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Set Default SIM Exceptions for Self-Pay Patients at Location Level
Select
Master Files
>
System
>
Locations
.
The
Locations List
window opens.
Open the appropriate location.
The
Location Information
window opens the
Location Defaults-1
tab.
In
Patient SIM Exception
, select the SIM exception to set as the default when patients are designated as self-pay.
Select
OK
.
Set Default SIM Exceptions for Self-Pay Patients at Location Level
File Maintenance Help for NextGen® Enterprise 8
Set Default SIM Exceptions for Self-Pay Patients at Practice Level
You can set a default SIM exception at the practice and location levels to use for self-pay encounters when patients have no insurance. Open Practice Preferences, then select the Libraries Preferences. In Private Pay SIM Exception, select the SIM exception to set as the default when patients are designated as self-pay. Select OK. Parent topic: Setting Up an Exception through the SIM Library
File Maintenance Help for NextGen® Enterprise 8
Set Up a New SIM Exception
In File Maintenance, select Libraries menu > Service Items. The Service Item Libraries window opens. Select a Service Item Library. Select Open Menu. Select SIM Exceptions from the shortcut menu. The SIM Exceptions List window opens. Select open menu button , and then select New. The SIM Exception Maintenance window opens. Complete the window by entering the exception information. For descriptions of the fields, see SIM Exception Setup Field Descriptions. Note: The SIM Exception fields in which you enter the exceptions are located in the spreadsheet section of the dialog box. Use the TAB key or arrow keys to move the insertion point to the applicable cell for your entry. Right-click on a cell to display the shortcut menu, then you can delete an entry by the cell or row. If your library has fewer than 50 SIM items, press the TAB key or arrow keys to move to the next SIM item that you want to enter an exception for. If your library has 50 or more SIM items, go back to the Type the first
File Maintenance Help for NextGen® Enterprise 8
Setting Up an Exception through the SIM Library
In the SIM library, you can create a new SIM exception or modify existing ones. Note: You must set up all SIM Exceptions, Groups, and SIM Exception Groups before you attach them to a provider. For information on attaching the appropriate SIM to a provider, see the section Assigning Exceptions for the Provider, Payer, and Location in the File Maintenance Master Files Guide for NextGen® Enterprise. Set Up a New SIM Exception Modify Existing SIM Exceptions Setting Up More Than One Exception per SIM Set Default SIM Exceptions for Self-Pay Patients at Practice Level Set Default SIM Exceptions for Self-Pay Patients at Location Level Parent topic: SIM Exceptions
File Maintenance Help for NextGen® Enterprise 8
Assigning Exceptions for the Provider, Payer, and Location
A provider can have exceptions to how charges are normally paid. To be able to apply these exceptions to a charge, you must assign them to the provider for each service location/payer combination. For each combination, you can assign one contract exception and one SIM exception. You can attach a SIM and a contract exception to the provider at a specific location for all payers or for specific payers. A SIM or contract exception for a specific payer overrides the default exception. To assign exceptions to the provider, payer, and location: From the Master Files - System list, select Providers. Double-click on a provider from the list or highlight the provider and select the Open Menu button. The Modify Provider Information dialog box displays. Select the Practice tab. Under Service Location, select the applicable location. A list of payers displays in the Group Information section. If you want to set the default for all payers, double-click the Default row in the Group Information secti
File Maintenance Help for NextGen® Enterprise
Assigning Exceptions for the Provider, Payer, and Location
A provider can have exceptions to how charges are normally paid. To be able to apply these exceptions to a charge, you must assign them to the provider for each service location/payer combination. For each combination, you can assign one contract exception and one SIM exception. You can attach a SIM and a contract exception to the provider at a specific location for all payers or for specific payers. A SIM or contract exception for a specific payer overrides the default exception. To assign exceptions to the provider, payer, and location: From the Master Files - System list, select Providers. Double-click on a provider from the list or highlight the provider and select the Open Menu button. The Modify Provider Information dialog box displays. Select the Practice tab. Under Service Location, select the applicable location. A list of payers displays in the Group Information section. If you want to set the default for all payers, double-click the Default row in the Group Information secti
File Maintenance Help for NextGen® Enterprise 8
Select a Default SIM Pricing Region Library for an Enterprise
The system uses a pricing region associated with the enterprise only when there is no pricing region associated with the payer or if the encounter is self pay. Access the Enterprise Preferences > Libraries tab. Select a default region in the following fields: Pricing Region Library for Self Pay field – The system uses this pricing region if an encounter is self-pay and, therefore, has no payer. Default Pricing Region Library field – The system uses this pricing region if the encounter has a payer but no pricing region is selected for the payer (the Pricing Regions Library field in the Payer master file > Payer Defaults-1 tab is blank). This pricing region is also used when the Pricing Region Library for Self Pay field is blank. Select OK. Parent topic: SIM Pricing Regions Library
