Post Prepayment

 

On the Main Menu, click Financials. Under PAYMENTS, click Prepayment Worklist. On the Prepayments Worklist, click Post Prepayment in the Actions column.

 

 

You must have the Add/Edit New Patient Insurance Policy role or permission to access this page.

 

 

When a patient has money in a prepayment plan and also has outstanding patient balances on adjudicated claims, the athenaOne system sets the claims to MGRHOLD status and applies the PREPAYRVW kick code. You can use the Post Prepayment page to apply collected prepayment plan money to the patient balance on a claim.

Note: After you apply money from the prepayment plan to the outstanding patient balance on an adjudicated claim, the athenaOne system posts the payment immediately and removes the MGRHOLD hold status from the claim.

 

When a patient has unadjudicated claims, you can use the Post Prepayment page to link the claims to the patient's prepayment plan for future posting. After the claim is adjudicated, the athenaOne system will post the payment to that claim.

 

Open the Prepayment Worklist page to see the list of all patients who have balances in prepayment plans and also have outstanding patient balances.

1. Display the Prepayment Worklist page: On the Main Menu, click Financials. Under PAYMENTS, click Prepayment Worklist.

2. The Prepayment Worklist page appears with the default view: Active, which lists plans with outstanding patient balances.

3. You can sort the list by any column that has the sort icon (click the up and down arrows next to the column name).
   
4. To post prepayment plan balances to a patient's claims, locate the patient in the list and click Post Prepayment in the Actions column.
   The Post Prepayment page appears.
   Note: The amount of money in the prepayment plan is displayed at the top of the Post Prepayment page, along with other information about the prepayment plan.
5. On the Post Prepayment page, you can click Cancel to return to the Prepayment Worklist page.

 

Adjudicated Claims section

5. To apply money from a prepayment plan to outstanding patient balances on adjudicated claims, click Apply in the Actions column.
   The full amount owed by the patient appears in the Prepayment Applied column. If the claim includes multiple procedure codes, the athenaOne system applies the appropriate payment to each code.
   
   Note: To undo the Apply action, click Reset.
6. Edit the amounts in the Prepayment Applied column, if needed.
7. To edit the default claim note for this transaction, click Edit Note, then make your edits and click Save.
   
8. Do you want to remove the unapplied claims from this prepayment plan permanently? — If you did not apply prepayment plan money to all the adjudicated claims on the Post Prepayment page, you can choose to remove these claims from the Prepayments Worklist and the Post Prepayment page.
   Note: You cannot make a selection in this field if you applied money to all the claims.
   • No — Display these claims in the future on the Prepayments Worklist and the Post Prepayment page.
   • Yes — Remove the claims from the Prepayments Worklist and the Post Prepayment page (do not display these claims again).
     Note: The athenaOne system removes the MGRHOLD status from these claims and removes the claims from all other prepayment plans for the patient. The claim status changes to PATIENT DROP and the patient receives a statement for the outstanding balance.

Unadjudicated Claims section

9. To link unadjudicated claims to the money from a prepayment plan, click Link to plan in the Actions column.
   
   Note: To undo this action, click Unlink.
10. To edit the default claim note for this transaction, click Edit Note, then make your edits and click Save.
    
11. Do you want to remove the unlinked claims from this prepayment plan permanently? — If you did not link all the unadjudicated claims to prepayment plan money on the Post Prepayment page, you can choose to remove these claims from the Prepayments Worklist and the Post Prepayment page.
    Note: You cannot make a selection in this field if you linked all the unadjudicated claims to prepayment plan money.
    • No — Display these claims in the future on the Prepayments Worklist and the Post Prepayment page.
    • Yes — Remove the claims from the Prepayments Worklist and the Post Prepayment page (do not display these claims again).
      Note: The athenaOne system will not move those claims to HOLD status after adjudication, even if the patient has a prepayment plan balance. The patient will receive a statement for any outstanding balances after the claims are adjudicated.

Submit your work

12. After you complete your work on the Post Prepayment page, click Submit.
    If a balance remains in the prepayment plan, a window appears prompting you to select where to keep the plan balance.
    
13. To transfer the prepayment plan balance to unapplied money and deactivate the plan, click Transfer the balance to unapplied and deactivate the plan.
    • If you applied money to adjudicated claims only, the athenaOne system deactivates the plan and transfers the balance to unapplied immediately.
    • If you linked unadjudicated claims to prepayment plan money, the athenaOne system transfers the plan balance to unapplied after the claims are adjudicated.
14. To keep the balance in the prepayment plan, click Retain the balance and keep the plan active.

 

From the Prepayment Worklist page, you can access the Post Prepayment page.

Note: Click Cancel on the Post Prepayment page to return to the Prepayment Worklist page.

 

On the Post Prepayment page, you can:

• Apply balances from a patient's prepayment plan to the patient's outstanding balance for an adjudicated claim.
• Link a prepayment plan to an unadjudicated claim for future posting.
• Transfer prepayment plan balances to unapplied money.
  Note: You can also use the Update Prepayment Plan page to transfer money between a prepayment plan and the patient's unapplied balance.

Note: Adjudicated claims on the Prepayment Worklist are set to MGRHOLD status with the PREPAYRVW kick code applied. athenaOne removes the hold after you apply prepayment money to the outstanding balance.

 

When you use the Post Prepayment page to apply prepayment plan money to adjudicated claims, the posting information appears on these pages:

• Update Prepayment Plan
• Patient Activity
• Quickview (Outstanding Balances section)

 

Column headings — Adjudicated Claims
Claim ID	athenaOne claim ID number.
Date of Service	Date that the service on the claim was rendered.
Department	Department where the service was rendered. Note: On the Prepayments Worklist and Post Prepayment pages, you see information for all departments, even if you don't have access to some of the departments elsewhere in the athenaOne system.
Rendering Provider	Name of the provider who performed the services.
Procedure code	Billing codes for the procedures that were performed.
Patient responsibility	Total balance owed by the patient for adjudicated claims.
Prepayment Applied	Money to be applied from the prepayment plan to the balance owed by the patient. The athenaOne system automatically populates this field with the full amount that the patient owes after you click Apply in the Actions column. You can edit the amount in this field as needed.
Claim notes	You can edit the default claim note after you apply money from the prepayment plan.
Actions	Click Apply to apply money from the prepayment plan to the balance that the patient owes.
Column headings — Unadjudicated Claims
Claim ID	athenaOne claim ID number
Date of Service	Date that the service on the claim was rendered.
Department	Department where the service was rendered. Note: On the Prepayments Worklist and Post Prepayment pages, you see information for all departments, even if you don't have access to some of the departments elsewhere in the athenaOne system.
Rendering Provider	Name of the provider who performed the services.
Procedure code	Billing codes for the procedures that were performed.
Claim notes	You can edit the default claim note after you link an unadjudicated claim to a prepayment plan.
Actions	Click Link to plan to link the unadjudicated claim to the prepayment plan.