Service Package Library

File Maintenance Help for NextGen® Enterprise 8

Deleting Service Packages

A Service Package library includes one or more Service Package Configurations, a service package configuration includes one or more Service Unit Details, and a service unit detail includes one or more CPT4/Modifier combinations. If needed, you can do any of the following: Delete a Service Package Configuration from a Service Package Library Delete a Service Unit Detail from a Service Package Configuration Delete a CPT4/Modifier Combination from a Service Unit Detail Delete a Service Package Configuration from a Service Package Library Delete a Service Unit Detail from a Service Package Configuration Delete a CPT4/Modifier Combination from a Service Unit Detail Parent topic: Service Package Library

File Maintenance Help for NextGen® Enterprise 8

Add or Modify a Service Package Library

Open File Maintenance. Select Libraries, and then Service Package. The Service Package List window opens. Do one of the following: To create a library, select open menu button and select New. The Add Service Package window opens. To modify a library, select it from the list and then select open menu button and select Open. The Service Package Maintenance window opens. In the Description field, enter a name for the library. This field is required. Set up Service Package Configurations as needed. To save changes and close the window, select OK. Set Up Service Package Configurations Copy a Service Package Configuration Service Package Conflicts and Messages Parent topic: Service Package Library

Help Guide for NextGen® Enterprise PM 8

Service Package Library

The Service Package library enables you to define the various sets of packaged services that payers may authorize for patients. Each service package includes groupings of specific CPT4 code and modifier combinations with defined service unit limitations. A single library can be created and used by the practice. The library may include multiple service package configurations, each with different CPT4 and modifiers, service unit limits and service duration limits. A service package configuration is then linked to a patient's insurance in NextGen® Enterprise PM. Note: This is a practice-level library only. A library cannot be linked to specific payers in the Payers master file. You can generate the following report from the Service Package library : Service Package Library Listing Service Package Configuration Service Package Configuration Details For more information, go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM. Add or

Help Guide for NextGen® Enterprise PM 8

Service Packages in NextGen® Enterprise PM

Practices may provide services to their patients or clients based on the various service packages authorized by payers. Each service package includes groupings of specific CPT4 code and modifier combinations with defined service unit limitations. A patient's authorized package services may be used within a specific time frame determined by the payer. For example, in a Behavioral Health practice, a payer may authorize a patient for a package that includes the following services: Addiction counseling not to exceed 40 hours within 90 days; Individual therapy not to exceed 50 units within 180 days; Group therapy not to exceed 60 units within 180 days; Medication management not to exceed 70 hours within 180 days. The service package functionality in NextGen® Enterprise PM enables you to do the following: Set up service packages with service unit and duration limitations. Enter service unit authorizations for payers that authorize packaged services for patients. Generate reports for patients

Help Guide for NextGen® Enterprise PM 8

Service Unit Authorizations

A payer can provide an authorization for the patient to have a specific service package with unit limitations, and those packaged services may be rendered within a date range defined by the payer. This type of authorization is entered in NextGen® Enterprise PM as a service unit authorization. From the Service Unit Limitation Maintenance window, you can enter a service unit authorization with the following information: Free-text description Authorization code (required) Start and stop dates (required) Assessment date Package (required) Add-on packages Additional free-text notes Note: Service Unit Authorizations are available only if a Service Package Library is selected in Practice Preferences > Libraries. For more information on Service Packages and Service Unit Authorizations, NextGen® Enterprise EHR, go to the NextGen Healthcare Success Community and download the Behavioral Health Billing User Guide forNextGen® Enterprise PM. Parent topic: About the Authorizations Tab in Insurance Ma

Help Guide for NextGen® Enterprise PM 8

Service Unit Authorizations

When a payer authorizes a service package with unit limitations for a patient, and those packaged services may be rendered within a date range defined by the payer, you can enter the authorization in NextGen® Enterprise PM as a Service Unit Authorization. Note: Service Unit Authorizations are available only if a Service Package Library is selected in Practice Preferences > Libraries. For more information on Encounter Mode and Units Mode authorizations, refer to the Encounter Maintenance User Guide for NextGen® Enterprise PM. Access Authorizations for a Patient's Insurance Add or Modify Service Unit Authorization You can add or modify a service unit authorization. Delete a Service Unit Authorization Parent topic: Working with Service Packages in NextGen Enterprise PM

Service Package Library

Recommendations

Deleting Service Packages

Add or Modify a Service Package Library

Service Package Library

Service Packages in NextGen® Enterprise PM

Service Unit Authorizations

Service Unit Authorizations