Adjust the Case Reference Number for a Primary Payer

Help Guide for NextGen® Enterprise PM 8

Adjust the Primary Payer Authorization Number for a Case

If necessary, you can adjust the primary payer authorization number for the primary payer of a case. Open an existing case and select the Financial tab. Select Primary Payer Auth Number. The Authorization Listing window opens. Select the open menu icon and then select Open. The Authorization Code Tracking window opens. Adjust the number in the Authorization Code field as necessary. Select OK. Parent topic: Add Payers and Guarantors to a Case on the Financial Tab

Help Guide for NextGen® Enterprise PM 8

Attach Authorizations to a Case

Access an existing case and select the Financial tab. Right-click on the payer and select Authorizations from the shortcut menu. Note: If a payer is not attached to the case, you must attach one. Authorization Listing window opens. Select the open menu icon and then select New. The Authorization Code Tracking window opens. Complete the following authorization fields as needed: Authorization Code Effective Date Expiration Date Nbr Encounters - Complete this field to ensure the authorization is attached to an encounter associated with the case. Select OK. Parent topic: Add Payers and Guarantors to a Case on the Financial Tab

Help Guide for NextGen® Enterprise PM 8

Add Payers and Guarantors to a Case on the Financial Tab

To set up payers and guarantors for a case, access the Financial tab. Access the desired case. Select the Financial tab. Select the patient's Employer. Select whether condition for this Case is related to the patient's employment. Enter any Employer Notes. Select the Guarantor for the Case. If needed, perform a search for a person or an employer. Select the Payers for this Case. Select the open menu icon. The Case Insurance Selection window opens. Select the pertinent Payers. Select OK. CAUTION: All of the Encounters attached to the Case must contain the same Payer as the selected Case. Once you have set up Case Payer, you are able to select Available Encounters and set up Synchronizing Encounters to a Case. If necessary, set up the payer authorization information. If necessary, set up the primary payer authorization number. If necessary, set up the primary payer reference number. If necessary, enter the Primary Payer Property/Casualty Number. If necessary, enter worker's compensation,

Help Guide for NextGen® Enterprise PM 8

Modify an Insurance Referral

From the Ins/Diag tab, highlight the referral to be modified. Right-click and select Open Referral. The Referral Code Tracking window opens. Modify the referral information as needed. To save changes and close the window, select OK. The referral modifications are saved. Parent topic: Add or Modify an Insurance Referral

Help Guide for NextGen® Enterprise PM 8

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. 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 the Insurance tab under it. Right-click the insurance listed on the Encounter Insurance section, and select Referral. The Referrals Listing window opens. Referral Listing window Right-click and select New Referral from the menu. The Referral Code Tracking window opens. Referral Code Tracking Window Enter the desired

Help Guide for NextGen® Enterprise PM 8

Set up General Case Information

The General tab of the Case Management window is where you enter the case details and assign related cases. Create a new case in PM. Select one of the following options in the Case Status field: Open Closed Pending Reopened Note: In NextGen® Enterprise PM, you cannot close cases created in NextGen® Enterprise EHR and have open clinical encounters. A message displays indicating that the case contains unlocked clinical encounters. You must lock encounters and child encounters before closing the case. Select Patient Type. Enter Case Description. Enter the Effective Date, Expiration Date, Onset Date, and Onset Time. Select Occurrence Code. Select State. Enter Same/Similar Date for the Occurrence. Select the Referring Provider. If necessary, select the search button to access the Provider Lookup window. If available, select Case Diagnosis and/or Case Procedure. If necessary, add a Case Contact. If necessary, select Related Cases. Select Available Encounters and set up Case or Encounter Sync

Adjust the Case Reference Number for a Primary Payer

Recommendations

Adjust the Primary Payer Authorization Number for a Case

Attach Authorizations to a Case

Add Payers and Guarantors to a Case on the Financial Tab

Modify an Insurance Referral

Add Referral Code Tracking in the Encounters tab

Set up General Case Information

Adjust the Primary Payer Authorization Number for a Case

Attach Authorizations to a Case

Add Payers and Guarantors to a Case on the Financial Tab

Modify an Insurance Referral

Add Referral Code Tracking in the Encounters tab

Set up General Case Information