Setup an Exception Through the Contract Library

File Maintenance Help for NextGen® Enterprise 8

Access Contract Library Maintenance

Access the Contract Library Maintenance window, to create contract defaults, such as co-payments, deductibles, and physician referrals and authorizations. In File Maintenance, select Libraries and then Contract. The Contracts List window opens. Double-click the applicable library. The Contract Library Maintenance window opens. General Tab of Contract Library Maintenance Activate and Assign a Payer to a Practice You can limit a practice's access to certain Payers master files. Add or Modify a Contract Set Up a Fee Schedule for Contract Payers Modifier Reimbursement Tab Multiple Procedure Discounting Tab Payer/Provider Tab Contract Exceptions Parent topic: Contracts 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

Define Contract Subgrouping Categories

Contract subgrouping categories represent different types of contracts, such as Capitated, Government, Non-government, and Medicare. For example, you could create a subgrouping named Medicare for all the Medicare contracts that are set up in your contract library. After you create the subgrouping categories, they display as selections in the Provider master file and the Contract library (on the Practice tab of the Add/Modify Provider Information window and on the General tab of Contract Library Maintenance window) where you can attach the contracts to providers and contract libraries. On the File Maintenance desktop, select Master Lists. The Master Lists List window opens. Select Contract Subgrouping. Do one of the following: To add a new item, select open menu button , and then select New. To modify an existing item, select the item in list, select open menu button , and then select Open. You can also double-click to open the item. The Add/Modify Contract Subgrouping Information windo

Setup an Exception Through the Contract Library

Recommendations

Access Contract Library Maintenance

Add an Exception to an Existing Contract Exception Group

Setting Up a New Contract Exception

Modify Existing Contract Exceptions

Contracts Library

Define Contract Subgrouping Categories

Setup an Exception Through the Contract Library

Access Contract Library Maintenance

Add an Exception to an Existing Contract Exception Group

Setting Up a New Contract Exception

Modify Existing Contract Exceptions

Contracts Library

Define Contract Subgrouping Categories