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Add or Modify a Non-Coordinated SIM Library
Add or Modify a Non-Coordinated SIM Library
Open File Maintenance and select
Libraries
>
Non-Coordinated SIM
.
The
Non-Coordinated SIM List
window opens.
From the
NDC List
window, select the open menu button
to add or open an existing Non-Coordinated SIM library.
The
Non-Coordinated Service Item Library Maintenance
window opens.
In the
Non-Coordinated SIM Library Name
field, enter a name for the library.
In the
Payer SIM Configuration
section, you can configure a new payer SIM or modify an existing one by selecting the open menu
button.
The
Non-Coordinated SIM Maintenance
window opens.
Enter values in the fields, and then select the respective open folder
icons to configure the service item.
Setting Up Non-Coordinated SIM Rules
You can set up non-coordinated SIM rules for configuring a SIM.
File Maintenance Help for NextGen® Enterprise
Billing Rules for in the Non-Coordinated SIM Library
The Non-Coordinated SIM library enables you to set up billing rules for payer-specific service items. This includes service items that are only reimbursed by specific payers such as a state plan, special grant program, or Medicaid, that will not be reimbursed if billed to other payers. For example, a range of behavioral health SIM codes can be billed to Medicaid but not to any other payer. These SIM codes can be set up in this library with Medicaid selected as the only valid payer, therefore making the SIM codes non-coordinated for all other payers. The library also defines other parameters that affect how non-coordinated SIM codes are handled during charge posting and billing. These parameters include options and settings for balance control, auto-adjustments, and claims. Note: This is a practice level library only. A library cannot be linked to specific payers. You can generate the Non-Coordinated SIM report from the Non-Coordinated SIM library , go to NextGen Healthcare Success Comm
Help Guide for NextGen® Enterprise PM 8
Add or Modify a Non-Coordinated SIM Library
Open File Maintenance and select Libraries > Non-Coordinated SIM. The Non-Coordinated SIM List window opens. From the NDC List window, select the open menu button to add or open an existing Non-Coordinated SIM library. The Non-Coordinated Service Item Library Maintenance window opens. In the Non-Coordinated SIM Library Name field, enter a name for the library. In the Payer SIM Configuration section, you can configure a new payer SIM or modify an existing one by selecting the open menu button. The Non-Coordinated SIM Maintenance window opens. Enter values in the fields, and then select the respective open folder icons to configure the service item. Set Up Non-Coordinated SIM Configurations In Non-Coordinated library, you can configure billing rules for SIM codes. Parent topic: Billing Rules for in the Non-Coordinated SIM Library
Help Guide for NextGen® Enterprise PM 8
Add or Modify a Non-Coordinated SIM Library
Open File Maintenance. Select Libraries, and then Non-Coordinated SIM Library. The Non-Coordinated SIM List window opens. Do one of the following: To create a library, select open menu button and select New. To modify a library, select the library from the list, and then select open menu button and select Open. The Non-Coordinated Service Item Library Maintenance window opens. In the Non-Coordinated SIM Library Name field, enter a name for the library. This field is required. Set up Non-Coordinated SIM Configuration as needed. For more information on setting up Non-Coordinated SIM Configuration, see Set up Non-Coordinated SIM Configurations. To save changes and close the window, select OK. Set Up Non-Coordinated SIM Configurations In Non-Coordinated library, you can configure billing rules for SIM codes. Parent topic: Non-Coordinated SIM Library
File Maintenance Help for NextGen® Enterprise 8
Add or Modify a Non-Coordinated SIM Library
Open File Maintenance. Select Libraries, and then Non-Coordinated SIM Library. The Non-Coordinated SIM List window opens. Do one of the following: To create a library, select open menu button and select New. To modify a library, select the library from the list, and then select open menu button and select Open. The Non-Coordinated Service Item Library Maintenance window opens. In the Non-Coordinated SIM Library Name field, enter a name for the library. This field is required. Set up Non-Coordinated SIM Configuration as needed. For more information on setting up Non-Coordinated SIM Configuration, see Set up Non-Coordinated SIM Configurations. To save changes and close the window, select OK. Parent topic: Non-Coordinated SIM Library
Help Guide for NextGen® Enterprise PM 8
Set Up Non-Coordinated SIM Configurations
You can configure billing rules for SIM codes that are valid for specific payers, and are therefore considered invalid or non-coordinated for other payers on the Non-Coordinated SIM Maintenance window. The rules can be configured in a way that ensures a non-coordinated SIM code is billed only to a valid payer. The rules can also be configured to ensure that services rendered by a provider with a specific credential are billed only to a valid payer. You can define additional rules for balance control, auto-adjustments, and claims. In File Maintenance, select Libraries, and then select Non-Coordinated SIM Library. The Non-Coordinated SIM List window opens. Double-click a library. The Non-Coordinated Service Item Library Maintenance window opens. In the Payer SIM Configuration section, do one of the following: To create a new SIM configuration or row, select open menu and then select New. To modify an existing SIM configuration, select the row, select open menu and then select Open. The N
File Maintenance Help for NextGen® Enterprise 8
Set Up Non-Coordinated SIM Configurations
You can configure billing rules for SIM codes that are valid for specific payers, and are therefore considered invalid or non-coordinated for other payers on the Non-Coordinated SIM Maintenance window. The rules can be configured in a way that ensures a non-coordinated SIM code is billed only to a valid payer. The rules can also be configured to ensure that services rendered by a provider with a specific credential are billed only to a valid payer. You can define additional rules for balance control, auto-adjustments, and claims. In File Maintenance, select Libraries, and then select Non-Coordinated SIM Library. The Non-Coordinated SIM List window opens. Double-click a library. The Non-Coordinated Service Item Library Maintenance window opens. In the Payer SIM Configuration section, do one of the following: To create a new SIM configuration or row, select open menu and then select New. To modify an existing SIM configuration, select the row, select open menu and then select Open. The N
