About the External Tab in Insurance Maintenance

Help Guide for NextGen® Enterprise PM 8

About the Website Tab in Insurance Maintenance

The Website tab on the Insurance Maintenance window can be used to access the payer's website. A pushpin icon on the tab indicates that access to the payer's website is available. Note: This tab is functional only if the Payer Website has been defined in the Payers > Payer Defaults-1 tab in File Maintenance. The workstation must also have internet access. Parent topic: Insurance Maintenance Window

Help Guide for NextGen® Enterprise PM 8

About the Eligibility/Referral Tab in Insurance Maintenance

The Elig/Referral tab on the Insurance Maintenance window can be used with NextGen Eligibility Verification. The following real-time transactions can be submitted from this tab: Eligibility Verification requests New Referral requests Referral History requests A Push Pin icon on the tab indicates one or more real-time transactions exist for the payer. Note: This tab is available only if the Enable Eligibility/Referral option has been selected in Practice Preferences > General. Parent topic: Insurance Maintenance Window

Help Guide for NextGen® Enterprise PM 8

About the Benefit Info Tab in Insurance Maintenance

The Benefit Info tab on the Insurance Maintenance window allows you to enter eligibility, benefits, and financial information for the insurance. A pushpin icon on the tab indicates that eligibility, benefits, and financial information exist for the payer. Eligibility and Benefits Information The Eligibility and Benefits tab includes a standardized set of prompts with either a free-text or a pick-list response. Note: You can customize the captions for the two note fields on the right side of the window in Enterprise Preferences > Client Defined. Financial Information Tab The Financial Information tab includes a standardized set of prompts with either a free-text, a dollar amount, or a pick-list response. Parent topic: Insurance Maintenance Window

Help Guide for NextGen® Enterprise PM 8

About the Referrals Tab in Insurance Maintenance

The Referrals tab on the Insurance Maintenance window enables you to enter one or more referrals for the patient's insurance. For example, when a patient's primary care provider refers them to a specialist for a specific procedure, the specialist may need to obtain a referral from the payer prior to performing that procedure. The referral number provided by the payer can be entered in NextGen® Enterprise PM, so it is included on claims sent by the specialist to that payer for the referred procedure. A Push Pin icon on the tab indicates one or more referrals exist for the patient's insurance. Existing referrals are listed with the following information: Effective Date Expiration Date Referral Code Encounters Encounters Left Units Units Left Description Referrals and Encounters When a referral is entered for the insurance before an encounter is created, it automatically attaches to a new encounter that meets all criteria defined within the referral. Note: If the ICD or CPT4 codes have be

Help Guide for NextGen® Enterprise PM 8

Insurance Maintenance Window

The Insurance Maintenance window is used to add or update a patient's insurance information. The subscriber of the insurance may be the patient, or another person to which the patient has a relationship, such as a spouse or a parent. The Insurance Maintenance window includes the following tabs: Detail Detail-2 Insurance Cards Benefit Information Authorizations Referrals Eligibility/Referral Website External About the Detail Tab in Insurance Maintenance You can find basic information about the patient's insurance. About the Detail-2 Tab in Insurance Maintenance You can find additional information about the patient's insurance in this tab. About the Ins Cards Tab in Insurance Maintenance You can capture images of the front and back of the insurance card using a scanner or a digital camera. About the Benefit Info Tab in Insurance Maintenance You can enter eligibility and benefits information for the insurance. About the Authorizations Tab in Insurance Maintenance You to enter one or more

Help Guide for NextGen® Enterprise PM 8

External Tab for Payer Information

The External tab allows you to add external systems that interface with the NextGen® application and to associate an external system with a Payer. The External tab displays the following columns: Fields in the External Tab Add or Modify External Interface on the External Tab Parent topic: Payers Master File

About the External Tab in Insurance Maintenance

Recommendations

About the Website Tab in Insurance Maintenance

About the Eligibility/Referral Tab in Insurance Maintenance

About the Benefit Info Tab in Insurance Maintenance

About the Referrals Tab in Insurance Maintenance

Insurance Maintenance Window

External Tab for Payer Information

About the Website Tab in Insurance Maintenance

About the Eligibility/Referral Tab in Insurance Maintenance

About the Benefit Info Tab in Insurance Maintenance

About the Referrals Tab in Insurance Maintenance

Insurance Maintenance Window

External Tab for Payer Information