Enable Facility Billing for Places of Service

File Maintenance Help for NextGen® Enterprise 8

Enable Facility Billing for Places of Service

The place of service can indicate whether a line item is facility or non-facility, which can be priced and reimbursed differently for the same service. For example, service rendered in a surgical center could have different reimbursement from service rendered in an office. Open File Maintenance, and then select Code Tables. The Code Tables List window opens. Select Places of Service code table from the Code Table list, and then double-click a place of service. The Modify Place of Service Information window opens. Select the Facility check box, and then select OK. The Code Tables List window displays a green check mark in the Facility column for the place of service. Selecting a Place of Service You can assign a place of service to a location or service item code after you have set up the Places of Service code table and indicated the facilities. Parent topic: Code Tables

File Maintenance Help for NextGen® Enterprise

Code Tables

NextGen® Enterprise PM uses enterprise-wide code tables. Code tables are lists of codes and their descriptions that are required for billing and reporting purposes, such as allergy severity, claim types, race category, and sexes. The data in these tables is set up when your server is staged. For example, the Claim Types code table lists the codes that are required for different payers, such as Medicare, Blue Cross Blue Shield, and Workers' Compensation. Code Table Descriptions You can know the functions of the code tables through their descriptions. Enable Facility Billing for Places of Service You can enable facility billing for a place of service using the Place of Service code table in the Code Tables section of File Maintenance. External Systems for Code Tables You can add external systems that interface with the NextGen Healthcare applications and associate them with a code table.

Help Guide for NextGen® Enterprise PM 8

Set Up Payers for Enhanced UB Users

In File Maintenance, select Master Files - System > Payers. Right-click the applicable payer and then select Open. The Modify Payer Information window appears. Select the Practice tab and then the UB tab. Modify Payer Information In the Location field, select the practice location, if applicable. This enables all the fields and check boxes on the tab. The location that you select must be the same as the location that is selected on the Create Encounter or Encounter Maintenance window. Enter the applicable information in the Field Locator fields and enable the check boxes to display the information on the UB claim. The following conditions must be met for Enhanced UB users that want to use the automated UB billing process: Field Locator 51 must be populated. The Type of Facility field must be equal to 7 (Clinic). The Bill Classification field must be equal to 4 (Outpatient Rehab Facility). The Bill Frequency field must be blank. Select OK. Parent topic: Setting Up UB Claims for Enhanced

Help Guide for NextGen® Enterprise PM 8

Set Up Billing Options

The Billing Options tab is used to specify which Place of Service code and ICD codes should be used on claims when multiple Behavioral Health charges on an encounter each have different codes. It also allows selection of an adjustment reason code for auto-balancing a variance amount on COB claims. Open File Maintenance. Select Libraries, and then select Behavioral Health Billing. The Behavioral Health Billing List window opens. From the list, double-click to open the desired library. The Behavioral Health Billing Library Maintenance window opens. Select the Billing Options tab. Complete the fields to set up Billing Options. For more information on each field, see Billing Options Field Descriptions. To save changes and close the window, select OK. Billing Options Field Descriptions Parent topic: Add or Modify a Behavioral Health Billing Library

File Maintenance Help for NextGen® Enterprise 8

Set Up Billing Options

The Billing Options tab is used to specify which Place of Service code and ICD codes should be used on claims when multiple Behavioral Health charges on an encounter each have different codes. It also allows selection of an adjustment reason code for auto-balancing a variance amount on COB claims. Open File Maintenance. Select Libraries, and then select Behavioral Health Billing. The Behavioral Health Billing List window opens. From the list, double-click to open the desired library. The Behavioral Health Billing Library Maintenance window opens. Select the Billing Options tab. Complete the fields to set up Billing Options. For more information on each field, see Billing Options Field Descriptions. To save changes and close the window, select OK. Billing Options Field Descriptions Parent topic: Behavioral Health Billing Library

Help Guide for NextGen® Enterprise PM 8

Set Up Payers for Enhanced UB Users

In File Maintenance, select Master Files - System > Payers. Right-click the applicable payer and then select Open.The Modify Payer Information window appears. Select the Practice tab and then the UB tab. In the Location field, select the practice location, if applicable. This enables all the fields and check boxes on the tab. The location that you select must be the same as the location that is selected on the Create Encounter or Encounter Maintenance window. Enter the applicable information in the Field Locator fields and enable the check boxes to display the information on the UB claim. The following conditions must be met for Enhanced UB users that want to use the automated UB billing process: Field Locator 51 must be populated. The Type of Facility field must be equal to 7 (Clinic). The Bill Classification field must be equal to 4 (Outpatient Rehab Facility). The Bill Frequency field must be blank. Select OK. Parent topic: Setting Up UB Claims for Enhanced UB Users

Enable Facility Billing for Places of Service

Recommendations

Enable Facility Billing for Places of Service

Code Tables

Set Up Payers for Enhanced UB Users

Set Up Billing Options

Set Up Billing Options

Set Up Payers for Enhanced UB Users

Enable Facility Billing for Places of Service

Code Tables

Set Up Payers for Enhanced UB Users

Set Up Billing Options

Set Up Billing Options

Set Up Payers for Enhanced UB Users