Contract Subgrouping

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

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. Parent topic: Setup an Exception Through the Contract Library

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

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

Setup an Exception Through the Contract Library

Use the Contract Library to create a new Contract Exception or to add or modify an exception through an existing Contract Exception Name. Setting Up a New Contract Exception Add an Exception to an Existing Contract Exception Group Modify Existing Contract Exceptions Setting Up More Than One Exception per CPT4 Code Charges and Contracts Globally Update Pricing in a Contract Library Contract Subgrouping Define Contract Subgrouping Categories Rename the Subgrouping Field Labels Assign Subgroupings to a Contract Attach Contract Subgroupings to a Provider Parent topic: Contracts Library

File Maintenance Help for NextGen® Enterprise 8

Contracts Library

Contracts can be set up for payers to indicate: The amount you expect to be reimbursed for procedures. When an authorization is required. When a referral is required. Other contract specific items, for example, the ability to send $0.00 claims such as capitated with contracts, you can: Attach payers to the contract. Create contract subgroupings for reporting purposes. For more information on contract subgrouping, go to NextGen Healthcare Success Community and download the latest File Maintenance Libraries Guide for NextGen® Enterprise, and refer to the Contract Subgrouping section. Access Contract Library Maintenance Setup an Exception Through the Contract Library

Contract Subgrouping

Recommendations

Attach Contract Subgroupings to a Provider

Assign Subgroupings to a Contract

Define Contract Subgrouping Categories

Rename the Subgrouping Field Labels

Setup an Exception Through the Contract Library

Contracts Library

Attach Contract Subgroupings to a Provider

Assign Subgroupings to a Contract

Define Contract Subgrouping Categories

Rename the Subgrouping Field Labels

Setup an Exception Through the Contract Library

Contracts Library