Insurance and Financials

Learn about Insurance and Financial workflows at athenaOne to create and manage different patient claims, and manage payments and payment instructions. 

Workflows

Adding and Updating Case Policies

Learn to fetch and create new case policies for a patient.

Adding and Updating Insurance Information

Instructions and APIs for creating and managing insurance and insurance package details for a patient.

Payment Plans

Learn about payment plans in athenaNet for a practice. Use the instructions to create and manage payment plans for patients

Record Payment

Record, manage payments made via different modes (cash, check, credit) for a patient.

Appointment Based Claim Creation

Create and manage claims for appointments. Learn the workflows and instructions to submit accurate claims.

Attach documents to a Claim

Add, manage claim documents for assisting in claim processing. Use attachment class information for better document organization.

Bypassing athenaNet’s allowable and fee schedules

Learn about the fee-schedules and instructions on bypassing fee schedule or allowable schedule at the time of claim creation

Charge Entry - Billing for Services

Review and confirm the services, CPT codes, units, diagnosis and other information for an encounter before creating a claim.

Claim Creation Outside of an Appointment

Learn claim creation process for claims not associated with either appointments or encounters.

Credit Card Payment - Email Receipts

Instructions for sending patient emails for credit card payments

Patient Balances and Payment Collection

Check patient's expected copay for the appointment (checking-in or booking), and the patient's outstanding balances at the claim level

Payment Contracts

Learn about patient contracts in athenaOne and how to better leverage/integrate with patient contracts feature.

Payment Testing

Instructions for testing payments workflows via test-numbers, and quick tips on error/exception handling.

Insurance Package Search

Check the insurance packages available for a patient at a practice

API Reference

Appointment Insurance

View, update list of insurance packages of a patient for a given appointment

CCM Enrollment

View, update Chronic Care Management (CCM) enrollment of patient with CCM eligible insurances

Claim

Create, view, manage claim details for an appointment. Additionally subscribe to list of changes to patient's claims.

Claim Attachment

View, create, modify, or delete any claim documentation from the specific claim.

Claim Note

View, create, or modify patient's claim notes documented in the claim.

Claims customfields

View list of custom-fields available for a claim at the practice

Fee Schedule

View, create or delete fee-schedules for a procedure at the practice

Insurance Card Image

View, upload or manage patient's insurance card-image for a given patient

Insurance Package

View list of standard, or case-policies for insurance packages. Additionally create, manage local insurance packages at the practice.

Inventory

Update inventory details by recording inventory consumption in general ledger.

One Year Payment Contract

View list of 1-year contract for a department at the practice. Additionally view, manage 1-year contract details.

Patient Insurance Eligibility Information

Add or view patient's insurance benefits details

Patient Insurance

View, manage patient's insurance package details. And create patient's specific case-policy details.

Payment Plan

View, create patient's payment plan details. Additionally retrieve list of non-credit card payment methods.

Payment

Create patient's payment information details, or void an individual e-payment details.

Receipt

Create or view payment-receipts for a patient, or paymentID. And send emails with payment-receipt details.

Referral authorization

View, manage patient referral authorization information

Single Appointment Payment Contract

View single-appointment contract payment terms/contracts. And create appointment's payment information.

Stored Card

View, upload or manage patient's credit card details stored in the system.
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