Apply Patient Responsibility Schedule to Payers

Help Guide for NextGen® Enterprise PM 8

Copy Patient Responsibility Schedules

You can copy Patient Responsibility Schedule rows and rename them. All information will copy except the payer configurations. To copy Patient Responsibility Schedule detail rows, do the following: In the Patient Responsibility master file, select the Patient Responsibility Schedule row that you want to copy. Select the Open Menu button, and then select Copy. Enter a name for the new schedule, and then select OK. The new schedule is added as a new row in the Patient Responsibility Schedule section. Parent topic: Patient Responsibility

Help Guide for NextGen® Enterprise PM 8

Set Up Patient Responsibility Schedules

The Patient Responsibility Schedule defines the percentage used in conjunction with a payer that requires the patient to be responsible for a certain percentage of the allowed amount. At charge entry, after all automatic adjustments, SIM exceptions, and contract exceptions are applied but before any sliding fee adjustments are applied, the Patient Responsibility percentage is used to distribute the remaining charge balance between the Ins1 bucket and the patient responsibility bucket. The distribution is based on the percentage determined by the patient's HOH family size and income. For example, if the patient's family size and income qualify for a 40% patient responsibility, a $100 charge balance splits to $60 in the Ins1 bucket and $40 in the patient responsibility bucket. The split also occurs when the ER SIM is inserted. You can create multiple patient responsibility schedules and then apply them to payers. To set up the patient responsibility percentages, do the following: Under t

File Maintenance Help for NextGen® Enterprise 8

Apply Patient Responsibility Schedule to Payers

After you save a Patient Responsibility Schedule, you can configure the schedule for one or more specific payers. Only one active schedule can exist for a payer. If there is already an existing schedule for a payer, it must be expired before you can configure another schedule for that payer. To apply a patient responsibility schedule to payers, do the following: In the Patient Responsibility master file, select the applicable patient responsibility schedule row. Select the Open Menu button, and then select Payer Configurations. The Configure Payer window opens. If the schedule row applies to all payers, select the All Payers check box, and then select OK. To apply the row to specific payers, select the Open Menu button, and then select New. The Payers window opens. Use the arrows to move the items from the Available list to the Included list, and then select OK. Any selected payer names display on the Configure Payer window. Note: To remove a payer from the list, select the payer name

File Maintenance Help for NextGen® Enterprise 8

Copy Patient Responsibility Schedules

You can copy Patient Responsibility Schedule rows and rename them. All information will copy except the payer configurations. To copy Patient Responsibility Schedule detail rows, do the following: In the Patient Responsibility master file, select the Patient Responsibility Schedule row that you want to copy. Select the Open Menu button, and then select Copy. Enter a name for the new schedule, and then select OK. The new schedule is added as a new row in the Patient Responsibility Schedule section. Parent topic: Patient Responsibility

File Maintenance Help for NextGen® Enterprise 8

Set Up Patient Responsibility Schedules

The Patient Responsibility Schedule defines the percentage used in conjunction with a payer that requires the patient to be responsible for a certain percentage of the allowed amount. At charge entry, after all automatic adjustments, SIM exceptions, and contract exceptions are applied but before any sliding fee adjustments are applied, the Patient Responsibility percentage is used to distribute the remaining charge balance between the Ins1 bucket and the patient responsibility bucket. The distribution is based on the percentage determined by the patient's HOH family size and income. For example, if the patient's family size and income qualify for a 40% patient responsibility, a $100 charge balance splits to $60 in the Ins1 bucket and $40 in the patient responsibility bucket. The split also occurs when the ER SIM is inserted. You can create multiple patient responsibility schedules and then apply them to payers. To set up the patient responsibility percentages, do the following: Under t

NextGen® Enterprise EHR Help

Add a Patient Provider

Open the Person Information or Patient Information window for the desired person or patient. Select the Provider tab. Select the Open Menu button, and select New. The Add Patient Provider window appears. In the Preference Name field, select a user-defined provider type. This field is required. Note: Items available for selection are from Practice Preferences, Providers. In the Provider field, do one of the following. This field is required. Select a provider from the list. Select the search button to access the Provider Lookup window, and find the provider. Note: Providers available for selection are those that are flagged with the selected Preference Name in the Providers master file in File Maintenance. In the Effective Date field, enter a start date for the selected patient provider in mm/dd/yyyy format, if applicable. In the Expiration Date field, enter an end date for the selected patient provider in mm/dd/yyyy format, if applicable. If an expiration date was entered, select an Ex

Apply Patient Responsibility Schedule to Payers

Recommendations

Copy Patient Responsibility Schedules

Set Up Patient Responsibility Schedules

Apply Patient Responsibility Schedule to Payers

Copy Patient Responsibility Schedules

Set Up Patient Responsibility Schedules

Add a Patient Provider

Copy Patient Responsibility Schedules

Set Up Patient Responsibility Schedules

Apply Patient Responsibility Schedule to Payers

Copy Patient Responsibility Schedules

Set Up Patient Responsibility Schedules

Add a Patient Provider