The SIM Pricing Regions library enables you to set prices based on geographical regions that vary by payer. The library contains a group of pricing regions, the Service Item library for each pricing region, and the specific locations that belong to each pricing region.
After you set up the library, you can attach it to:
- A payer in the Payers master file > Payer Defaults - 1 tab > Pricing Regions Library field.
- Enterprise Preferences > Libraries tab > Default Pricing Region Library field.
- Enterprise Preferences > Libraries tab > Pricing Region Library for Self Pay field
NextGen® Enterprise PM determines the SIM library to use based on the following conditions:
- If the encounter has a payer, then it uses the SIM Pricing Regions Library specified in the Payer master file.
- If the encounter has a payer with no pricing region selected (the Pricing Regions Library field in the Payer master file > Payer Defaults-1 tab is blank), then it uses the library specified in the Enterprise Preferences > Library tab > Default Pricing Region Library field.
- If the encounter is self-pay (it has no payer), then it uses the Pricing Region Library specified in the Enterprise Preferences > Library tab > Default Pricing Region Library for Self Pay field.
- If the encounter is self-pay, but no library is selected in the Default Pricing Region Library for Self Pay field in Enterprise Preferences, then it uses the library in the Default Pricing Region Library specified in Enterprise Preferences.
- If a pricing region is not selected in any of the above places, it uses the library selected in Libraries Practice Preferences > Service Item Library field.
