Providers Eligibility/Referral Tab

File Maintenance Help for NextGen® Enterprise 8

Order Module Tab

For information about the Order Module settings, go to NextGen Healthcare Success Community and download the latest Orders Module User Guide for NextGen® Enterprise EHR . Parent topic: Create or Modify Locations Parent topic: Payers Master File Parent topic: Providers Master File

File Maintenance Help for NextGen® Enterprise 8

Providers Credentialing Tab

The Credentialing tab in the Providers master files enables you to track the various credentials obtained by each provider, such as degrees, licenses and certifications. You can enter credentials for each provider and use them for informational purposes only. If the Enable Provider Credential Billing option is enabled in Enterprise Preferences > General, you can also use them in the configuration of the Non-Coordinated SIM and Claim Modifiers libraries for billing purposes in NextGen® Enterprise PM. Add or Modify Provider Credentials Provider Credentials with Overlapping Dates Delete Provider Credentials Hide Provider Credentials Primary Credentials Parent topic: Providers Master File

File Maintenance Help for NextGen® Enterprise 8

Providers Notes Tab

Notes can be added for a referring provider. The provider notes are not practice-specific. You can set them to display as an alert throughout the enterprise whenever the provider is used as a referring physician during appointment scheduling in NextGen® Enterprise PM. To add a note for a referring provider: On the Add/Modify Provider Information window, select the Notes tab. In the Provider Notes box, enter the notes. You can enter a maximum of 255 characters. If you want an alert to display this note, select the Show notes as alert when this provider is used as a referral source on appointments check box. The alert displays in NextGen® Enterprise PM when the referring provider is added to an appointment in the Referring Provider field and each time the Edit Appointment window is accessed. Parent topic: Providers Master File

Help Guide for NextGen® Enterprise PM 8

Eligibility Referral Report

The Eligibility Referral report is available if your system is licensed for NextGen Eligibility Verification. You can use the report to track referral requests submitted to payers from NextGen® Enterprise PM. For more information, go to the NextGen Healthcare Success Community and download the User Guide for NextGen® Eligibility Verification Report configuration and filter options include Create Date, Status, Inquiry Type, Response Status, Payer Subgrouping, Primary Payer, Provider Subgrouping, and Rendering Provider. To access the report in NextGen® Enterprise PM, select Reports > General and then select Eligibility Referral. Eligibility Referral Report Columns Parent topic: General Reports

System Administrator Help

Managed Care Operation

The Managed Care Operations subgroup in the System Administrator enables you to set rights for NextGen® Eligibility Verification. Subgroup Used in Description Eligibility Referral Inquiry NextGen® Enterprise PM Enables users to run the Eligibility and Referral Inquiries process to obtain results. Elig Manager NextGen® Enterprise PM Enables users to track NextGen® Eligibility Verification eligibility transactions by day and status using a user-friendly visual graph and detailed grid; allowing users to: view eligibility responses, submit or resubmit eligibility inquiries, access the Eligibility Referral Report, create tasks, manage transactions, and print. Submit Eligibility Request NextGen® Enterprise PM Enables users to submit eligibility requests. Submit Historical Authorization Request NextGen® Enterprise PM Currently not available. Submit Historical Referral Request NextGen® Enterprise PM Enables users to submit Historical Referral Requests in NextGen® Enterprise PM using RTS (Real-

Help Guide for NextGen® Enterprise PM 8

Eligibility Referral Reconciliation Report

The Eligibility Referral Reconciliation report is available if your system is licensed for NextGen Eligibility Verification. You can use the report to reconcile your monthly invoices to the number of inquiry transactions submitted to payers from NextGen® Enterprise PM. For more information, go to the NextGen Healthcare Success Community and download the User Guide for NextGen® Eligibility Verification Report configuration and filter options include Create Date, Status, Inquiry Type, Response Status and Primary Payer. To access the report in NextGen® Enterprise PM, select Reports > General and then select Eligibility Referral Reconciliation. Eligibility Referral Reconciliation Report Columns Parent topic: General Reports

Providers Eligibility/Referral Tab

Recommendations

Order Module Tab

Providers Credentialing Tab

Providers Notes Tab

Eligibility Referral Report

Managed Care Operation

Eligibility Referral Reconciliation Report

Order Module Tab

Providers Credentialing Tab

Providers Notes Tab

Eligibility Referral Report

Managed Care Operation

Eligibility Referral Reconciliation Report