CSC Library with Timespan Details Report

Column	Description	Data Populates From
Lib Name	Library Name	Consolidated Services Claim Library Name field
Description	Consolidated Services Claim Rules	Consolidated Services Claim Maintenance window > Description field
Timespan	Length of Timespan	Consolidated Services Claim Maintenance window > Claim Consolidation Rules tab > CSC Timespan Rules window > Length of Timespan field
CSC TS Desc	CSC Timespan Description	Consolidated Services Claim Maintenance window > Claim Consolidation Rules tab > CSC Timespan Rules window > Description field
Hide	Delete Indicator	Consolidated Services Claim Maintenance window > Claim Consolidation Rules tab > CSC Timespan Rules window > Hide Timespan Rules check box Displays Y or N
Payers	Valid Payers	Consolidated Services Claim Maintenance window > Valid Payers section
Enc Rate SIM	Enc Rate SIMs for Consolidation	Consolidated Services Claim Maintenance window > Claim Consolidation Rules tab > CSC Timespan Rules window > Select Encounter Rate for Consolidation section
CSC Form Type	Consolidated Claim Form Type	Consolidated Services Claim Maintenance window > Claim Consolidation Rules tab > CSC Timespan Rules window > Consolidate Claim Form Type field
Consolidate ER Claim only	Consolidate Encounter Rate Claim only	Consolidated Services Claim Maintenance window > Claim Consolidation Rules tab > CSC Timespan Rules window > Consolidate Encounter Rate Claims only field Displays Y or N
Consolidate with Same ER SIM	Consolidate Claims with Same Encounter Rate SIM	Consolidated Services Claim Maintenance window > Claim Consolidation Rules tab > CSC Timespan Rules window > Consolidate only claims with the same Encounter Rate SIM field Displays Y or N
ER Rollup Ind	Enc Rate Rollup Indicator	Consolidated Services Claim Maintenance window > Claim Consolidation Rules tab > CSC Timespan Rules window > Rollup Encounter Rate Service Line field Displays Y or N
ER Quan	Enc Rate Quantity	Consolidated Services Claim Maintenance window > Claim Consolidation Rules tab > CSC Timespan Rules window > Encounter Rate SIM Quantity field
ER Amt	Enc Rate Charge Amount	Consolidated Services Claim Maintenance window > Claim Consolidation Rules tab > CSC Timespan Rules window > Encounter Rate Service Line Amount field
ER Date From	Enc Rate Line Date From	Consolidated Services Claim Maintenance window > Claim Consolidation Rules tab > CSC Timespan Rules window > From Date field
ER Date To	Enc Rate Line Date To	Consolidated Services Claim Maintenance window > Claim Consolidation Rules tab > CSC Timespan Rules window > To Date field

File Maintenance Help for NextGen® Enterprise 8

Consolidated Services Claim Library Listing Reports

The Consolidated Services Claim Library Listing report includes information from the Consolidated Services Claim library in File Maintenance. Information on the report pulls from the Consolidated Services Claim Maintenance window. The report includes the following information: Column Description Data Populates From Lib Name Library Name Consolidated Services Claim Library Name field Description Consolidated Services Claim Rules Consolidated Services Claim Maintenance window > Description field Eff Dt Effective Date Consolidated Services Claim Maintenance window > Effective Date field Exp Dt Expiration Date Consolidated Services Claim Maintenance window > Expiration Date field Encounter with Greatest Dollar Value Select Responsible Attending with greatest dollar value across same-timespan encounters Displays Y or N Consolidated Services Claim Maintenance window > Claim Header Rules tab > Select Responsible Attending from Encounter with greatest dollar value when two providers of the sam

Help Guide for NextGen® Enterprise PM 8

Set Up Rules for Consolidation of Case Claims

To set up rules for consolidation of claim on a case basis, you can choose the claim form type, rollup encounter rate service lines, and identify dates of services for encounters. In File Maintenance, select Libraries > Consolidated Services Claim and then double-click the applicable library. The Consolidated Services Claim Library window opens. Select open menu , and then select New or Open. The Consolidated Services Claim Maintenance window opens. To access the Payers window, select the Valid Payer folder icon, and then select the valid payers for case consolidation of claims. To access the CSC Timespan Rules window, on the Claim Consolidation Rules tab, Select open menu . In the Length of Timespan field, select Consolidate Case Claims. In the Description field, enter a description for the consolidation of case claims. Use the following table as a reference to add or modify case claim consolidation rules: Note: The claim consolidation rules are applied to all payers in the Valid Paye

