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Set Up for Eligible Number of Patient Days Billing
Access
File Maintenance
.
Select
Libraries
, and then
Consolidated Services Claim
library.
The
Consolidated Services Claim List
window opens.
Double-click to open the desired library.
The
Consolidated Services Claim Library Maintenance
window opens.
Select the open menu button .
The
Consolidated Services Claim Maintenance
window opens.
Complete the following fields:
Effective Date
Expiration Date
Description
Add the Valid Payers
Select the
Claim Consolidation Rules
tab and then select the open menu button and select
New
.
The
CSC Timespan Rules
window opens.
Complete the following fields:
In the
Length of Timespan
field, select
Consolidate Monthly Claims
.
In the
Description
field, enter a description for this type of billing.
In the
Rollup Encounter Rate Service Line
field, select
Yes
.
In the
Encounter Rate SIM Quantity
field, select
Number of Eligible Days
.
In the
Encounter Rate Service Line Amount
field, select
Eligible Patient Days times Original Charge Amount
.
Select
OK
.
Set Up for Eligible Number of Patient Days Billing
Help Guide for NextGen® Enterprise PM 8
Set Up for Eligible Number of Patient Days Billing
Access File Maintenance. Select Libraries, and then Consolidated Services Claim library. The Consolidated Services Claim List window opens. Double-click to open the desired library. The Consolidated Services Claim Library Maintenance window opens. Select the open menu button . The Consolidated Services Claim Maintenance window opens. Complete the following fields: Effective Date Expiration Date Description Add the Valid Payers Select the Claim Consolidation Rules tab and then select the open menu button and select New. The CSC Timespan Rules window opens. Complete the following fields: In the Length of Timespan field, select Consolidate Monthly Claims. In the Description field, enter a description for this type of billing. In the Rollup Encounter Rate Service Line field, select Yes. In the Encounter Rate SIM Quantity field, select Number of Eligible Days. In the Encounter Rate Service Line Amount field, select Eligible Patient Days times Original Charge Amount. Select OK. Parent topic:
Help Guide for NextGen® Enterprise PM 8
Set Up for Eligible Number of Patient Days Billing
Mental illness or substance abuse services can be performed outside of a professional medical setting such as a patient’s home, a senior center, or a community services center. You can now bill these services for the number of days the patient is authorized to receive these services from your practice. If a patient is enrolled in the program for the month of January or 31 days. The patient has a crisis and is admitted to an inpatient facility for 10 days. Therefore, the patient is only authorized to receive these services from you for 21 days. Formula for Billing Days in the Month = 31 Days Eligible for Billing = 21 (eligible patient days minus non-eligible patient days) Billed Amount = (21 Days X Daily Rate) Open File Maintenance. Select Libraries, and then select Consolidated Services Claim. The Consolidated Services Claim List window opens. Double-click the library. The Consolidated Services Claim Library Maintenance window opens. Select the open menu button. The Consolidated Servic
File Maintenance Help for NextGen® Enterprise
Set Up for Eligible Number of Patient Days Billing
Mental illness or substance abuse services can be performed outside of a professional medical setting such as a patient’s home, a senior center, or a community services center. You can now bill these services for the number of days the patient is authorized to receive these services from your practice. If a patient is enrolled in the program for the month of January or 31 days. The patient has a crisis and is admitted to an inpatient facility for 10 days. Therefore, the patient is only authorized to receive these services from you for 21 days. Formula for Billing Days in the Month = 31 Days Eligible for Billing = 21 (eligible patient days minus non-eligible patient days) Billed Amount = (21 Days X Daily Rate) Open File Maintenance. Select Libraries, and then select Consolidated Services Claim. The Consolidated Services Claim List window opens. Double-click the library. The Consolidated Services Claim Library Maintenance window opens. Select the open menu button. The Consolidated Servic
Help Guide for NextGen® Enterprise PM 8
Add Claim Consolidation Rules to a CSC Library
To enable claims consolidation, you must select the form types that you want to consolidate. Then you can choose to consolidate only encounter rate claims and/or claims with the same encounter rate SIM. These rules will apply to all of the payers in the Valid Payers list. Access the Consolidated Services Claim Maintenance window for the applicable library. Note: To access a CSC library, refer to the Accessing a Consolidated Services Claim Library procedure. After opening the Consolidated Services Claim Maintenance window, select a valid payer for the claim, then Claim Consolidation Rules. From the Claims Consolidation Rules tab, select a Claim Consolidation Rules row (CCR row) and open by doing one of the following: Right-click the library and select Open. Select the open menu button and select Open. The CSC Timespan Rules window opens for the library you selected. Complete the timespan rules. Note: When creating a new library, the Claim Consolidation Rules row (CCR row) is not require
File Maintenance Help for NextGen® Enterprise 8
Add Claim Consolidation Rules to a CSC Library
To enable claims consolidation, you must select the form types that you want to consolidate. Then you can choose to consolidate only encounter rate claims and/or claims with the same encounter rate SIM. These rules will apply to all of the payers in the Valid Payers list. Access the Consolidated Services Claim Maintenance window for the applicable library. Note: To access a CSC library, refer to the Accessing a Consolidated Services Claim Library procedure. After opening the Consolidated Services Claim Maintenance window, select a valid payer for the claim, then Claim Consolidation Rules. From the Claims Consolidation Rules tab, select a Claim Consolidation Rules row (CCR row) and open by doing one of the following: Right-click the library and select Open. Select the open menu button and select Open. The CSC Timespan Rules window opens for the library you selected. Complete the timespan rules. Note: When creating a new library, the Claim Consolidation Rules row (CCR row) is not require
Help Guide for NextGen® Enterprise PM 8
Add Claim Consolidation Rules to a CSC Library
To enable claims consolidation, you must select the form types that you want to consolidate. Then you can choose to consolidate only encounter rate claims and/or claims with the same encounter rate SIM. These rules will apply to all of the payers in the Valid Payers list. In File Maintenance, select Libraries > Consolidated Services Claim. The Consolidated Services Claim List window opens. Select the applicable library. Select Open Menu , and then select Open. The Consolidated Services Claim Library Maintenance window opens. In Consolidated Services Claim Library Maintenance, select Open Menu , and then select Open. The Consolidated Services Claim Maintenance window opens. In Consolidated Services Claim Maintenance, select a valid payer for the claim, and then select Claim Consolidation Rules. In Claims Consolidation Rules, select a CCR row, and then right-click the library and select Open. The CSC Timespan Rules window opens. Complete the timespan rules. Note: While creating a new lib
