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 |
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| 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.
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| Department | Departments can be assigned to procedures to group revenue or report by category. The Department field appears only if the SIM fields: Show dept, modality and component check box is selected in the Libraries Practice Preferences.
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| Revenue Code | Revenue codes are codes used to bill the UB claims. UB Payer information cannot be entered unless something is entered here. |
| Modality | Modality describes the category of service and is used for reporting purposes. The service is usually physical in nature, for example, the modalities of rehab could be physical therapy, occupational therapy, or speech therapy. The Modality field appears only if the SIM fields: Show dept, modality and component check box is selected in the Libraries Practice Preferences.
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| Form | Select the 1500, ADA, or UB claim form type for the selected SIM. The default is 1500.
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| Alt Procedure Code 1Alt Procedure Code 2 | Enter an alternate code for the SIM when a charge interface is being used by a third party vendor. |
| After Care Days | Enter the number of days (After Care Period) that the patient should not be charged for services related to a specific service item. |
| Exempt patient adjustment code | |
| Eff Date | Enter the date that the price entered begins. This field is required |
| Exp Date | Enter the date that the price for the SIM expires. this field is required |
| Non-Facility PriceFacility Price | Enter 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 | Enter the actual cost of the procedure. |
| Time to Perform | Enter the time allocated for the procedure. |
| RVU 1 - 8 | Enter the Relative Value Units for this SIM.
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| UD1 Non-Facility PriceUD1 Facility PriceUD2 Non-Facility Price UD2 Facility Price | 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 Enterprise Preferences > Libraries tab. These columns are added to a claim if one of the user-defined fields is selected in the Payer master file > . |
| Force to paper | Select this check box to force a paper claim to generate for the service item at the practice level even if the payer is set for electronic transmission. |
| Force patient responsibility | |
| Suppress Patient Procedure | Used for NextGen® Enterprise PM when a charge is created to control whether or not a NextGen® Enterprise EHR patient procedure is also created. Select this check box to NOT create the patient procedure in NextGen® Enterprise EHR. Clear the check box to create a patient procedure in NextGen® Enterprise EHR when a NextGen® Enterprise PM charge is created. |
| Encounter billing exempt | |
| Suppress from Statement | Select this check box to suppress the SIM during statement processing so the SIM does not appear on patient statements. |
| Prevent charge amount overrides | Select this check box to disable the Override field in charge entry. If it is not selected, the field is enabled if the user already has the Charge Price Override security right set to Yes.
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| Send $0 charge on claim | Select this check box if the SIM code has a $0.00 price but still needs to appear on claims for all payers.
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| Enc rate exempt | Select this check box to make the service item exempt from the Encounter Rate. See the Claims Guide for NextGen® Enterprise PM for more information about exempting SIMs from encounter rates. |
| Suppress Billing | Used for NextGen® Enterprise EHR when a patient procedure is created to control whether or not a NextGen® Enterprise PM charge is also created. Select this check box to NOT create a charge in NextGen® Enterprise PM when a patient procedure is created in NextGen® Enterprise EHR. Clear the check box to create a NextGen® Enterprise PM charge when a patient procedure is created.
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| Sliding fee exempt | Select this check box to exclude the service item from Sliding Fee Schedule calculations. |
| Qualifying Encounter | From the drop-down, select one or more of the following for the SIM code, if applicable:
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| SIM Type | From the drop-down, select one of the following for the SIM code, if applicable:
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| Rental Duration per Unit | This field becomes enabled and required when Rental is selected in the SIM Type field. Select one of the following for the Rental SIM code:
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| Anes Base Unit | This field becomes enabled when Anesthesia SIM is selected in the SIM Type field. Enter the number of base units for the SIM code. This defaults to the Base Unit field on the Charge Posting window when the anesthesia SIM is entered as a charge. Base units are used in the calculation of total units for an anesthesia charge. Base Units + Time Units + Modifier Units = Total Anesthesia Units One base unit is equal to the number of minutes entered in the Anesthesia Minutes Per Unit field on the Defaults-2 tab > Rounding Rules sub-tab in the Payers master file. For example, if you enter Anes Base Unit = 3 for the SIM code and Anesthesia Minutes Per Unit = 15 for the payer, then the base units would be equal to 45 minutes. Base unit values are assigned each year by the American Society of Anesthesiologists (ASA). The number represents the minimum number of units that can be billed for a procedure before time units are added. |
| Behavioral Health Base Minutes | This field becomes enabled and required when Behavioral Health is selected in the SIM Type field. Select the number of minutes that equal one unit for the behavioral health SIM code. For example, the total time entered on a charge is 60 minutes. If 15 is selected for base minutes, then total charge units equals 4. If 30 is selected for base minutes, then total charge units equals 2.Select one of the following values, or select Custom to enter a custom value:
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| Custom | This button becomes enabled when Behavioral Health is selected in the SIM Type field. To enter a custom value in the Behavioral Health Base Minutes field, other than the standard 15, 30, 60 and 240 values, do the following:
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