Configure SIM Groups to Display for Location/Payer Configurations

File Maintenance Help for NextGen® Enterprise 8

Add SIM Groups

In File Maintenance, select Libraries, and then select Service Items. The Service Items List window opens. Select the applicable library, right-click and select SIM Groups. The SIM Groups List window opens. To create a new SIM Group, select open menu button , and select New. The SIM Group Maintenance window opens. In SIM Group field, enter a short name of the SIM Group. In the Description field, enter a description of the SIM Group. To add a new SIM, select Open Folder and search for the SIM. To add the item to the group, use the blue Include arrow to move the item to the Available list. To remove a SIM item from the Available list by selecting the SIM item and then the blue Exclude arrow. The indicates the search type. If the icon is listed next to the SIM column, the system will search by SIM number. You can select the Description column, which enables you to search by the service item description. The service item must already exist in the Service Item Library before you can add it

File Maintenance Help for NextGen® Enterprise 8

Modify Existing SIM Groups

In File Maintenance > Libraries select Service Items. The Service Items List window opens. Select the applicable library, right-click and select SIM Groups. The SIM Groups List window opens. Double-click the SIM Group. The SIM Group Maintenance window opens. To modify a SIM or add a new SIM, select Open Folder. The Service Items window opens. Do one of the following: To add a new SIM, search for the SIM. To add the item to the group, use the blue Include arrow to move the item to the Available list. The indicates the search type. If the icon is listed next to the SIM column, the system will search by SIM number. You can select the Description column, which enables you to search by the service item description. The service item must already exist in the Service Item Library before you can add it to the group. To remove a SIM item from the Available list by selecting the SIM item and then the blue Exclude arrow. Select OK to return to the SIM Group Maintenance window. If you want the SIM

File Maintenance Help for NextGen® Enterprise 8

SIM Groups

When multiple procedures are performed for particular types of encounter or appointments, you can set up one Service Item Group (SIM Group) code that includes all the SIM codes and descriptions for all of the procedures. SIM Groups enable you to enter one code during charge posting for multiple procedures and their associated charges. You can create a SIM Group with only one SIM and the single SIM can be added to the group multiple times. You can then be more efficient and error-free as you enter charges for multiple procedures that are typically performed together. For example, if your practice frequently does childhood immunizations, you could set up a SIM Group called "CHIZ", which would include all the CPT4 codes and descriptions for each immunization and the office encounter. Access SIM Groups Add SIM Groups Modify Existing SIM Groups Calculations for SIM Group Charges Configure SIM Groups to Display for Location/Payer Configurations Parent topic: Service Items Library

File Maintenance Help for NextGen® Enterprise 8

Assigning Exceptions for the Provider, Payer, and Location

A provider can have exceptions to how charges are normally paid. To be able to apply these exceptions to a charge, you must assign them to the provider for each service location/payer combination. For each combination, you can assign one contract exception and one SIM exception. You can attach a SIM and a contract exception to the provider at a specific location for all payers or for specific payers. A SIM or contract exception for a specific payer overrides the default exception. To assign exceptions to the provider, payer, and location: From the Master Files - System list, select Providers. Double-click on a provider from the list or highlight the provider and select the Open Menu button. The Modify Provider Information dialog box displays. Select the Practice tab. Under Service Location, select the applicable location. A list of payers displays in the Group Information section. If you want to set the default for all payers, double-click the Default row in the Group Information secti

Help Guide for NextGen® Enterprise PM 8

SIM Groups for Service Items

You can initiate the cost estimation for a patient or person using an appointment, encounter, a person or people lookup, or the taskbar menu. Irrespective of what you use to initiate the process, you can set up a Service Item Group (SIM Group) code that includes all SIM codes and the descriptions for all services. It makes the cost estimation process more efficient and error-free as you enter charges for multiple services that are typically performed together. In File Maintenance, you can configure a SIM Group based on the location or payer. For more information on configuring a SIM Group based on location or payer, go to NextGen Healthcare Success Community, and download the latest File Maintenance Libraries Guide for NextGen® Enterprise. When you enter a SIM Group in the Service Items section on the Estimate Patient Cost window, the SIM Group expands and displays the SIM codes in the SIM Group. A SIM Group displays the SIM codes on the Estimate Patient Cost window based on the follow

NextGen® Enterprise EHR Help

Assign Default SIM Pricing Region Libraries to Payers

If Advanced Service Item Mode is enabled and SIM Pricing Region libraries are defined, you can assign the libraries to payers. Select File Maintenance > System > Payers. Double-click a payer. The Modify Payer Information window opens. Under Payer-Defaults-1 tab, in the Pricing Regions Library field, select a SIM Pricing Region Library. Select OK. Parent topic: SIMs Groups in the Orders Tests Master File

Configure SIM Groups to Display for Location/Payer Configurations

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Add SIM Groups

Modify Existing SIM Groups

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SIM Groups for Service Items

Assign Default SIM Pricing Region Libraries to Payers

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Modify Existing SIM Groups

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Assigning Exceptions for the Provider, Payer, and Location

SIM Groups for Service Items

Assign Default SIM Pricing Region Libraries to Payers