Libraries Tab - Enterprise Preferences Descriptions

Field	Description
Enable Advanced Service Item Library Mode	Caution: Once you enable this feature, you cannot disable it. This check box turns on all features that enable you to set prices by configuring locations into payer-centric groupings. For example, Medicare might have different regional groupings than Aetna, and pricing would be determined accordingly.
Default Pricing Region Library for Self Pay	Select the appropriate SIM Pricing Regions library that defines the pricing when an encounter is self-pay. For more information, go to NextGen Healthcare Success Community and download the latest File Maintenance Libraries Guide for NextGen Enterprise.
Default Pricing Region Library	Select the appropriate SIM Pricing Regions library that defines the pricing for payers of this enterprise. For more information, go to NextGen Healthcare Success Community and download the latest File Maintenance Libraries Guide for NextGen Enterprise.
User Defined Price Description 1 and User Defined Price Description 2	Enter a pricing label to use for customized facility and non-facility labels throughout the system. Each name creates two column labels, facility and non-facility, in the Service Item and SIM Pricing Template libraries. The pricing labels you enter, display on: The NextGen® Enterprise PMCharge Posting window. The File Maintenance > Master Files > Practice > Other tab in the User-defined claims override price field drop-down box. The File Maintenance > Libraries > Sim Pricing Template > SIM Pricing Template List on SIM Pricing Template window. The File Maintenance > Libraries > Sim Pricing Template > Service Items List on Service Item Library Maintenance window.
Require Effective Location in Pricing Region	When you select this check box, it requires an effective location in the pricing region when a user enters a charge or procedure while Advanced Service Item mode is enabled. If the pricing region associated with the payer does not have an effective location, a message displays that a location is not selected in the pricing region. The user will not be able to continue with the charge or procedure entry. The message displays in charge entry in NextGen® Enterprise PM, NextGen® Enterprise EHR procedures module, NextGen® Enterprise templates that use a procedure trigger, and NextGen® Adaptive Content Engine templates that use a NextGen® Enterprise EHR procedure trigger. Alerts will not display in the NextGen® Enterprise Orders module. Note: If Advanced Service Item Mode is not enabled and the pricing region used does not have a location, the default SIM library selected in the Practice Preferences is used.
Use Default Library If SIM Not Found In Derived	Select this check box when an active SIM is not found in an initial search of the derived library. The Advanced Service Item mode allows a search of the practice default SIM library. The application will allow users to continue with the charge entry process.
Charge Entry Message	When you select Use Default Library If SIM Not Found In Derived check box, you can create an alert message that displays when a SIM is not found in the derived Service Items library. The message displays in NextGen® Enterprise PM during charge entry, NextGen® Enterprise EHR in procedures module, NextGen® Enterprise EHR templates that use a procedure trigger, and in NextGen® Adaptive Content Engine templates that use a NextGen® Enterprise EHR procedure trigger. The alert is not viewable in the NextGen® Enterprise Orders Module.

File Maintenance Help for NextGen® Enterprise 8

Preventing Use of Default SIM Library to Determine Charges

When your practice uses Advanced Service Item Library Mode, you will require an effective location to be selected in the pricing regions before the application can determine which Service Items library to use. When Default Pricing Region Library for Self Pay and Default Pricing Region Library are defined in the Enterprise Preferences, but no effective location exists, then when a user enters a procedure, the Service Item library selected in the Libraries Practice Preferences is used, by default. You can prevent the practice-level Service Item library from being used by selecting Require Effective Location in Pricing Region check box in the Enterprise Preferences Libraries tab. Requiring an effective location provides more control over which payer a user can attach to a charge or procedure. For example, users will be unable to select a payer that is not affiliated with a location. When a user enters a procedure, a message displays that a location is not selected in the pricing region. T

