SIM Pricing Template Library Field Descriptions

Section	Description
Search	Located on the left side of the dialog box, this section enables you to search for specific SIM. If there are fewer than 50 SIM items defined in the SIM Library, all active SIM items automatically display in the Search list. If there are more than 50 SIM items defined in the SIM Library, the SIM codes do not automatically display. Instead, you must manually enter the SIM code or the first few digits of the code in the Search field. To find a specific SIM, enter the SIM code. To list all existing SIMs, enter an asterisk.
Service Item #	For a new SIM, enter meaningful Service Item numbers and descriptions to correlate to the appropriate CPT4 code. If you searched for a SIM, this field displays the SIM that you searched for. In addition, you can select the Open menu button, select New, and then enter a new Service Item Number.
Hide SIM	Select this check box if you want to hide this SIM. In the Search results, the Hidden icon displays next to hidden SIMs. Users cannot see or use hidden SIMs.
Non-Facility/ Facility Price	Enter the non-facility and facility price, if applicable, for the SIM for the defined time period. When a service item has both facility and non-facility prices, the price charged is based on whether the place of service is indicated as a facility in the Place of Service code table.
Cost to Perform	Enter the actual cost of the procedure.
Time to Perform	Enter the time allocated for the procedure.
RVU 1 - 8	Enter the Relative Value Units for this SIM. Note: You can change the labels for the RVU columns.
UD1 Price/ UD1 Facility Price/ UD2 Price/ UD2 Facility Price	User-defined facility and non-facility price. These values print on the claim; they do not become the amount of a charge. The column names are defined on the Enterprise Preferences > Libraries tab. These columns are added to a claim if one of the user-defined fields is selected in the Payer master file > Practice tab > Other tab > User-defined claims override price.
Unassigned Benefits Price	Enter the non-facility unassigned benefits price. Vague
Unassigned Benefits Facility Price	Enter the facility unassigned benefits price. Vague

File Maintenance Help for NextGen® Enterprise 8

Setup SIM Pricing Template Library

In the Libraries list, select SIM Pricing Template. The SIM Pricing Template List window opens. Select open menu button , and then select New. The SIM Pricing Template window opens. Enter a name in the SIM Pricing Template Name field. Complete the remaining fields. For more information on the field descriptions, see SIM Pricing Template Library Field Descriptions. Set the SIM Library Configurations that link the SIM Pricing Templates to the SIM Libraries. Note: After configurations have been set up, a green check mark in the SIM Library Configuration section > BBP column indicates that the configuration will be included in the SIM Pricing Template - Auto Update BBP job. Instead of opening an existing configuration to designate it to be sent to BBP, you can select the BBP column for the row in the SIM Library Configuration section or you can right-click the configuration, and then select BBP. To see a snapshot of the current SIM data targeted for update along with what the data will be

Help Guide for NextGen® Enterprise PM 8

Service Item Library Maintenance Field Descriptions

The following table describe the fields for setting up a Service Item Library. Field Description Search You can search for any specific SIM. If there are less than 50 SIM items defined in the SIM Library, all active SIM items automatically appear in the Search list. If there are more than 50 SIM items defined in the SIM Library, the SIM codes do not appear automatically. You must manually enter the SIM code or the first few digits of the code in the Search field. To find a specific SIM, enter the SIM code. To list all existing SIMs, enter an asterisk. SIM Library Name SIM Library name is a required field. Service Item For a new SIM, you can enter meaningful service item numbers and descriptions to correlate to the appropriate CPT4 code. This field is required. When you search for a SIM, this field displays the SIM that you search for. You can also select the open menu button, select New, and then enter a new service item Number. Hide SIM You can select this check box to hide the SIM. I

File Maintenance Help for NextGen® Enterprise 8

Libraries Tab - Enterprise Preferences Descriptions

The following table provides descriptions of the fields located in the Libraries Enterprise Preferences. Field Description Enable Advanced Service Item Library Mode Caution: Once you enable this feature, you cannot disable it. This check box turns on all features that enable you to set prices by configuring locations into payer-centric groupings. For example, Medicare might have different regional groupings than Aetna, and pricing would be determined accordingly. Default Pricing Region Library for Self Pay Select the appropriate SIM Pricing Regions library that defines the pricing when an encounter is self-pay. For more information, go to NextGen Healthcare Success Community and download the latest File Maintenance Libraries Guide for NextGen Enterprise. Default Pricing Region Library Select the appropriate SIM Pricing Regions library that defines the pricing for payers of this enterprise. For more information, go to NextGen Healthcare Success Community and download the latest File Mai

File Maintenance Help for NextGen® Enterprise 8

SIM Exception Setup Field Descriptions

You can use the following table when setting up SIM Exceptions. Field Description SIM Exception Name Enter a name for the SIM Exception that describes the group of exceptions. If there are fewer than 50 SIM items defined in the SIM Library, all active SIM items automatically load into the grayed-out section of the spreadsheet area from the SIM Library. If there are more than 50 SIM items defined in the SIM Library, the SIM codes do not automatically load into the spreadsheet. Instead, you must manually enter the SIM code or the first few digits of the code in the Filter Criteria box, which loads the spreadsheet with SIM items that match your entry. Hide Exception Select this check box if you want to hide the SIM Exception in the SIM Exceptions List. Note: You can also right-click in the Description area of the SIM Exceptions List, then select Hide. Type the first number(s) of the SIM item you want to locate Use this field if you have more than 50 SIM items. Otherwise skip to the next f

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

General Tab

The Service Items Library > General tab includes general information for each SIM code that affects charge posting, billing, claims and reporting in NextGen® Enterprise PM. The General tab includes the following fields: Field Description Place of Service You can select a default Place of Service. This default displays on the Charge Posting window. Notes: A place of service selected at the SIM level overrides a place of service at the location level. You can select <none> as the place of service if the service can be performed at different kinds of places. However, if you select <none>, the charge does not create. Component Select the component type for this service item: Global (both the technical and professional), Professional (physician supervision and interpretation), or Technical (equipment or technology). The Component field appears only if the SIM fields: Show dept, modality and component check box is selected in the Libraries Practice Preferences. This field is required. Note:

SIM Pricing Template Library Field Descriptions

Recommendations

Setup SIM Pricing Template Library

Service Item Library Maintenance Field Descriptions

Libraries Tab - Enterprise Preferences Descriptions

SIM Exception Setup Field Descriptions

Add a New Service Item

General Tab

Setup SIM Pricing Template Library

Service Item Library Maintenance Field Descriptions

Libraries Tab - Enterprise Preferences Descriptions

SIM Exception Setup Field Descriptions

Add a New Service Item

General Tab