Integrating with Athena – FormDr Product Guide

To Integrate with Athena
To Connect your Packet
To Update your packet
Insurance Codes
Builder Examples

To Integrate with Athena:

Sign and submit the consent form provided by Athena
Once Athena has approved your account you can connect

To Connect your Packet:

Go to the 'Integrations' tab and select 'Export submissions to athenahealth'
Enter your 'Athena Practice ID' and 'Department ID.' (Department ID is 1)
Click 'Authenticate Athenahealth'
Select form to export into Athenahealth
Select where you want the PDF to upload within Athena.
Click 'Save and Back'
Each packet connected packet will have a blue check box.
Once you have saved your information you have the option to turn on 'Export automatically.' If this option is turned on it will automatically push your submissions through to Athena at the top of every hour. Leaving this option off means you can push the submission through to Athena at your discretion.
You are now ready to update your form with the correct Athena shortcodes.

Now that your account is configured you will need to update your packet with the correct shortcodes. This can be accomplished by updating your existing questions or by dragging the Athena Template onto your packet.

Go to 'My Forms' and update your packet with the correct Athenahealth shortcodes in the form builder.
Add the Athena template to your packet by clicking the "Athena Template" widget in the form builder under the "Integration Templates" section.

To Update your packet:

Please use the list of provided shortcodes on your integrated packet.

Department ID

Level	Default	Display	Definition
	1	Department ID

Patient Name

Level	Shortcode	Display	Definition
1	firstName	First Name	*Must Have/ Ex: Image 2
1	middleName	Middle Name
1	lastName	Last Name	*Must Have
1	athenaPreferredName	Preferred Name	Ex: Image 2
1	athenaAltFirstName	Alternate First Name	Ex: Image 2

Demographics

Level	Shortcode	Display	Definition
1	athenaDriversLicense	Driver's License Number	Ex: Image 3
1	athenaSSN	Social Security Number	Ex: Image 3
1	athenaDob	Birthday	*Must Have
1	athenaRace	Race
2	2054-5	African American
2	1002-5	American Indian or Alaska Native
2	2028-9	Asian
2	2029-7	Asian Indian
2	2106-3	White
2	2131-1	Other
1	athenaPreferredPronouns	Pronouns
2	he/him	He/Him
2	she/her	She/Her
2	they/them	They/Them
1	athenaMaritalStatus	Marital Status	Ex: Image 4
2	S	Single
2	M	Married
2	D	Divorced
2	W	Widowed
2	X	Separated
2	P	Partner
2	U	Unknown
1	athenaSex	Sex
2	M	Male
2	F	Female
1	athenaBirthSex	Sex at Birth
2	M	Male
2	F	Female
1	athenaSexualOrientation	Sexual Orientation
2	Straight or heterosexual	Straight or heterosexual
2	Lesbian, gay or homosexual	Lesbian, gay or homosexual
2	Bisexual	Bisexual
2	Something else	Something else
3	athenaSexualOrientationOther	Specify Sexual Orientation
2	Don't know	Don't know
2	Choose not to disclose	Choose not to disclose
1	athenaGenderIdentity	Gender Identity
2	Male	Male
2	Female	Female
2	Genderqueer (neither exclusively male nor female)	Gender NonConforming
2	Additional gender category or other	Other
3	genderidentityother	Specify Gender
2	Choose not to disclose	Choose not to disclose
1		Address
1	athenaStreet	Street
1	athenaStreet2	Street 2
1	athenaCity	City
1	athenaState	State
1	athenaZip	Zip
1	athenaMobilePhone	Mobile Phone
1	athenaHomePhone	Home Phone
1	athenaWorkPhone	Work Phone
1	athenaEmail	Email Address
1	athenaConsentToCall	Consent to call
1	athenaConsentToText	Consent to text
1	athenaPrivacy	*Privacy Agreement	*Must Have/ Recommended as an update for privacy agreement signatures

Insurance

Level	Shortcode	Display	Definition
1	athenaIsInsured	Do you have insurance
2	athenaInsuranceHolder	Are you the insurance holder
2	True	Yes	Default FormDr Shortcodes
2	False	No
3	athenaInsurancePolicyHolderFirstName	Policy Holder First Name
3	athenaInsurancePolicyHolderLastName	Policy Holder Last Name
3	athenaRelationshipToInsuredId	Relationship to the Insured
3	2	Spouse
3	3	Child
3	4	Other
3	athenaInsurancePolicyHolderSex	Policyholder Sex
3	M	Male
3	F	Female
3	athenaInsuranceHolderDob	Policyholder date of Birth
2	athenaInsuranceID	Insurance ID
2	athenaInsurancePolicySequenceNumber	Insurance Type
2	1	Primary
2	2	Secondary
2	athenaInsurancePolicyProvider	Insurance Provider
2		Upload Insurance
2	AthenaInsuranceCardFront	Front Image Needed
2	athenaInsuranceCardBack	Back Image Needed

Insurance Codes: (Athena Provided - Required to integrate insurance information)

Level	Shortcode	Display	Definition
	5310	Blue Shield Blue Cross
	9081	Kaiser Permenante
	1352	Aetna
	16991	Aetna POS
	38340	BCBS AZ (PPO)
	38417	BCBS AZ
	74	Cigna
	982	United Healthcare
	2150	United Healthcare PPO
	149947	UMR- Unitedhealthcare

Where to location Insurance ID:

Department ID Example:

Patient Name Example:

Patient Name Alternative Example:

Identification Example:

Marital Status Example:

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