Applying Pre-Services Payment

Help Guide for NextGen® Enterprise PM 8

Pre-Services Cost Estimation

NextGen® Enterprise PM offers a pre-service solution that offers clear estimation for planned or completed services. You can perform patient cost estimation if you have administrator privileges to perform administration tasks for the practice. The cost estimation feature enables you to: Obtain a breakdown of financial responsibilities between the patient and insurance provider. Inform the patient about the amount payable by the patient before or after using the services and the amount that will be settled by the insurance provider. Collect timely payments from the person or patient. Print cost estimation results in customized formats. Keep plain text notes for the estimation. Associate diagnosis code for the estimation. View previous cost estimates. Visit the account profile, patient balance, and chart of the person or patient from the cost estimation. Generate and view cost estimate reports. Patient Cost Estimation Workflow After your administrator configures the library and master fi

Help Guide for NextGen® Enterprise PM 8

Posting Transactions

In NextGen® Enterprise PM, a payment is considered posted only if has gone through the posting process. You can add or modify payments for an encounter only until it is posted. The posting process is a way of telling the application that everything has been done correctly and is ready to be committed to the system. Payment posting could be manual in paper format as Explanation of Benefits (EOB) or electronically as Electronic Remittance Advice (ERA). In NextGen® Enterprise PM, there are two sources for transactions, patients or payers. Payments may come from primary, secondary or tertiary payers. Transaction Posting Process You can create a batch to enter relevant information for payments and posting the payments. Viewing Transaction Dates You can view different dates associated with all transactions in the Batch Maintenance window. Recording Transactions to a Batch You can create a transaction batch header to enter payments or transactions. Posting Encounter and Account Level Payments

Help Guide for NextGen® Enterprise PM 8

Set Payment Preferences for Pre-Services

Open NextGen® Enterprise PM. From the Admin menu, select Preferences > Practice. The Practice Preferences window opens. Select Pre-Services from the preference list. If the patient wants to pay in advance, enter the recommended percentage that needs to be collected from the patient in Patient Payment %. Select Update patient insurance with copay/deductible information from cost estimation to update the co-pay and deductible values in the patient insurance information from the current cost estimate. Select OK. Parent topic: Configuring Pre-Services Practice Preferences

Help Guide for NextGen® Enterprise PM 8

Configuring Pre-Services Practice Preferences

Before you perform or complete the cost estimation in NextGen® Enterprise PM, your administrator can set the preferences for Pre-Services in the Practice Preferences window. However, setting the practice preferences is not mandatory. If you are an administrator, your preferred selections for pre-services determine the following values in cost estimation: Percentage of payment that the patient agrees to pay in advance Co-pay or deductible values in the patient's insurance information Allowed amount Coinsurance amount For descriptions of the fields for the Pre-Services preferences, go to the NextGen Healthcare Success Community and download the File Maintenance Preferences Guide forNextGen®Enterprise. Set Payment Preferences for Pre-Services Your administrator can set payment preferences that determines the amount the patient can pay in advance and update the insurance information. Configuring Practice Preferences for Allowed Amount The allowed amount can be retrieved from contracts and

Help Guide for NextGen® Enterprise PM 8

Estimating Patient Cost

In NextGen® Enterprise PM, the Estimate Patient Cost window enables you to specify the inputs required for calculating the patient and insurance responsibility amounts for services planned or rendered. You can initiate cost estimation from: The People Lookup window for a person. The Patient Lookup window for a patient. The Appointment Lookup window or the appointment book for an appointment or event. The Encounter Lookup window or the Encounters tab on the Patient Chart window for an encounter. The Estimation Results in the Clinical History/Notes tab on the Patient Chart window. When you initiate the cost estimation, the Estimate Patient Cost window opens: Every time you specify and submit data on the Estimate Patient Cost window, a new cost estimation record will be created with a unique cost estimation ID. Multiple cost estimates can be created for one person, patient, appointment, or encounter. Estimate Patient Cost Fields Details are provided for the fields that define the distribu

Help Guide for NextGen® Enterprise PM 8

Cost Estimation for a Patient

In NextGen® Enterprise PM, a patient is a record that has a chart created in the practice and is denoted by . A chart includes the clinical and financial details related to the patient's encounters in the practice. A person can become a patient in the practice when a chart is created for the person. A patient record that has an account in the practice is denoted by . You can search for and find a patient in the practice on the Patient Lookup window. You can open the Patient Lookup window by selecting Chart on the toolbar or selecting Tasks > Lookup > Charts. You can use the search criteria to find the desired patient. To open the Estimate Patient Cost window, you can right-click the specific patient and select Estimate Patient Cost. If you initiate cost estimation for a patient using the Patient Lookup window, the following information is displayed. Demographic information of the person or patient and the guarantor All active and unhidden insurances Parent topic: Estimating Patient Cos

Applying Pre-Services Payment

Recommendations

Pre-Services Cost Estimation

Posting Transactions

Set Payment Preferences for Pre-Services

Configuring Pre-Services Practice Preferences

Estimating Patient Cost

Cost Estimation for a Patient

Pre-Services Cost Estimation

Posting Transactions

Set Payment Preferences for Pre-Services

Configuring Pre-Services Practice Preferences

Estimating Patient Cost

Cost Estimation for a Patient