Non-Poverty-Based Sliding Fee Plans

athenaCollector

This page allows you to create a non-poverty-based sliding fee plan for patients in your practice. Before you create a plan, you must use the Sliding Fee Programs page to create a sliding fee program. For information about poverty-based sliding fee plans, see Poverty-Based Sliding Fee Plans.

 

On the Main Menu, click Settings > Billing. In the left menu, under Practice Links — Fee and Allowable Schedules, click Sliding Fee Plans (Non-Poverty-Based)

 

 

 

Your practice must have the Sliding Fee Programs feature enabled. You must have the Post-Adjudication Sliding Fee Plans feature enabled to adjust sliding fee plan balances automatically after primary and/or secondary payer adjudication.

 

To access this page, you must have the Practice Set-Up: Sliding Fee Programs/ Plans permission.

 

 

 

  1. Display the Non-Poverty-Based Sliding Fee Plans page: On the Main Menu, click Settings > Billing. In the left menu, under Practice Links — Fee and Allowable Schedules, click Sliding Fee Plans (Non-Poverty-Based).
  2. Click Add new.
  3. Sliding fee program — Select a non-poverty-based sliding fee program.
  4. Plan name — Enter a name for the plan.
    The name should identify the correct plan for a patient, for example: "Ryan White 30% patient responsibility."
  5. Calculation type — Select the appropriate calculation type:
    1. If the patient responsibility is to be only a flat fee, select "Flat fee only."
    2. If the patient responsibility is to be a percentage of charges only, select "Percentage only."
    3. If the patient responsibility includes both a flat fee and a percentage of charges remaining after the flat fee, select "Flat fee + percentage of the remaining balance."
    4. If the patient responsibility is a percentage of total charges plus an additional flat fee, select "Percentage of total charge + additional flat fee."
    5. If the patient responsibility is whichever amount is lesser of a flat fee or percentage, select "Lesser of flat fee and percentage."
    6. If the patient responsibility is whichever amount is greater of a flat fee or percentage, select "Greater of flat fee and percentage."
  6. Flat fee — Enter the flat fee responsibility amount in dollars (if applicable). athenaOne automatically requires or disables this field, based on the calculation type selected.
  7. Patient responsibility — Enter the percentage responsibility amount (if applicable). athenaOne automatically requires or disables this field, based on the calculation type selected.
  8. Custom transaction code — Select a custom transaction code (optional).
    Note: Custom transaction codes are used to differentiate between two collections agencies, or between free care for professional courtesy and free care in conjunction with a local charity. Custom transaction codes are administered via the Custom Transaction Codes page.
  9. Transaction reason — Select a transaction reason (optional).
  10. Notes — Enter any notes (optional).
  11. Click Save.

 

  1. Display the patient's Quickview page.
  2. Scroll down to the Insurances area and click add new.
    The Add Policy page appears with the Policy Lookup tab selected by default.
  3. Click the Self-Pay tab, or click Self Pay in the Favorites list.
  4. Click Select next to Sliding Fee Schedule - Discount.
    The Add Cash Policy Details page appears.
  5. Sliding fee program — Select a non-poverty-based sliding fee program from the menu.
    Additional fields appear.
  6. Sliding fee plan — Select a non-poverty-based sliding fee plan from the menu.
  7. Effective date — Enter the effective date for the sliding fee plan.
  8. Expiration date — Enter the expiration date for the sliding fee plan.
  9. Notes — Enter any notes about the plan and the patient.
  10. Click Add Cash Plan.

 

 

Sliding fee program

Select the desired sliding fee program from the Sliding Fee Program menu. This menu is administered via the Sliding Fee Programs page.

Plan name

Enter a unique name for the plan in the Name field. The name should identify the correct plan for a patient, for example: "Ryan White 30% patient responsibility."
Calculation type

Select the appropriate calculation type from the Calculation Type menu:

  • If the patient responsibility is to be only a flat fee, select "Flat fee only."
  • If the patient responsibility is to be a percentage of charges only, select "Percentage Only."
  • If the patient responsibility includes both a flat fee and a percentage of charges remaining after the flat fee, select, "Flat fee + percentage of the remaining balance."
  • If the patient responsibility is a percentage of total charges plus an additional flat fee, select "Percentage of total charge + additional flat fee."
  • If the patient responsibility is whichever amount is lesser of a flat fee or percentage, select "Lesser of flat fee and percentage."
  • If the patient responsibility is whichever amount is greater of a flat fee or percentage, select "Greater of flat fee and percentage."
Flat fee

Enter the flat fee responsibility amount in dollars (if applicable). athenaOne automatically requires or disables this field, based on the calculation type selected.
Patient responsibility

Enter the percentage responsibility amount (if applicable). athenaOne automatically requires or disables this field, based on the calculation type selected.
Custom transaction code

Select a custom transaction code (optional).

Note: Custom transaction codes are used to differentiate between two collections agencies, or between free care for professional courtesy and free care in conjunction with a local charity.

Custom transaction codes are administered via the Custom Transaction Codes page.

Transaction reason Select a transaction reason (optional).
Notes

Enter notes in the Note field if necessary (optional).
Column Headings
for Non-Poverty-Based Sliding Fee Plans
Program

The name of the sliding fee program.
Plan Name

The name of the sliding fee plan.
Calculation Type

See Calculation type field (above).
Flat Fee ($)

The amount of the patient's flat fee responsibility.
Patient Responsibility (%)

The percentage amount that the patient is responsible for.
Custom Transaction Code

The custom transaction code associated with this plan.
Transaction Reason The transaction reason associated with this plan.
Notes

Any notes about this plan.

 

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