About the Website Tab in Insurance Maintenance

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 Ins Cards Tab in Insurance Maintenance

The Ins Cards tab on the Insurance Maintenance window allows you to capture images of the front and back of the insurance card. Card images can be acquired using a scanner or captured using a digital camera. A pushpin icon on the tab indicates one or more insurance cards exist for the payer. Parent topic: Insurance Maintenance Window

Help Guide for NextGen® Enterprise PM 8

About the External Tab in Insurance Maintenance

The External tab on the Insurance Maintenance window enables you to add an External System that interfaces with the NextGen Enterprise applications and to associate an External ID for the insurance. Note: If the External ID and External System have been defined in the Payers > External tab in File Maintenance, they will default to the Insurance Maintenance > External tab for all patients with that insurance. 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 Authorizations Tab in Insurance Maintenance

The Authorizations tab on the Insurance Maintenance window enables you to enter one or more authorizations for the patient's insurance. For example, a provider may need to obtain an authorization from the payer prior to performing a specific procedure for the patient. The authorization number provided by the payer can be entered in NextGen® Enterprise PM, so it is included in the claims sent by the provider to that payer for the authorized procedure. A pushpin icon on the tab indicates one or more authorizations exist for the patient's insurance. Existing authorizations are listed with the following information: Effective Date Expiration Date Authorization Code Description Encounters Encounters Left Units Units Left If you have selected a service package library in Libraries > Service Package Library field on the Practice Preferences window, the existing authorizations are sorted by Effective Date in the descending order, so newer authorizations are at the top of the list and older aut

Help Guide for NextGen® Enterprise PM 8

About the Detail Tab in Insurance Maintenance

The Detail tab on the Insurance Maintenance window includes basic information about the patient's insurance such as plan name, policy number, group number, address, phone, effective and expiration dates, co-pay and deductible. When you estimate the cost for services, you can select to automatically update the co-pay and deductible in the Insurance Maintenance window from the cost estimation. Before estimating the cost for services, you must set the Update patient insurance with copay/deductible information from cost estimation preference in Ppractice Preferences. For more information on setting the preference, see Pre-Services Cost Estimation User Guide for NextGen® Enterprise PM . When you access the Insurance Maintenance window, the cursor's focus is on the HIC/Policy Nbr field. Enter a Co-Pay Amount You can enter the co-pay amount for an insurance. The amount entered indicates the patient's co-pay for the insurance, and the patient is responsible to pay that amount on encounters the

About the Website Tab in Insurance Maintenance

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About the Benefit Info Tab in Insurance Maintenance

About the Ins Cards Tab in Insurance Maintenance

About the External Tab in Insurance Maintenance

About the Eligibility/Referral Tab in Insurance Maintenance

About the Authorizations Tab in Insurance Maintenance

About the Detail Tab in Insurance Maintenance

About the Benefit Info Tab in Insurance Maintenance

About the Ins Cards Tab in Insurance Maintenance

About the External Tab in Insurance Maintenance

About the Eligibility/Referral Tab in Insurance Maintenance

About the Authorizations Tab in Insurance Maintenance

About the Detail Tab in Insurance Maintenance