What’s in the Guide
Credits can be created automatically or manually in Insights. They fall into one of two categories:
- Locked to a particular date of service (see the “Locked Credits” section in this guide for more details), or
- Available for use towards any of that patient’s outstanding balances.
This guide will walk you through both types of credits and how they’re used on our platform.
🌐 Overview
Where to View Credits
Patient Responsibility Page
The Patient Responsibility page can be filtered to show only patients with available, locked, or both types of credits, as shown here.
Patient Profile
On the individual level, each patient profile shows that patient’s available and locked credits in the right-hand heading card. To view more details about their credits, click the Credits tab. Note that only available credits are shown in this tab heading.
Patient Payment Modal
Because the most common time to apply credits is during payment, there is a collapsible view of all available credits within our payment modal, complete with their statuses and tooltips for clarification.
Types of Credits
Available Credits
Available credits belong to no particular date of service.
Every night, Insights automatically applies each patient’s available credits to any outstanding balances they may have.
These credits can also be manually refunded to patients. To learn about issuing refunds, see this guide.
Locked Credits
These credits are locked to a particular date of service.
Credits are locked when a non-finalized claim exists on their date of service. Until that claim is finalized, payments towards this date of service will be held and then applied when insurance processing is complete.
Locked credits do not require any action on your part.
However…
If you really want to unlock credits and you are absolutely sure that Insights is waiting needlessly for a decision by a payer who won’t respond, you can manually unlock the credits.
From the Patient Responsibility page, switch to the Locked Credits tab.
Select which patients’ credits you wish you unlock.
Click Unlock Credits.
Sources of Credits
There are three main ways that credits can be added to a patient’s account.
Automatically Generated Credits
When a patient makes a PR payment, and then a remittance is received that reduces the amount of PR owed, Athelas will create a credit in the amount of the overpayment. These funds are held in reserve in case remittances from payers do not cover the outstanding balance. (For more information on this process, check out our guide on Overpayment Refunds).
Automatic credit generation can also happen when a claim that’s received a remittance is Resubmitted. In this event, the full payment amount will be turned into credits and locked to this date of service, to ensure they’re still available when the new payer decision arrives later on.
Manually Created Credits
You can manually Add or Remove credits in the Credits tab of the Patient Profile. These credits function like any others, but lack the paper trail of a remittance or a purchase. Created credits are generally used to import credits from an external system.
Purchased Credits
Patients also have the ability to purchase credits for future use. When they do this they’ll have the option to select either Flexible (Available) or Date of Service credits for any date they prefer.
Applying Credits
And finally, here’s a rundown of the way credits can be applied:
Automatic (Nightly)
Each evening when Athelas processes remittances and adds new PR to patient accounts, any usable credits will automatically be applied to pay off new balances. Credits will be considered usable, and applied in the following order, if:
- They are locked to the same DoS as the new PR
- They are in the general pool of available credits
Any other credits will not be applied.
Note: Soon (as of 9/20/24), you will be able to toggle this auto-apply function on or off. This will allow more flexibility in cases where patients with outstanding balances request credits to be refunded instead, for example.
Manual (via Payment Modal)
Your staff and patients also have the option to apply their credits when they are making a payment.
- Check the
Apply patient creditsbox or click theCredit breakdownlink on the bottom-left side of the payment modal.
- This will expand the full list of available credits
- When you expand this section, credits will automatically be selected to cover the full amount the patient owes, if there are enough available.
In Conclusion
Credits add a layer of flexibility to collections, allowing your practice to hold on to dollars owed while payer decisions are not yet finalized. The key things to know about how credits work in Insights are:
- There are Available Credits and Locked Credits. See the corresponding sections above for details.
- Credits are only locked when Insights is waiting for final decisions by payers (or if there’s an outstanding balance that needs resolution). Pending remittances may not fully cover charges. Therefore, credits related to that date of service are locked there until that encounter is balanced. Once it is balanced, any remaining credits will be made available for general use.
- Each night, Insights automatically applies each patient’s usable (read: either available or locked to that exact DoS) credits to their outstanding balances, if there are any. A toggle to turn this feature on and off will soon be available.
- Available credits may be refunded through Insights as long as the payment that created those credits was also taken through Insights (Athelas card reader or patient payment portal).
- You are free to refund credits manually through some other method, such as cutting a check and then manually editing that patient’s total credits to match. Just be sure to leave a note explaining the manual adjustment.
📢 Further Assistance
We’re here to help! Please contact your account manager for some hands-on assistance.
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