Help Guide for NextGen® Enterprise PM 8

Add Claim Consolidation Rules to a CSC Library

To enable claims consolidation, you must select the form types that you want to consolidate. Then you can choose to consolidate only encounter rate claims and/or claims with the same encounter rate SIM. These rules will apply to all of the payers in the Valid Payers list. Access the Consolidated Services Claim Maintenance window for the applicable library. Note: To access a CSC library, refer to the Accessing a Consolidated Services Claim Library procedure. After opening the Consolidated Services Claim Maintenance window, select a valid payer for the claim, then Claim Consolidation Rules. From the Claims Consolidation Rules tab, select a Claim Consolidation Rules row (CCR row) and open by doing one of the following: Right-click the library and select Open. Select the open menu button and select Open. The CSC Timespan Rules window opens for the library you selected. Complete the timespan rules. Note: When creating a new library, the Claim Consolidation Rules row (CCR row) is not require

File Maintenance Help for NextGen® Enterprise 8

Add Claim Consolidation Rules to a CSC Library

To enable claims consolidation, you must select the form types that you want to consolidate. Then you can choose to consolidate only encounter rate claims and/or claims with the same encounter rate SIM. These rules will apply to all of the payers in the Valid Payers list. Access the Consolidated Services Claim Maintenance window for the applicable library. Note: To access a CSC library, refer to the Accessing a Consolidated Services Claim Library procedure. After opening the Consolidated Services Claim Maintenance window, select a valid payer for the claim, then Claim Consolidation Rules. From the Claims Consolidation Rules tab, select a Claim Consolidation Rules row (CCR row) and open by doing one of the following: Right-click the library and select Open. Select the open menu button and select Open. The CSC Timespan Rules window opens for the library you selected. Complete the timespan rules. Note: When creating a new library, the Claim Consolidation Rules row (CCR row) is not require

Help Guide for NextGen® Enterprise PM 8

Set Up for Eligible Number of Patient Days Billing

Access File Maintenance. Select Libraries, and then Consolidated Services Claim library. The Consolidated Services Claim List window opens. Double-click to open the desired library. The Consolidated Services Claim Library Maintenance window opens. Select the open menu button . The Consolidated Services Claim Maintenance window opens. Complete the following fields: Effective Date Expiration Date Description Add the Valid Payers Select the Claim Consolidation Rules tab and then select the open menu button and select New. The CSC Timespan Rules window opens. Complete the following fields: In the Length of Timespan field, select Consolidate Monthly Claims. In the Description field, enter a description for this type of billing. In the Rollup Encounter Rate Service Line field, select Yes. In the Encounter Rate SIM Quantity field, select Number of Eligible Days. In the Encounter Rate Service Line Amount field, select Eligible Patient Days times Original Charge Amount. Select OK. Parent topic:

File Maintenance Help for NextGen® Enterprise 8

Set Up for Eligible Number of Patient Days Billing

Access File Maintenance. Select Libraries, and then Consolidated Services Claim library. The Consolidated Services Claim List window opens. Double-click to open the desired library. The Consolidated Services Claim Library Maintenance window opens. Select the open menu button . The Consolidated Services Claim Maintenance window opens. Complete the following fields: Effective Date Expiration Date Description Add the Valid Payers Select the Claim Consolidation Rules tab and then select the open menu button and select New. The CSC Timespan Rules window opens. Complete the following fields: In the Length of Timespan field, select Consolidate Monthly Claims. In the Description field, enter a description for this type of billing. In the Rollup Encounter Rate Service Line field, select Yes. In the Encounter Rate SIM Quantity field, select Number of Eligible Days. In the Encounter Rate Service Line Amount field, select Eligible Patient Days times Original Charge Amount. Select OK. Parent topic:

CSC Library with Timespan Details Report

Recommendations

Consolidated Services Claim Library Listing Reports

Set Up Rules for Consolidation of Case Claims

Add Claim Consolidation Rules to a CSC Library

Add Claim Consolidation Rules to a CSC Library

Set Up for Eligible Number of Patient Days Billing

Set Up for Eligible Number of Patient Days Billing

Consolidated Services Claim Library Listing Reports

Set Up Rules for Consolidation of Case Claims

Add Claim Consolidation Rules to a CSC Library

Add Claim Consolidation Rules to a CSC Library

Set Up for Eligible Number of Patient Days Billing

Set Up for Eligible Number of Patient Days Billing