required." Clicking the link removes the batch from the "Not Reviewed" section of the dashboard. No further action is needed from the Download Non-athena Remittance page.
- If the remittance is meant for athenahealth, click the "Non-athena Records" cell for that batch to push the records to a worklist. For each record, use the reclassification or Find Matching Charge options to transition the records as needed. No further action is needed from the Download Non-athena Remittance tab.
- If the remittance needs to be posted to a secondary billing system, click the download action for the desired format (for example, ANSI 835, MREP, or CVS). Save the file and send it to your secondary billing system.
- After you send the remittance to your secondary billing system, denote any record-level exceptions in athenaOne by either applying the appropriate event (e.g., Refund Required) or reclassifying the record. To do so:
- Either click the "Non-athena Records" cell for that batch to push the records to a worklist or use the Advanced Filters section to search for a particular batch or set of records.
- For each record, use the reclassification or Find Matching Charge options to transition the records as needed.
- If there were no exceptions in posting the remittance to the secondary billing system, then no further action is needed within athenaOne.
Note: athenaOne automatically closes Route to Foreign System (RTFS) non-athena remittances which have been downloaded or marked as No Action Required.
- Display the Manage Remittance page and click the Download Non-athena Remittance tab.
The page displays a summary of all non-athena remittance from the past year that you have not yet reviewed. - Click a linked number in the Batches column to display a list of all the batches within that time period that contain non-athena records you have not yet reviewed.
- Click a linked number for the row containing your batch.
The Non-athena Worklist appears in the Task Bar, listing all non-athena records. - Alternatively, to search for a specific batch or record:
- Click the plus sign (+) next to Advanced Filters.
The section expands. - Enter search criteria.
- Click Return Records.
The Non-athena Worklist appears in the Task Bar, listing all non-athena records. - Organize by — Select the method by which to sort the records (optional).
- Click a linked ID number (for example, 12345).
The Remittance Record page appears with the record-level details. - Under Select an action to resolve or reassign record, select the Update status and reassign record option.
- Update status — Select Posted to Foreign System.
- Notes — Enter detailed information about the actions you've taken.
- Click Submit.
- Display the Manage Remittance page and click the Download Non-athena Remittance tab.
- Click a number in the Batches column to display a list of all the batches within that time period that contain non-athena records that you have not yet reviewed.
- Click preview EOB to review the EOB of a specific payment batch.
- Click Close Window after you review the EOB.
- Click n/a to mark the batch as needing no action. Or click one of the download links (MREP, REOB, CSV, ANSI 835) to download the batch for posting in your other billing system.
The Status column is updated after you click a link. - You can click Refresh to update the count of batches in "Not Reviewed" status.
- Display the Manage Remittance page and click the Download Non-athena Remittance tab. The page displays a summary of all non-athena remittance from the past year that you have not yet reviewed.
- Click a linked number in the Batches column to display a list of all the batches within that time period that contain non-athena records you have not yet reviewed.
- Click a linked number for the row containing your batch.
The Non-athena Worklist appears in the Task Bar, listing all non-athena records. - Alternatively, to search for a specific batch or record:
- Click the plus sign (+) next to Advanced Filters.
The section expands. - Enter search criteria.
- Click Return Records.
The Non-athena Worklist appears in the Task Bar, listing all non-athena records. - Organize by — Select the method by which to sort the records (optional).
- Click a linked ID number (for example, 12345).
The Remittance Record page appears with the record-level details. - Update the details as needed.
- Display the Manage Remittance page and click the Download Non-athena Remittance tab. The page displays a summary of all non-athena remittance from the past year that you have not yet reviewed.
- Click a cell in the Batches column for the time period of interest to display a list of all the batches within that time period that contain non-athena records you have not yet reviewed.
- In the resulting "Report" section, click the Non-athena Records cell hyperlink for the row containing your records of interest.
Note: Records awaiting confirmation have a link to the Confirm Deposit tab. Including records that are awaiting confirmation gives you a more accurate picture of the true count of all non-athenahealth records. - Alternatively, to search for a specific record, click the plus sign (+) next to Advanced Filters.
Additional fields appear. - Enter search criteria in the fields provided.
- Click Return Records.
The Non-athena Worklist appears in the Task Bar, listing all non-athena records. - Organize by — Select the method by which to sort the records (optional).
- Check the checkbox for the record on which you need to act.
- Scroll down to the Actions section of the worklist.
- Click an action button under the Download Actions heading. The only record-level download actions are reset, n/a, CSV, and PDF. (The ANSI-835, MREP, and REOB formats are only applicable for downloading an entire batch.)
Note: The PDF download action is limited to 50 records at a time. If one of the selected records does not have a paper EOB page attached, athenaOne will not marked it as "downloaded."
- Display the Manage Remittance page and click the Download Non-athena Remittance tab.
- Click the plus sign (+) next to Advanced Filters.
- Scroll down to the "Containing records with ..." section.
- Status — Select one or more statuses.
- Last Event — Select an event.
- Click Return Records.
