Add Authorizations Code Tracking in the Encounter tab
- A single location
- A single location and a specialty
- A single location and one or more providers.
- Open NextGen® Enterprise PM.
- On the main toolbar, select Chart or Chart Lookup.
.
The Patient Lookup window opens. - In the Search Criteria section, enter the patient's information, and select Find.
Patient records that match the search criteria, appear in the Matching Records section.
- Select the patient, and then select Open.
The Patient Chart window opens.
- Select Encounters, and then select on the Insurance tab under it.
- Right-click the insurance listed on the Encounter Insurance section, and select Authorization.
The Authorization Listing window opens.
- Select the authorization that you want to use.
- Select the open menu
, and select New.
The Authorization Code Tracking window opens. - Enter the desired authorization code tracking information for line level and claim level authorizations.
Field
Description
Authorization Mode
Select one of the following options:- Encounter Mode - when the authorization is for the entire encounter.
- Units Mode - when the authorization is for units (procedures).
Tracking Only - do not send on claim
Select this check box to track the number of encounters or units on authorizations for internal purposes.
The authorization tracking totals are not sent on the claim or the EDI file.
Authorization Code
Enter the authorization code provided by the insurance company.
Effective Date
Select the effective date from the pop-up calendar.
Expiration Date
Select the expiration date from the pop-up calendar.
Nbr Encounters
Enter the number of encounters allowed for this authorization.
Used
Displays the number of authorizations utilized.
Pending
Displays the number of non-billed authorizations linked to an encounter.
Encounters Left
Displays the number of authorizations remaining for the patient.
Rendering
Select a single provider or multiple providers to attach to the authorization. The selected providers display in this field.CAUTION:When you select rendering providers, the Specialty field becomes unavailable.Location
To assign the authorization by location, select a single location.
Specialty
Select the specialty to attach to the authorization.CAUTION:When you select a specialty, the Rendering field becomes unavailable.Description
Enter a description for the authorization code.
ICD Thru ICD
Select the open menu
button to access the ICD-CM Code Range window and add, modify, or delete the ICD code range.
CPT4 Thru CPT4
Select the open menubutton to access the CPT4 Code Range window and add, modify, or delete the CPT4 code range.
Note: The Line Item Authorization column displays with a green check mark when an alternate claim send method is selected in the Payers master file. The path for this field is File Maintenance > Master Files > System > Payers > System tab Claims-2 sub tab Alternate Claim Send Method for Auth/Referral field.Encounters Utilizing This Authorization
Displays the encounter number and encounter date of the encounters attached to the authorization.
Appointments Pending This Authorization
Displays the case description and the appointment date of future encounters that will be attached to this authorization.
Date Authorization Requested
Enter the date of the request for the authorization.
Date Authorization Received
Enter the date the authorization was received.
Issue a Predetermination?
Select in this field to display a
check mark to specify that a predetermination is required.
Letter of Medical Necessity Required
Select in this field to display a
check mark to specify that a letter of medical necessity is required.
Date LMN Requested
Enter the date the LMN was requested.
Timely Filing Limit
The date provided by the payer when requesting information on the authorization.
Purchase Order Number
Enter the purchase order number if applicable.
Notes
Enter additional information about this authorization.
- Select OK