SIM Pricing Template Library Field Descriptions

Section	Description
Service Item # and Description	Displays a meaningful Service Item numbers and descriptions to correlate to the appropriate CPT4 code. You can also select New from the open menu button, and then enter a new Service Item Number.
Non-Facility/ Facility Price	Displays the non-facility and facility price, if applicable, for the SIM for the defined time period. When a service item has both facility and non-facility prices, the price charged is based on whether the place of service is indicated as a facility in the Place of Service code table.
Cost to Perform	Displays the actual cost of the procedure.
Time to Perform	Displays the time allocated for the procedure.
RVU 1 - 8	Displays the Relative Value Units for this SIM.
UD1 Price/ UD1 Facility Price/ UD2 Price/ UD2 Facility Price	Displays the user-defined facility and non-facility price. These values print on the claim; they do not become the amount of a charge. The column names are defined on the Libraries tab of the Enterprise Preferences window. These columns are added to a claim if one of the user-defined fields is selected in the Payer Master File > Practice > Other > User-defined claims override price.
Unassigned Benefits Price	Displays the non-facility unassigned benefits price, Vague.
Unassigned Benefits Facility Price	Displays the facility unassigned benefits price, Vague,

File Maintenance Help for NextGen® Enterprise 8

SIM Pricing Template Library Field Descriptions

Use the following table as a reference when you add or modify service items. Section Description Search Located on the left side of the dialog box, this section enables you to search for specific SIM. If there are fewer than 50 SIM items defined in the SIM Library, all active SIM items automatically display in the Search list. If there are more than 50 SIM items defined in the SIM Library, the SIM codes do not automatically display. Instead, you must manually enter the SIM code or the first few digits of the code in the Search field. To find a specific SIM, enter the SIM code. To list all existing SIMs, enter an asterisk. Service Item # For a new SIM, enter meaningful Service Item numbers and descriptions to correlate to the appropriate CPT4 code. If you searched for a SIM, this field displays the SIM that you searched for. In addition, you can select the Open menu button, select New, and then enter a new Service Item Number. Hide SIM Select this check box if you want to hide this SIM.

Help Guide for NextGen® Enterprise PM 8

Service Item Library Maintenance Field Descriptions

The following table describe the fields for setting up a Service Item Library. Field Description Search You can search for any specific SIM. If there are less than 50 SIM items defined in the SIM Library, all active SIM items automatically appear in the Search list. If there are more than 50 SIM items defined in the SIM Library, the SIM codes do not appear automatically. You must manually enter the SIM code or the first few digits of the code in the Search field. To find a specific SIM, enter the SIM code. To list all existing SIMs, enter an asterisk. SIM Library Name SIM Library name is a required field. Service Item For a new SIM, you can enter meaningful service item numbers and descriptions to correlate to the appropriate CPT4 code. This field is required. When you search for a SIM, this field displays the SIM that you search for. You can also select the open menu button, select New, and then enter a new service item Number. Hide SIM You can select this check box to hide the SIM. I

Help Guide for NextGen® Enterprise PM 8

Service Item Library Maintenance Field Descriptions

The following table describe the fields for setting up a Service Item Library. Field Description Search You can search for any specific SIM. If there are less than 50 SIM items defined in the SIM Library, all active SIM items automatically appear in the Search list. If there are more than 50 SIM items defined in the SIM Library, the SIM codes do not appear automatically. You must manually enter the SIM code or the first few digits of the code in the Search field. To find a specific SIM, enter the SIM code. To list all existing SIMs, enter an asterisk. SIM Library Name SIM Library name is a required field. Service Item For a new SIM, you can enter meaningful service item numbers and descriptions to correlate to the appropriate CPT4 code. This field is required. When you search for a SIM, this field displays the SIM that you search for. You can also select the open menu button, select New, and then enter a new service item Number. Hide SIM You can select this check box to hide the SIM. I

File Maintenance Help for NextGen® Enterprise 8

Libraries Tab - Enterprise Preferences Descriptions

The following table provides descriptions of the fields located in the Libraries Enterprise Preferences. Field Description Enable Advanced Service Item Library Mode Caution: Once you enable this feature, you cannot disable it. This check box turns on all features that enable you to set prices by configuring locations into payer-centric groupings. For example, Medicare might have different regional groupings than Aetna, and pricing would be determined accordingly. Default Pricing Region Library for Self Pay Select the appropriate SIM Pricing Regions library that defines the pricing when an encounter is self-pay. For more information, go to NextGen Healthcare Success Community and download the latest File Maintenance Libraries Guide for NextGen Enterprise. Default Pricing Region Library Select the appropriate SIM Pricing Regions library that defines the pricing for payers of this enterprise. For more information, go to NextGen Healthcare Success Community and download the latest File Mai

File Maintenance Help for NextGen® Enterprise

Set Up Enterprise Preferences for Payment Libraries

To open the Enterprise Preferences window, do one of the following: From NextGen® Enterprise PM, select Admin > > Preferences > Enterprise. From File Maintenance, select Master Files > System > Enterprises, and from the list, choose an enterprise and then select Preferences. From Preference List, select Libraries. To turn on all features that allow users to set prices by configuring locations into payer-centric groupings, select Enable Advanced Service Item Library Mode. Note: You cannot turn off this feature after you have turned it on. In Default Pricing Region Library for Self Pay, select the appropriate SIM pricing regions library that defines the pricing for self-pay encounters. In Default Pricing Region Library, select the appropriate SIM pricing regions library that defines the pricing for payers in this enterprise. For more information, go to NextGen Healthcare Success Community, and download the latest File Maintenance Libraries Guide for NextGen Enterprise. In User Defined Pr

File Maintenance Help for NextGen® Enterprise 8

General Tab

The Service Items Library > General tab includes general information for each SIM code that affects charge posting, billing, claims and reporting in NextGen® Enterprise PM. The General tab includes the following fields: Field Description Place of Service You can select a default Place of Service. This default displays on the Charge Posting window. Notes: A place of service selected at the SIM level overrides a place of service at the location level. You can select <none> as the place of service if the service can be performed at different kinds of places. However, if you select <none>, the charge does not create. Component Select the component type for this service item: Global (both the technical and professional), Professional (physician supervision and interpretation), or Technical (equipment or technology). The Component field appears only if the SIM fields: Show dept, modality and component check box is selected in the Libraries Practice Preferences. This field is required. Note:

SIM Pricing Template Library Field Descriptions

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