Payment Plans

Summary

Payment plans are another offering that helps to ensure and expedite the collection of outstanding medical balances. A payment plan is essentially an automated pay-down plan that allows the patient to indicate a set amount to be charged or billed each month, until the selected claims are paid off. This documentation focuses on two types of payment plans that athenahealth offers:

  1. Credit Card: This payment plan will store credit card information for the patient and charge the card at monthly intervals until the specified claims are paid in full. 
  2. Sendstatement: The sendstatement plan will send the patient regular statements for the outstanding amount. 

Note: We recommend only surfacing the credit card option in the Digital Check-in workflow to minimize confusion and attempt to collect balances at the time of service. Both plans require the user to set the "cycleamount" to be paid during each period. We are intentionally limiting the frequency to monthly in order to streamline the user experience.

The paymentplan API call allows users to create a payment plan for an individual patient.

(You can use the /collectpayment/oneyear to verify the post.)

Implementation Notes

Selecting Claims:

- The user must specify which claims they want included in the payment plan. Payment plans may be applied to one or many claims, and only for the full/remaining balance on each. Users may select from a list of claim balances, but may not designate a partial claim balance to be included in a payment plan. When surfacing potential payment plan claims to a patient, only include those with “clean” balances. Claims without clean balances are already being addressed in another manner (either a payment contract or a different payment plan). If non-clean balances exist, we recommend surfacing the fact that there are other balances that are already associated with an existing payment contract or payment plan (whether or not you display those specific amounts) to avoid confusion, and drive the patient to the front desk if they have questions or want more detail. In addition, you may include any claims within the same "provider group" as where the patient is currently being treated (only applies to Enterprise clients … see below).

- Credit Card Info: Credit card plans require that the user supply standard credit card info (such as that outlined in the /patients/:patientid/collectpayment call). In this case, the cardsecuritycode and an email address are also required.  

- Downpayment Amount: Credit card plans may also specify a downpayment amount. This amount will be used the first time the credit card is billed. For example, if the downpayment amount is $50 and the cycle amount is $10, then the credit card will first be billed $50 on the selected payment plan start date and then one month later, the card will be billed $10. If no downpayment is specified, the regular cycle amount of $10 will be billed on the start date, and again each subsequent month. Also, if the balance does not divide evenly across the number of monthly payments, we recommend the partner adjust for this in the initial downpayment amount. For example, if the patient balance is $100 and the desired plan duration is 3 months, the partner should create a downpayment of $33.34 so the subsequent monthly amounts of $33.33 will total $100 even.

- Associating claims to provider group: Both payment plan varieties (credit card and send statements) require a department ID and a start date. In the case of Enterprise practices, the claims for a payment plan must belong to the provider group associated with that department. For example, if the department is associated with provider group ID 10, then you may only specify claims associated to provider group ID 10.  (See the clean balance documentation for more information.) Provider groups only matter for Enterprise clients. Non-Enterprise practices can add ANY claim to the payment plan.

- Monthly billing for Credit Card Plans: The patient’s card will be charged each month on the "startdate." For example, if the start date is 01/15/2015, then the card will be billed the initial cycle amount on that date, and the next cycle amount on 02/15/2015. In the case where a start date does not exist in a subsequent month (for example the 31st or leap year), the system will automatically adjust to the closest prior day in those months.

NOTE: We are in the process of adding additional validation to our payment plan functionality (for example, functionality that rejects a request that supplies credit card information for a sendstatements payment plan).

Please see this page about emailing patient receipts.

- How to tell if a department supports credit card payment plans: Where a department supports payment contracts, it automatically supports both contract types. If a practice supports payment contracts, it also will automatically support both types of payment plans. Practice policy determines which contract type should be offered. Similarly, the practice should choose which to implement for Digital Check-in at the practice/provider group/department level. This should be handled between the partner and practice during onboarding. We strongly suggest keeping this simple in the partner UI by only offering one.

- How to tell if a department supports sendstatement plans: All departments support sendstatement plans.

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