Add or Modify a Non-Coordinated SIM Library

Help Guide for NextGen® Enterprise PM 8

Set Up Non-Coordinated SIM Configurations

You can configure billing rules for SIM codes that are valid for specific payers, and are therefore considered invalid or non-coordinated for other payers on the Non-Coordinated SIM Maintenance window. The rules can be configured in a way that ensures a non-coordinated SIM code is billed only to a valid payer. The rules can also be configured to ensure that services rendered by a provider with a specific credential are billed only to a valid payer. You can define additional rules for balance control, auto-adjustments, and claims. In File Maintenance, select Libraries, and then select Non-Coordinated SIM Library. The Non-Coordinated SIM List window opens. Double-click a library. The Non-Coordinated Service Item Library Maintenance window opens. In the Payer SIM Configuration section, do one of the following: To create a new SIM configuration or row, select open menu and then select New. To modify an existing SIM configuration, select the row, select open menu and then select Open. The N

Help Guide for NextGen® Enterprise PM 8

Non-Coordinated SIM Library

The Non-Coordinated SIM library enables you to set up billing rules for payer-specific service items. This includes service items that are only reimbursed by specific payers such as a state plan, special grant program, or Medicaid, that would not be reimbursed if billed to other payers. Example: A range of behavioral health SIM codes can be billed to Medicaid but not to any other payer. That range of SIM codes can be set up in this library with Medicaid selected as the only valid payer, therefore making the SIM codes “non-coordinated” for all other payers. The library also defines other parameters that affect how non-coordinated SIM codes are handled during charge posting and billing. These parameters include options and settings for Balance Control, auto-adjustments, and claims. A single library can be created and used by the practice. The library may include multiple detail rows, each with different parameters and requirements for a specific payer. Note: This is a practice level libr

File Maintenance Help for NextGen® Enterprise 8

Add or Modify a Non-Coordinated SIM Library

Open File Maintenance. Select Libraries, and then Non-Coordinated SIM Library. The Non-Coordinated SIM List window opens. Do one of the following: To create a library, select open menu button and select New. To modify a library, select the library from the list, and then select open menu button and select Open. The Non-Coordinated Service Item Library Maintenance window opens. In the Non-Coordinated SIM Library Name field, enter a name for the library. This field is required. Set up Non-Coordinated SIM Configuration as needed. For more information on setting up Non-Coordinated SIM Configuration, see Set up Non-Coordinated SIM Configurations. To save changes and close the window, select OK. Parent topic: Non-Coordinated SIM Library

File Maintenance Help for NextGen® Enterprise 8

Set Up Non-Coordinated SIM Configurations

You can configure billing rules for SIM codes that are valid for specific payers, and are therefore considered invalid or non-coordinated for other payers on the Non-Coordinated SIM Maintenance window. The rules can be configured in a way that ensures a non-coordinated SIM code is billed only to a valid payer. The rules can also be configured to ensure that services rendered by a provider with a specific credential are billed only to a valid payer. You can define additional rules for balance control, auto-adjustments, and claims. In File Maintenance, select Libraries, and then select Non-Coordinated SIM Library. The Non-Coordinated SIM List window opens. Double-click a library. The Non-Coordinated Service Item Library Maintenance window opens. In the Payer SIM Configuration section, do one of the following: To create a new SIM configuration or row, select open menu and then select New. To modify an existing SIM configuration, select the row, select open menu and then select Open. The N

File Maintenance Help for NextGen® Enterprise 8

Generate a Non-Coordinated SIM Library Report

To generate the Non-Coordinated SIM Library reports, do the following: Open File Maintenance. Select Libraries, and then Non-Coordinated SIM Library. The Non-Coordinated SIM List window opens. Select open menu button and select Print. The Non-Coordinated SIM Library Reports menu opens. Select one of the following reports: Non-Coordinated SIM Library Listing Non-Coordinated SIM Libraries with Payer Detail The NextGen Report Filter window opens. Select the desired columns, filters and sorting for the report. To generate the report, select OK. The report opens. Non-Coordinated SIM Library Listing Report Columns Non-Coordinated SIM Library with Payer Detail Report Columns Parent topic: Non-Coordinated SIM Library Report

File Maintenance Help for NextGen® Enterprise 8

Non-Coordinated SIM Library

The Non-Coordinated SIM library enables you to set up billing rules for payer-specific service items. This includes service items that are only reimbursed by specific payers such as a state plan, special grant program, or Medicaid, that would not be reimbursed if billed to other payers. Example: A range of behavioral health SIM codes can be billed to Medicaid but not to any other payer. That range of SIM codes can be set up in this library with Medicaid selected as the only valid payer, therefore making the SIM codes “non-coordinated” for all other payers. The library also defines other parameters that affect how non-coordinated SIM codes are handled during charge posting and billing. These parameters include options and settings for Balance Control, auto-adjustments, and claims. A single library can be created and used by the practice. The library may include multiple detail rows, each with different parameters and requirements for a specific payer. Note: This is a practice level libr

Add or Modify a Non-Coordinated SIM Library

Recommendations

Set Up Non-Coordinated SIM Configurations

Non-Coordinated SIM Library

Add or Modify a Non-Coordinated SIM Library

Set Up Non-Coordinated SIM Configurations

Generate a Non-Coordinated SIM Library Report

Non-Coordinated SIM Library

Set Up Non-Coordinated SIM Configurations

Non-Coordinated SIM Library

Add or Modify a Non-Coordinated SIM Library

Set Up Non-Coordinated SIM Configurations

Generate a Non-Coordinated SIM Library Report

Non-Coordinated SIM Library