Note: If the Open Non-athena Records Upon Creation option is on, the Non-athena Worklist in the Task Bar lists each record's status and last event. If the option is off (athenahealth default), the status appears in the worklist only if the status is OPEN or PEND. Similarly, the last event appears in the worklist only if the record status is OPEN or PEND, or the last event is not the creation event.
It is good practice to ensure that the non-athena remittance downloaded from athenaOne is posted to your secondary billing system as expected. Because athenaOne does not have insight into your secondary billing system, this reconciliation must take place outside athenaOne. To complete the reconciliation, generate a list of all the remittance that was downloaded over a given period.
- Display the Manage Remittance page and click the Download Non-athena Remittance tab.
- Status — Select Downloaded.
- Route — To filter the results based on route, click Selected and select one or more routes, for example, if you want to see an aggregate of all non-athena remittance that is being routed to two or more foreign systems at once.
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Click Advanced Features and make other selections to narrow your search.
- Click Return Batches or Return Records.
A list of batches or records that have been downloaded in a given period appear. - Compare the resulting list to what posted in your secondary billing system.
If there were exceptions and those records require further action within athenaOne, denote the action by updating the record with the appropriate event, reclassification, or find matching charge. From the worklist, you can apply event and reclassification updates in bulk to multiple records at once, without any limitation on the number of records.
Status |
Download status of the Payment Batch. Possible values are
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Route |
To filter non-athena remittance record search results by route type, you can click Selected and then select one or more routes, for example, if you want to see an aggregate of all non-athena remittance that is being routed to two or more foreign systems at once. |
Batches | Number of batches (within the particular time period) that contain at least one non-athena record. |
Records | Number of non-athena records within the batches. |
Amount | Dollar amount of the non-athena records within the batches. |
Last Business Day | Since the last business day, the number of non-athena payment batches available. A batch becomes "available" on this page after it is in a Closed status. |
Last Seven Days | Within the last seven calendar days, the number of non-athena payment batches available. A batch becomes "available" on this page after it is in a Closed status. |
Last Thirty Days | Within the last 30 calendar days, the number of non-athena payment batches available. A batch becomes "available" on this page after it is in a Closed status. |
Last 365 Days | Within the last 365 calendar days, the number of non-athena payment batches available. A batch becomes "available" on this page after it is in a Closed status. |
Download Non-athena Remittance - Advanced Filters | |
Payment Batch ID | Payment batch ID of a batch containing at least one non-athena record. |
Deposit Batch ID | Deposit batch ID containing a payment batch that contains at least one non-athena record. |
Check Number | Check number for the batch. |
Check Identifier |
Check identifier for the batch. |
Check Amount | Check amount of the batch. |
Bank Account | Bank account associated with the deposit batch. |
Remittance Forwarded by Practice | This field appears only when there are "Routed to Foreign System" records within a batch that were forwarded to athenahealth by your practice. |
Deposit Date | The deposit date range of the deposit batch that contains the non-athena remittance. |
Batch Available Date | The payment batch available date range. A payment batch becomes available for download on the day it is Closed. |
Batch Download Status |
Download status of the payment batch. Possible values are
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Payer | Payer associated with the batch. |
Record ID | Non-athena remittance record ID. |
Record Amount | Dollar amount of the non-athena remittance record. |
Patient First Name | First name of the patient associated with a particular non-athena remittance record. |
Patient Last Name | Last name of the patient associated with a particular non-athena remittance record. |
Control Number | The payer's control number associated with a particular non-athena remittance record. |
Route |
Name of the route associated with a particular non-athenaOne remittance record. Note: You can request routes by opening a case with the CSC, per the Unpostable Routing page. athenahealth also monitors the non-athenaOne remittance received and creates a standard "Route" labeled "default" to auto-classify certain records as Route to Foreign System. |
Record Download Status |
Download status of the particular non-athena remittance record. Possible values are:
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Prior to athena go-live |
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Last Event | The last event that was applied to the non-athena remittance record. |
Status |
The status of the remittance record:
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Type | Remittance record type (that is, Route to Foreign System). |
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ID | ID of the remittance record. |
Amount | Dollar amount of the remittance record. |
Routed To |
Route (label) for non-athenaOne remittance records. Note: You can request routes by opening a case with the CSC. athenahealth also monitors the non-athenaOne remittance received and creates a standard "Route" labeled "default" to auto-classify certain records as Route to Foreign System. |
Created | Created date of the remittance record. |
Payment Batch Created | Created date of the payment batch containing the remittance record. |
Deposit Date | Deposit date of the deposit batch containing the remittance record. |
Kick Reason Category |
Payer associated with the remittance record. This field is read-only. |
Check Number | Check number for the batch containing the remittance record. |
Check Identifier | Check identifier for the batch containing the remittance record. |
Check Amount | Total check amount of the batch containing the remittance record. |
Check Date | Check date of the batch containing the remittance record. |
Note | Enter any notes about this remittance record. |
Post Date | Post date of the remittance record. This reflects the value that is set as the post date if the record is updated/saved. |