Add a Sliding Fee Schedule to an Encounter

Help Guide for NextGen® Enterprise PM 8

Apply Sliding Fee Adjustments to a Single Encounter

Calculating and applying a Sliding Fee Schedule to an encounter On Demand can only be done when the Insurance Amounts 1, 2 and 3 in Balance Control are equal to zero and the Patient Amount in Balance Control is greater than zero. For example, if payers are attached to an encounter, then the encounter must be billed and all payments from the payers must be posted, leaving only a patient balance. Note: The Sliding Fee Schedule must be encounter based. Open NextGen® Enterprise PM. Select the Chart button on the main toolbar. The Patient Lookup window opens. Enter Search Criteria to locate the desired patient. Select Find. From the search results, double-click to open the desired patient. The Patient Chart opens. Select the Encounters tab. Right-click on the desired encounter, and then select Sliding Fee. To view the sliding fee adjustment, select the Transactions tab. Note: If you add the sliding fee or process while the chart is open, you must close the chart and re-open it to see the cr

Help Guide for NextGen® Enterprise PM 8

Apply Sliding Fee Adjustments to Multiple Encounters

When calculating and applying a Sliding Fee Schedule against charges in batch mode, the patient responsibility must be greater than zero dollars and the COB 1 – 3 must be equal to zero dollars. If payers are attached to the encounters, then the encounters must be billed and all payments from the payers must be posted, leaving only a patient balance on the encounters. From the Main menu select Tasks and then Lookup. Open NextGen® Enterprise PM. Select Tasks > Lookup > Encounters. The Encounter Lookup window opens. Enter the appropriate search criteria. Select Find. Select the appropriate patients and encounters to calculate and apply the Sliding Fee Schedule. Right-click to display the short-cut menu, and then select Sliding Fee. You can verify that the Sliding Fee Schedule is calculated and applied against the patient responsibility charges on the Transactions tab in the applicable patient chart. Parent topic: Applying Sliding Fee Schedules to Charges

Help Guide for NextGen® Enterprise PM 8

Applying Sliding Fee Schedules to Charges

When a Sliding Fee Schedule is attached to a patient or guarantor account profile, the Sliding Fee Schedule can be applied against charges for an encounter and the application automatically calculates the adjustment. You can right-click on a line item in the Encounter Maintenance window and either remove or apply a sliding fee adjustment. If the insurance for a patient is discovered to be expired after charges have been applied to the encounter, the patient becomes eligible for a sliding fee adjustment. You can apply the sliding fee adjustment on the line item in the Encounter Maintenance window. Note: Sliding Fee adjustments uses the same process date as the charge process date. If it is overridden, the transaction posting date for the adjustment reflects the current date. Sliding Fee Schedule attached at the encounter level overrides Sliding Fee Schedule attached at the patient level. You can also attach more than one Sliding Fee Schedule to an encounter. This process can occur in th

Help Guide for NextGen® Enterprise PM 8

Attach Sliding Fee to a Patient or Person

You can set up the sliding fee schedule master file and sliding fee preferences. In NextGen® Enterprise PM, on the Estimated Patient Cost window, select a patient or person who you want to perform the cost estimation for. In the Patient/Guarantor Information section, select . The Modify Patient Information window opens. Select the UDS tab. In the Sliding Fee Schedule Verification section, select the open menu , and select New. The Sliding Fee Verification window opens. Select the Sliding Fee Schedule for the patient or person. Note: The Sliding Fee Schedule list displays the schedules defined in the sliding fee schedules master file in File Maintenance. Hidden and expired sliding fee schedules are not listed. Select the effective and expiration dates for the sliding fee schedule. In the Head of Household Family Information section, select the open menu , and select New. Note: To enter family information, a head of household must be selected for the patient or person. The Family Info wi

File Maintenance Help for NextGen® Enterprise 8

Set Up the Sliding Fee Schedule Details

Each Sliding Fee Schedule master contains one or more detailed sliding fee schedules. Each detailed sliding fee schedule is created with specific parameters such as sliding fee mode, CPT4 code ranges, diagnosis code ranges, locations, etc. It also includes a grid that defines discount percentages based on family size and annual income. Access File Maintenance. Select System Master Files > PM > Sliding Fee Schedules. The Sliding Fee Schedules List window opens. Select the desired sliding fee schedule master, select the Open Menu button and select Open. The Sliding Fee Schedule Maintenance window opens. In the Sliding Fee Schedules section at the bottom of the window, do one of the following: To add a new sliding fee schedule, select the Open Menu button and select New. To modify an existing sliding fee schedule, select the item in the list, select the Open Menu button and select Open. The Sliding Fee Schedule Detail Maintenance window opens. In the Name field, enter a descriptive name f

NextGen® Enterprise EHR Help

Add a Sliding Fee Schedule

Open the Person Information or Patient Information window for the desired person or patient. Select the UDS tab. In the Sliding Fee Schedule Verification section, select the Open Menu button, and select New. The Sliding Fee Verification window appears. In the Sliding Fee Schedule field, select a sliding fee schedule for the patient. This field is required. Note: Items available for selection are from the Sliding Fee Schedules master file in File Maintenance. Hidden and expired sliding fee schedules are not listed. In the Effective Date field, enter the start date for the sliding fee schedule. This field is required. In the Expiration Date field, enter the end date for the sliding fee schedule. This field is required. If a head of household has been entered for the patient, complete the Head of Household Family Information section. Note: A head of household must be selected for a patient to enter family information. To save changes and close the window, select OK. Note: When multiple sl

Add a Sliding Fee Schedule to an Encounter

Recommendations

Apply Sliding Fee Adjustments to a Single Encounter

Apply Sliding Fee Adjustments to Multiple Encounters

Applying Sliding Fee Schedules to Charges

Attach Sliding Fee to a Patient or Person

Set Up the Sliding Fee Schedule Details

Add a Sliding Fee Schedule

Apply Sliding Fee Adjustments to a Single Encounter

Apply Sliding Fee Adjustments to Multiple Encounters

Applying Sliding Fee Schedules to Charges

Attach Sliding Fee to a Patient or Person

Set Up the Sliding Fee Schedule Details

Add a Sliding Fee Schedule