Setup an Exception Through the Contract Library

File Maintenance Help for NextGen® Enterprise 8

Add an Exception to an Existing Contract Exception Group

In File Maintenance, select Libraries and then Contract. In the Contracts List window, right-click on your library selection, and then select Contract Exceptions. Double-click on the Contract Exception name. The Contract Exception Maintenance window opens. To enter an exception for a contract, do one of the following: If your library has fewer than 50 CPT4 items, press the Tab key or arrow keys on your keyboard to move to the next CPT4 item. If your library has 50 or more CPT4 items, go back to the Type the first number(s) of the CPT4 item you want to locate field and enter the first few numbers of the next CPT4 item to enter an exception for. The CPT4 item displays in the spreadsheet area of the window. Continue this process until you enter all of exceptions and then select OK. Parent topic: Setup an Exception Through the Contract Library

File Maintenance Help for NextGen® Enterprise 8

Setting Up a New Contract Exception

In File Maintenance, select Libraries > Contract. The Contract List window opens. Select a library and select open menu button or right-click the selected library, and then select Contract Exceptions. The Contract Exceptions List window opens. Select the open menu button , or right-click in the Description area of the window, and then select New. The Contract Exception Maintenance window opens. In the Contract Exception Name field, enter a name for the Contract Exception that describes the group of exceptions. Note: If you do not want this exception to display in the Contract Exceptions List window, select the Hide Exception option. To use this contract as the base contract, select the Use as Base Contract check box (instead of being used as an exception to the contract). Enter the Filter Criteria to control which CPT4 items display in the CPT4 list and the contract exception information. You can move from field to field by pressing the TAB key. Enter the contract exception information

File Maintenance Help for NextGen® Enterprise 8

Modify Existing Contract Exceptions

In File Maintenance, select Libraries and then Contract. The Contracts List window opens. Right-click on your library selection, and then select Contract Exceptions. Double-click on the Contract Exception name. Enter the applicable exception changes in the spreadsheet section of the window, and then select OK. Parent topic: Setup an Exception Through the Contract Library

File Maintenance Help for NextGen® Enterprise 8

Contracts Library

Contracts can be set up for payers to indicate: The amount you expect to be reimbursed for procedures. When an authorization is required. When a referral is required. Other contract specific items, for example, the ability to send $0.00 claims such as capitated with contracts, you can: Attach payers to the contract. Create contract subgroupings for reporting purposes. For more information on contract subgrouping, go to NextGen Healthcare Success Community and download the latest File Maintenance Libraries Guide for NextGen® Enterprise, and refer to the Contract Subgrouping section. Access Contract Library Maintenance Setup an Exception Through the Contract Library

File Maintenance Help for NextGen® Enterprise 8

Attach Contract Subgroupings to a Provider

Contract subgroupings that are attached to a provider indicate which contracts the provider participates in because the subgroupings are assigned to the contracts. After you attach the subgroupings, the payers associated with the contracts are updated. Open a provider master file and then select the Practice tab. In the Contract Subgrouping field, select the contract categories to associate with the provider. Note: The Contract Subgrouping field label you see might be named differently. This provider becomes a participating provider for the payer. You can see these providers in the Payer master file. If you open a payer and select the contract on the Payer master file > Libraries tab, these participating providers are automatically selected in the Participating Providers field. Likewise, if you clear a Contract Subgrouping check box, then the providers name is removed from the Payer master file > Libraries tab > Participating Providers field. Parent topic: Setup an Exception Through th

File Maintenance Help for NextGen® Enterprise 8

Setting Up More Than One Exception per CPT4 Code

If you have a CPT4 code that requires more than one exception, you must first set up a new contract exception with a unique name for each instance of the exception. To set up more than one exception per CPT4 code, you must set up a new contract exception using a different contract exception name for each exception with the same CPT4 code. Parent topic: Setup an Exception Through the Contract Library

Setup an Exception Through the Contract Library

Recommendations

Add an Exception to an Existing Contract Exception Group

Setting Up a New Contract Exception

Modify Existing Contract Exceptions

Contracts Library

Attach Contract Subgroupings to a Provider

Setting Up More Than One Exception per CPT4 Code

Setup an Exception Through the Contract Library

Add an Exception to an Existing Contract Exception Group

Setting Up a New Contract Exception

Modify Existing Contract Exceptions

Contracts Library

Attach Contract Subgroupings to a Provider

Setting Up More Than One Exception per CPT4 Code