File Maintenance Help for NextGen® Enterprise 8

Advanced Service Item Library Mode

When you need to maintain pricing for several locations that are grouped into different regions, the Enable Advanced Service Item Library Mode allows you to set pricing based on how various payers divide the country into geographical regions. For example, Medicare has different regional groupings than Aetna, and pricing would be determined accordingly. With Enable Advanced Service Item Library Mode, you can also use SIM Pricing Templates to manage prices in the Service Item libraries. Note: Once you enable Advanced Service Item Library Mode, you cannot disable it. You can create a SIM Pricing Regions Library to support setting prices based on geographical regions that may vary by payer. For more information on SIM Pricing Regions Library see, File Maintenance Libraries Guide for NextGen® Enterprise. You can assign default pricing regions for the enterprise and payers by setting up additional pricing in the Service Items library for claim printing. You can assign permissions in the Syst

NextGen® Enterprise EHR Help

Using Advanced Service Item Library Mode

The Advanced Service Item Library Mode feature provides the ability to set pricing for tests and services based on how various payers divide the country into geographical regions. If you need to set up test pricing for your practice that is based on regions, the Advanced Service Item Library Mode is the way to accomplish this. You can set prices by configuring locations into payer centric groupings. As an example, Medicare may have different regional groupings than Aetna, and pricing is determined accordingly. In addition, the concept of SIM Pricing Templates was introduced to support the management of prices using parent/child relationships between libraries.If you do not need to set up payment based on pricing regions, do not use this parameter. Advanced Service Item Library Mode implementation in the Orders module uses File Maintenance, master files and libraries to assign a SIM code to a lab order test specimen charge. It does not allow you to assign the library at the same time be

File Maintenance Help for NextGen® Enterprise 8

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 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. Note:

File Maintenance Help for NextGen® Enterprise 8

SIM Pricing Regions Library

The SIM Pricing Regions library enables you to set prices based on geographical regions that vary by payer. The library contains a group of pricing regions, the Service Item library for each pricing region, and the specific locations that belong to each pricing region. After you set up the library, you can attach it to: A payer in the Payers master file > Payer Defaults - 1 tab > Pricing Regions Library field. Enterprise Preferences > Libraries tab > Default Pricing Region Library field. Enterprise Preferences > Libraries tab > Pricing Region Library for Self Pay field NextGen® Enterprise PM determines the SIM library to use based on the following conditions: If the encounter has a payer, then it uses the SIM Pricing Regions Library specified in the Payer master file. If the encounter has a payer with no pricing region selected (the Pricing Regions Library field in the Payer master file > Payer Defaults-1 tab is blank), then it uses the library specified in the Enterprise Preferences >

File Maintenance Help for NextGen® Enterprise 8

Setting Up General Default Information for Enterprises

The following table describes the fields on the General tab in Enterprise Preferences: Field Description Provider Subgrouping 1 and Provider Subgrouping 2 These user-defined fields are used as labels for reports at the enterprise or provider level. These labels appear as field names on the System tab on the Add/Modify Provider Information window.The tab labels appear for various report filters , and as column headings on reports. For more information, go to the NextGen Healthcare Success Community and download the Reports User Guide for NextGen® Enterprise PM. Reason Code Subgrouping 1 and Reason Code Subgrouping 2 You can enter the labels that you want to use in report filters and report columns. These labels appear as field names, on the Reason Code Library Maintenance window.The tab labels appear for various report filters , and as column headings on reports. Location Subgrouping 1 and Location Subgrouping 2 You can enter the labels you want to use in report filters and report colum

Libraries Tab - Enterprise Preferences Descriptions

Recommendations

Preventing Use of Default SIM Library to Determine Charges

Advanced Service Item Library Mode

Using Advanced Service Item Library Mode

General Tab

SIM Pricing Regions Library

Setting Up General Default Information for Enterprises

Preventing Use of Default SIM Library to Determine Charges

Advanced Service Item Library Mode

Using Advanced Service Item Library Mode

General Tab

SIM Pricing Regions Library

Setting Up General Default Information for Enterprises