NextGen Knowledge Center

Add Referral Code Tracking in the Encounters tab

Referrals can be created using ICD code ranges, CPT code ranges, encounters, or units. Multiple providers, a single specialty, or a location can be attached to a referral. You can track referrals by encounter use, pending encounters, and the number of encounters remaining on the referral.

  1. Open NextGen® Enterprise PM.
  2. On the main toolbar, select Chart or Chart Lookup. .
    The Patient Lookup window opens.
  3. 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.
  4. Select the patient, and then select Open.
    The Patient Chart window opens.
  5. Select Encounters, and then select the Insurance tab under it.
  6. Right-click the insurance listed on the Encounter Insurance section, and select Referral.
    The Referrals Listing window opens.
    Referral Listing window

  7. Right-click and select New Referral from the menu.
    The Referral Code Tracking window opens.

    Referral Code Tracking Window

  8. Enter the desired referral code tracking information.
  9. Select OK.
  10. Right-click and selectNew Referralfrom the menu.
    TheReferral Code Trackingwindow opens.

  11. In theReferral Modesection, select one of the following:
    • Encounter Mode: Select this button if the referral is approved for a specific number of encounters. This button is selected by default.
    • Units Mode: Select this button if the referral is approved for a specific number of charge units.
  12. In theReferral Codefield, enter the referral number obtained from the insurance company. This field is required.
  13. In theEffective Datefield, enter the start date for the referral. This field is required.
  14. In theExpiration Datefield, enter the end date for the referral. This field is required.
  15. In theNbr Encountersfield enter the number of encounters approved for the referral. This field is not available forUnits Modereferrals.
  16. TheUsedfield displays 0. The number increments by 1 each time the referral is linked to an encounter. The number cannot exceed the number in theNbr Encountersfield.
  17. ThePendingfield displays 0. The number increments by 1 each time an appointment is scheduled for the patient. The number cannot exceed the number in theNbr Encountersfield.
  18. TheEncounters Leftfield defaults to the number entered in theNbr Encountersfield. The number decrements by 1 each time the referral is linked to an encounter.
  19. In theRenderingfield, select one or more rendering providers for the referral, or leave blank if any rendering provider can be used with the referral.
  20. In theLocationfield, select a location for the referral, or leave blank if any location can be used with the referral.
  21. In theSpecialtyfield, select a rendering provider specialty for the referral, or leave blank if any provider specialty can be used with the referral.
  22. In theDescriptionfield, enter a free-text description for the referral.
  23. In theICDsection, enter one or more ICD code ranges for the referral, or leave blank if any ICD code can be used with the referral.
  24. In theCPT4section, do one of the following:
  25. Enter one or moreCPT4code ranges for the referral.
  26. In theNbr Unitsfield, enter the number of charge units approved for the referral for each CPT4 code range.
  27. TheUnits Leftfield defaults to the number entered in theNbr Unitsfield. The number decrements by 1 each time the referral is linked to an encounter with a charge that falls within the CPT4 code range.
  28. To save changes and close the window, selectOK.