Add Medical Necessity Certificate

Help Guide for NextGen® Enterprise PM 8

Add Medical Necessity Certificate

Open NextGen® Enterprise PM. On the main toolbar, select Chart, and then in Patient Lookup, enter your search criteria, and then select Find. Matching people and patient records appear in the search results. In Matching Records, select a patient record , and then select Open. The Patient Information tab opens in the Patient Chart window. Select the Encounters tab, and then select an encounter from the Encounters list, and then select the Insurance tab. Select the appropriate insurer, right-click and then select CMN. In Certificates of Medical Necessity Information, enter the necessary information, and then select OK. Parent topic: Add Insurance for Patients and Persons

Help Guide for NextGen® Enterprise PM 8

Access the CMN Information Window

In the Certificates of Medical Necessity Information window, you can enter the CMN information for a patient encounter insurance. Certificates of Medical Necessity Information window can be accessed from the following areas in NextGen® Enterprise PM. Patient Chart > Encounters tab Charge Posting window To open the Certificates of Medical Necessity Information window from the Patient Chart > Encounters tab, do the following: Open NextGen® Enterprise PM. Select Chart. The Patient Lookup window opens. Select the desired patient, and then select Open. The Patient Chart opens for the desired patient. Select the Encounters tab, and then select the desired encounter from the Encounters list. Select the Insurance sub-tab. In the Encounter Insurance section, highlight the insurance that requires the CMN information and do one of the following: Right-click on the insurance and select CMN from the menu. Select Open Record in the Verification section, and then select Open Record in the Certificate

Help Guide for NextGen® Enterprise PM 8

Access the CMN Information Window

In the Certificates of Medical Necessity Information window, you can enter the CMN information for a patient encounter insurance. Certificates of Medical Necessity Information window can be accessed from the following areas in NextGen® Enterprise PM. Patient Chart > Encounters tab Charge Posting window To open the Certificates of Medical Necessity Information window from the Patient Chart > Encounters tab, do the following: Open NextGen® Enterprise PM. Select Chart. The Patient Lookup window opens. Select the desired patient, and then select Open. The Patient Chart opens for the desired patient. Select the Encounters tab, and then select the desired encounter from the Encounters list. Select the Insurance sub-tab. In the Encounter Insurance section, highlight the insurance that requires the CMN information and do one of the following: Right-click on the insurance and select CMN from the menu. Select Open Record in the Verification section, and then select Open Record in the Certificate

Help Guide for NextGen® Enterprise PM 8

Adding Person or Patient Details

To add a patient, you must first enter data for all mandatory fields of the complete the required fields on each tab of the Add Patient Information or Add Person Information window, and then for other fields required by your practice. A system administrator can configure the mandatory fields in Enterprise Preferences and Practice Preferences in File Maintenance. The Add Patient Information or Add Person Information window contains the following tabs: Demographics UDS Status - complete the practice and enterprise required fields Client Defined Provider Relations/Role Ext Pharmacy Chart Details After you enter data in the mandatory fields, you can save the information. Adding Information to Person or Patient Profiles You can enter the general, contact, demographic and insurance information for persons or patients on the Demographics tab. Add Demographics to Patient Profiles You can add a patient's demographic information through the Add Person Information window. Set up Patient Status Yo

Help Guide for NextGen® Enterprise PM 8

Certificate of Medical Necessity

In File Maintenance, you can create Certificate of Medical Necessity (CMN) forms for Durable Medical Equipment (DME) devices by SIM code. Each form includes specific questions and answer formats that are required by payers for a specific DME device. When you create the CMN form, it is used in NextGen® Enterprise PM to enter information and answer questions related to a patient’s DME device. This information is then included in the electronic 837P (1500) claim file for payers that require CMN information for that specific CPT4 code. Note: The CMN Information is not related to the Medical Necessity functionality in NextGen® Enterprise PM that evaluates CPT4 and ICD codes to determine whether the procedure is medically necessary. Access the CMN Information Window You can enter the CMN information for a patient's encounter insurance from the Certificates of Medical Necessity Information window. Add or Modify CMN Information for an Encounter Insurance You can add or modify the CMN informati

Help Guide for NextGen® Enterprise PM 8

Certificate of Medical Necessity

In File Maintenance, you can create Certificate of Medical Necessity (CMN) forms for Durable Medical Equipment (DME) devices by SIM code. Each form includes specific questions and answer formats that are required by payers for a specific DME device. When you create the CMN form, it is used in NextGen® Enterprise PM to enter information and answer questions related to a patient’s DME device. This information is then included in the electronic 837P (1500) claim file for payers that require CMN information for that specific CPT4 code. Note: The CMN Information is not related to the Medical Necessity functionality in NextGen® Enterprise PM that evaluates CPT4 and ICD codes to determine whether the procedure is medically necessary. Access the CMN Information Window You can enter the CMN information for a patient's encounter insurance from the Certificates of Medical Necessity Information window. Add or Modify CMN Information for an Encounter Insurance You can add or modify the CMN informati

Add Medical Necessity Certificate

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Add Medical Necessity Certificate

Access the CMN Information Window

Access the CMN Information Window

Adding Person or Patient Details

Certificate of Medical Necessity

Certificate of Medical Necessity

Add Medical Necessity Certificate

Access the CMN Information Window

Access the CMN Information Window

Adding Person or Patient Details

Certificate of Medical Necessity

Certificate of Medical Necessity