Assign Subgroupings to a Contract
By assigning subgroupings to a contract, you indicate the type of contract that it is.
Note:
You can create additional contract types in the Contract Subgrouping master list.
Open a contract in the
Contract Library Maintenance
window.
On the
General
tab, select the contract types in the
Contract Subgrouping
fields, and then select
OK
.
Note:
The field labels you see might be named differently.
You can remove the subgroupings by selecting
<none>
in the
Contract Subgrouping
fields and select
OK
.
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File Maintenance Help for NextGen® Enterprise 8
Attach Contract Subgroupings to a Provider
Contract subgroupings that are attached to a provider indicate which contracts the provider participates in because the subgroupings are assigned to the contracts. After you attach the subgroupings, the payers associated with the contracts are updated. Open a provider master file and then select the Practice tab. In the Contract Subgrouping field, select the contract categories to associate with the provider. Note: The Contract Subgrouping field label you see might be named differently. This provider becomes a participating provider for the payer. You can see these providers in the Payer master file. If you open a payer and select the contract on the Payer master file > Libraries tab, these participating providers are automatically selected in the Participating Providers field. Likewise, if you clear a Contract Subgrouping check box, then the providers name is removed from the Payer master file > Libraries tab > Participating Providers field. Parent topic: Setup an Exception Through th
File Maintenance Help for NextGen® Enterprise 8
Define Contract Subgrouping Categories
Contract subgrouping categories represent different types of contracts, such as Capitated, Government, Non-government, and Medicare. For example, you could create a subgrouping named Medicare for all the Medicare contracts that are set up in your contract library. After you create the subgrouping categories, they display as selections in the Provider master file and the Contract library (on the Practice tab of the Add/Modify Provider Information window and on the General tab of Contract Library Maintenance window) where you can attach the contracts to providers and contract libraries. On the File Maintenance desktop, select Master Lists. The Master Lists List window opens. Select Contract Subgrouping. Do one of the following: To add a new item, select open menu button , and then select New. To modify an existing item, select the item in list, select open menu button , and then select Open. You can also double-click to open the item. The Add/Modify Contract Subgrouping Information windo
File Maintenance Help for NextGen® Enterprise 8
Contract Subgrouping
You can use contract subgrouping to categorize contracts into groups for reporting purposes. In addition, you can assign all participating providers of a subgroup at one time when you attach a contract to a payer. The steps to using the contract subgroupings are: Define contract subgrouping categories in the Contract Subgrouping master list. Rename the subgrouping fields in Enterprise Preferences. Assign subgroupings to a contract (by using categories from step 1). Specify the contracts that a provider participates in (by using categories from step 1). These participating providers are automatically selected for a payer when the contract is attached to the payer in the Payer master file. Parent topic: Setup an Exception Through the Contract Library
File Maintenance Help for NextGen® Enterprise 8
Setting Up a New Contract Exception
In File Maintenance, select Libraries > Contract. The Contract List window opens. Select a library and select open menu button or right-click the selected library, and then select Contract Exceptions. The Contract Exceptions List window opens. Select the open menu button , or right-click in the Description area of the window, and then select New. The Contract Exception Maintenance window opens. In the Contract Exception Name field, enter a name for the Contract Exception that describes the group of exceptions. Note: If you do not want this exception to display in the Contract Exceptions List window, select the Hide Exception option. To use this contract as the base contract, select the Use as Base Contract check box (instead of being used as an exception to the contract). Enter the Filter Criteria to control which CPT4 items display in the CPT4 list and the contract exception information. You can move from field to field by pressing the TAB key. Enter the contract exception information
File Maintenance Help for NextGen® Enterprise 8
Rename the Subgrouping Field Labels
You can change the labels of the Contract, Location, Payer, and Provider subgrouping fields that display throughout File Maintenance. All the fields are used in reporting. If you do not rename the fields, they display with the original field names (for example, Payer Subgrouping 1). Open Enterprise Preferences General tab. Locate the subgrouping fields that you want to rename and enter the new name in the field. Provider Subgrouping 1 & 2 – These labels display as field names on the System tab of the Add/Modify Provider Information window, on the tab labels for the report filter for various reports, and as column headings on reports. Location Subgrouping 1 & 2 – These labels display as field names on the Location Defaults tab of the Location Information window. Enter the labels you want to use in the report filter and as column headings on reports. Payer Subgrouping 1 & 2 – These labels display as the field names on the Defaults - 2 tab of the Add/Modify Payer Information window, the t
File Maintenance Help for NextGen® Enterprise 8
Add an Exception to an Existing Contract Exception Group
In File Maintenance, select Libraries and then Contract. In the Contracts List window, right-click on your library selection, and then select Contract Exceptions. Double-click on the Contract Exception name. The Contract Exception Maintenance window opens. To enter an exception for a contract, do one of the following: If your library has fewer than 50 CPT4 items, press the Tab key or arrow keys on your keyboard to move to the next CPT4 item. If your library has 50 or more CPT4 items, go back to the Type the first number(s) of the CPT4 item you want to locate field and enter the first few numbers of the next CPT4 item to enter an exception for. The CPT4 item displays in the spreadsheet area of the window. Continue this process until you enter all of exceptions and then select OK. Parent topic: Setup an Exception Through the Contract Library
