Apply Sliding Fee Adjustments to a Single Encounter

Help Guide for NextGen® Enterprise PM 8

Apply Sliding Fee Adjustments to Multiple Encounters

When calculating and applying a Sliding Fee Schedule against charges in batch mode, the patient responsibility must be greater than zero dollars and the COB 1 – 3 must be equal to zero dollars. If payers are attached to the encounters, then the encounters must be billed and all payments from the payers must be posted, leaving only a patient balance on the encounters. From the Main menu select Tasks and then Lookup. Open NextGen® Enterprise PM. Select Tasks > Lookup > Encounters. The Encounter Lookup window opens. Enter the appropriate search criteria. Select Find. Select the appropriate patients and encounters to calculate and apply the Sliding Fee Schedule. Right-click to display the short-cut menu, and then select Sliding Fee. You can verify that the Sliding Fee Schedule is calculated and applied against the patient responsibility charges on the Transactions tab in the applicable patient chart. Parent topic: Applying Sliding Fee Schedules to Charges

Help Guide for NextGen® Enterprise PM 8

Apply Sliding Fee Adjustments using the Batch Process

You can process Sliding Fee Batch Adjustment in NextGen® Enterprise PM. To filter and select specific encounters, you can use the following fields: Date or Date Range Patient Type Service Location Rendering Physician Financial Class Primary Payer To apply sliding fee adjustments to multiple encounters in batch mode, do the following: Open NextGen® Enterprise PM. Select File > Processes > Sliding Fee Batch Adjustments. The Sliding Fee Batch Adjustment window opens. Enter the Search Criteria fields, and then select the encounters. Select Find. Encounters matching the search criteria display in the Encounter List grid. To apply a sliding fee adjustment to the selected encounters, select Batch Adjust. Search Criteria in Sliding Fee Batch Adjustment Window You can use Search Criteria in Sliding Fee Batch Adjustment window to search the desired encounters while appying sliding fee adjustments for batch encounters. Parent topic: Applying Sliding Fee Schedules to Charges

Help Guide for NextGen® Enterprise PM 8

Add a Sliding Fee Schedule to an Encounter

You can add a sliding fee schedule on the Encounter Maintenance > Billing and Collections tab. Open NextGen® Enterprise PM. Select Encounter. The Encounter Maintenance window opens. Select the patient or guarantor. Select the Billing and Collections tab. In the Sliding Fee Verification section, select the Open Menu button and select New. The Sliding Fee Verification window opens. Select the Sliding Fee Schedule, and then enter the Effective Date and Expiration Date for the schedule. A message appears stating that do you want to default the sliding fee schedules attached to the head of household to the patient who is attached to the head of household. If no head of household is set up already, you can select the Open Menu button in the Head of Household Family Information section. The Family Info window opens. Enter the number of family members in the Family field. Enter the family income in the Income field. Select Income Cycle, and then select the income cycle from the list. Enter the

Help Guide for NextGen® Enterprise PM 8

Self-Pay Patients

When a patient is a self-pay, NextGen® Enterprise PM calculates the Sliding Fee Schedule and applies it against the encounter charges that you enter on the Charge Posting window. When you save the charges, a message appears indicates that the Sliding Fee Schedule adjustment amount for the charges. The alert also displays the sliding fee detail grid information. Note: A Sliding Fee Schedule can be calculated and applied against an encounter as many times as you want. However, depending on how the Sliding Fee Schedule is defined to calculate, it may only apply against a charge one line item at a time. If you have any questions as to how the Sliding Fee Schedule is calculating charges, see your system administrator. Parent topic: Applying Sliding Fee Schedules to Charges

Help Guide for NextGen® Enterprise PM 8

Applying Sliding Fee Schedules to Charges

When a Sliding Fee Schedule is attached to a patient or guarantor account profile, the Sliding Fee Schedule can be applied against charges for an encounter and the application automatically calculates the adjustment. You can right-click on a line item in the Encounter Maintenance window and either remove or apply a sliding fee adjustment. If the insurance for a patient is discovered to be expired after charges have been applied to the encounter, the patient becomes eligible for a sliding fee adjustment. You can apply the sliding fee adjustment on the line item in the Encounter Maintenance window. Note: Sliding Fee adjustments uses the same process date as the charge process date. If it is overridden, the transaction posting date for the adjustment reflects the current date. Sliding Fee Schedule attached at the encounter level overrides Sliding Fee Schedule attached at the patient level. You can also attach more than one Sliding Fee Schedule to an encounter. This process can occur in th

Help Guide for NextGen® Enterprise PM 8

Sliding Fee in Cost Estimation

The sliding fee program offers differential pricing with adjustments based on the annual income and family size of a patient or person. Sliding fee schedules are attached to a patient or person or a specific encounter or chart in NextGen® Enterprise PM. When you attach a sliding fee schedule to an encounter, a percentage of the estimated amount specified on the Estimate Patient Cost window is automatically adjusted. In cost estimation, a patient or person eligible for sliding fee adjustments can only use the self-pay mode of payment. In NextGen® Enterprise PM, you can do the following: Attach sliding fee schedules at the chart level or encounter level for a person or patient. Note: The system does not combine encounter level and chart level sliding fees while judging which to apply. Encounter level sliding fee always take precedence over chart level sliding fee. Apply multiple sliding fee schedules at an encounter level or chart level for a person or patient. Note: When you add multipl

Apply Sliding Fee Adjustments to a Single Encounter

Recommendations

Apply Sliding Fee Adjustments to Multiple Encounters

Apply Sliding Fee Adjustments using the Batch Process

Add a Sliding Fee Schedule to an Encounter

Self-Pay Patients

Applying Sliding Fee Schedules to Charges

Sliding Fee in Cost Estimation