SIM Groups

File Maintenance Help for NextGen® Enterprise 8

Add a New Service Item

On the Service Item Library Maintenance window, select open menu button , then select New. Enter a CPT code or select on the to search for the CPT code. If you search for the code, the CPT4 Code Search window opens. Under Search Method, select either Code or Description to determine how you want the search results to list, then enter the search data either by code or description. Select the appropriate code, and then select OK. The service item number and default description automatically populate. The default description for the SIM is the same as the CPT4 code description. You can change the description if necessary. For example, if the description Office/outpatient visit, new, problem focused is not meaningful to the staff, you could change it to simply Office Visit New Patient. Enter the information on the General tab, including effective date range and price. Required fields display with red labels. If there are payers that use alternate codes for the SIM, then enter that informat

File Maintenance Help for NextGen® Enterprise 8

Payer Tab - SIM Library

On the Payer tab in the Service Item library, all of the billing information displays that is needed to correctly set up the service item with a specific payer so that the claims are promptly paid. Field Description Payer If a payer requires an alternate CPT4 or Revenue code for the service item, then select that payer name. If you need to set multiple payers, fill out the information for the first payer, then select a new payer. The window will clear, but the first payer's information is saved. Suppress Rendering/ Attending Loop You can select the option to determine whether the Attending (2310A) and Rendering (2310B) loops should be suppressed. Do Not Sum Units for CPT4 Code You can select this check box to indicate that for a specific payer and SIM combination, multiple identical charge lines are prevented from being combined on one line and summed on the paper claim. The identical charges display on separate lines on the paper HCFA 1500 claim or are entered individually in an elect

NextGen® Enterprise EHR Help

SIMs Groups in the Orders Tests Master File

When multiple procedures are performed for particular types of encounter or appointments, you can set up one Service Item Group (SIM Group) code that includes all the SIM codes and descriptions for all of the procedures. SIM Groups enable you to enter one code during charge posting for multiple procedures and their associated charges. You can then be more efficient and error-free as you enter charges for multiple procedures that are typically performed together. For example, if your practice frequently does childhood immunizations, you could set up a SIM Group called "CHIMM", which would include all the CPT4® codes and descriptions for each immunization for the office encounter. For more information on SIM Groups, go to the NextGen Healthcare Success Community, download the latest System Administrator Guide for NextGen® Enterprise and the File Maintenance Master Files Guide for NextGen® Enterprise. Assign Default SIM Pricing Region Libraries to Payers Parent topic: Using Advanced Servi

File Maintenance Help for NextGen® Enterprise 8

Configure SIM Groups to Display for Location/Payer Configurations

You can set up a SIM group so that it can only be entered or displayed during charge entry only when the location and payer for the encounter match certain location/payer configurations. Open the SIM Groups library. The SIM Groups List window opens. Select open menu , then select Location/Payer Configurations. The Configure Payer/Locations window opens. Under Service Location, select the location to associate with the SIM group. Do one of the following: Select open menu button , then select Add to select one or more payers. You can select All Payers. Note: To delete a payer from the list, select the payer name, then selecte Open Menu , then select Delete. Parent topic: SIM Groups

File Maintenance Help for NextGen® Enterprise 8

Service Items Library

The Service Items library is the center of the billing functions. Within the Service Items library you can set up CPT4 codes for each practice, along with prices, and claim form designations. You can also group Service Items together under one main number or name. Libraries are available enterprise-wide, but each practice must designate which Service Items library to use by selecting it in the Libraries Practice Preferences. You can generate the Service Item Library Listing report from the Service Items library. For more information go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM. Set Up the Service Item Library You can set up your Service Item Library by setting up CPT4 codes for each practice, along with the prices and claims. General Tab Other Tab - SIM Library Payer Tab - SIM Library Labels Tab - SIM Library Notes/Significant Events Tab - SIM library Drugs Tab - SIM library Add a New Service Item Editing the Provider

File Maintenance Help for NextGen® Enterprise 8

Add SIM Groups

In File Maintenance, select Libraries, and then select Service Items. The Service Items List window opens. Select the applicable library, right-click and select SIM Groups. The SIM Groups List window opens. To create a new SIM Group, select open menu button , and select New. The SIM Group Maintenance window opens. In SIM Group field, enter a short name of the SIM Group. In the Description field, enter a description of the SIM Group. To add a new SIM, select Open Folder and search for the SIM. To add the item to the group, use the blue Include arrow to move the item to the Available list. To remove a SIM item from the Available list by selecting the SIM item and then the blue Exclude arrow. The indicates the search type. If the icon is listed next to the SIM column, the system will search by SIM number. You can select the Description column, which enables you to search by the service item description. The service item must already exist in the Service Item Library before you can add it

SIM Groups

Recommendations

Add a New Service Item

Payer Tab - SIM Library

SIMs Groups in the Orders Tests Master File

Configure SIM Groups to Display for Location/Payer Configurations

Service Items Library

Add SIM Groups

Add a New Service Item

Payer Tab - SIM Library

SIMs Groups in the Orders Tests Master File

Configure SIM Groups to Display for Location/Payer Configurations

Service Items Library

Add SIM Groups