Provider Credentials with Overlapping Dates

File Maintenance Help for NextGen® Enterprise 8

Delete Provider Credentials

When Enable Provider Credential Billing is not enabled in Enterprise Preferences > General, a provider's credentials can be deleted, if needed. Access the Modify Provider Information window for a provider. Select the Credentialing tab. Credentials for the provider are listed on the tab. To delete a credential, select the item from the list and then select Open Menu and select Delete. The following prompt displays: Do you want to Delete the record? To delete the credential, select Yes. The credential is deleted and removed from the list. Parent topic: Providers Credentialing Tab

File Maintenance Help for NextGen® Enterprise 8

Add or Modify Provider Credentials

Access the Modify Provider Information window for a provider. Select the Credentialing tab. The appearance of the tab is based on the setting for the Enable Provider Credential Billing option in Enterprise Preferences > General. If the option is enabled, you cannot delete credentials because they are used for billing purposes, but you can hide them if needed. From the Open Menu button, a Hide or Un-Hide option is available, a Hide Provider Credential check box is available, an Include Hidden Items check box is available, and the Hide icon displays for hidden credentials. In addition, a Primary Credentials section is available at the bottom of the tab. For more information, see Primary Credentials. If the option is not enabled, you can delete credentials if needed because they are not used for billing purposes. From the Open Menu button, a Delete option is available, the Hide Provider Credential and Include Hidden Items check boxes are not available, and the Hide icon does not display.

File Maintenance Help for NextGen® Enterprise 8

Hide Provider Credentials

When Enable Provider Credential Billing is enabled in Enterprise Preferences > General, a provider's credentials can be hidden if needed, but not deleted. Access the Modify Provider Information window for a provider. Select the Credentialing tab. Credentials for the provider are listed in the top section of the tab. To hide a credential, do one of the following: Select the credential from the list, and then select the Hide Provider Credential check box. Select the credential from the list, and then select Open Menu and select Hide. The following prompt displays: Confirm hide of [Credential Name]? To hide the credential, select Yes. The credential is hidden and removed from the list. To display hidden credentials, select the Include Hidden Items check box. Hidden credentials display with the Hide icon. Parent topic: Providers Credentialing Tab

Help Guide for NextGen® Enterprise PM 8

Provider Credentials with Overlapping Dates

When Enable Provider Credential Billing is not enabled in Enterprise Preferences > General, a provider can have multiple entries for the same credential type with overlapping dates. For example: Dr. Smith obtained a State License on 11/01/2016. The license is effective from 11/01/2016 - 12/31/2017. Dr. Smith renewed the State License on 10/15/2017. The renewed license is effective from 11/01/2017 - 12/31/2018. In the above example, two entries can be made on the Modify Provider Information > Credentialing tab for State License, even though the effective date for the renewed license falls within the date range on the original license. When Enable Provider Credential Billing is enabled in Enterprise Preferences > General, a provider cannot have multiple entries for the same credential type with overlapping dates. Using the same example above, the following prompt displays when a second entry is made on the Modify Provider Information > Credentialing tab for State License with an effectiv

File Maintenance Help for NextGen® Enterprise 8

Providers Credentialing Tab

The Credentialing tab in the Providers master files enables you to track the various credentials obtained by each provider, such as degrees, licenses and certifications. You can enter credentials for each provider and use them for informational purposes only. If the Enable Provider Credential Billing option is enabled in Enterprise Preferences > General, you can also use them in the configuration of the Non-Coordinated SIM and Claim Modifiers libraries for billing purposes in NextGen® Enterprise PM. Add or Modify Provider Credentials Provider Credentials with Overlapping Dates Delete Provider Credentials Hide Provider Credentials Primary Credentials Parent topic: Providers Master File

File Maintenance Help for NextGen® Enterprise 8

Primary Credential Conflicts and Messages

You can enter multiple Primary Credentials for a provider on the Credentialing tab. However, there can only be one primary credential in effect at a time. When you enter a primary credential with an effective or expiration date that overlaps with another, the following prompt displays: Effective/Expiration dates overlap with another Primary Credential. A provider's Primary Credential, in combination with another credential, can be used in the configuration of the Claim Modifiers Library to add a charge-level modifier to claims during the billing process in NextGen® Enterprise PM. The Claim Modifiers Library adds the modifier only if the primary credential is defined in both the Credentialing and Primary Credentials sections of the Credentialing tab. When you enter a primary credential for a provider that is not listed as one of their credentials, the following prompt displays: The Credential does not exist in the Credentialing table above. The Claim Modifier Library will not apply a Pr

Provider Credentials with Overlapping Dates

Recommendations

Delete Provider Credentials

Add or Modify Provider Credentials

Hide Provider Credentials

Provider Credentials with Overlapping Dates

Providers Credentialing Tab

Primary Credential Conflicts and Messages

Delete Provider Credentials

Add or Modify Provider Credentials

Hide Provider Credentials

Provider Credentials with Overlapping Dates

Providers Credentialing Tab

Primary Credential Conflicts and Messages