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
.
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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
Adjust the Case Reference Number for a Primary Payer
Access an existing case and then select the Financial tab. Select Primary Payer Ref Number. The Referral Listing window opens. Select the open menu icon and then select New. The Referral Code Tracking window opens. Enter the following required fields: Referral Code Effective Date Expiration Date 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
Add an Insurance Authorization
From the Ins/Diag tab, select the insurance for which an authorization is to be added. Right-click and select New Authorization from the menu. The Authorization Code Tracking window opens. In the Authorization Mode section, select one of the following: Encounter Mode: Select this button if the authorization is approved for a specific number of encounters. This button is selected by default. Units Mode: Select this button if the authorization is approved for a specific number of charge units. If the authorization is for tracking proposes only and should not be included on claims, select the Tracking Only - Do not send on claim check box. In the Authorization Code field, enter the authorization number obtained from the insurance company. This field is required. In the Effective Date field, enter the start date for the authorization. This field is required. In the Expiration Date field, enter the end date for the authorization. This field is required. In the Nbr Encounters field enter the
Help Guide for NextGen® Enterprise PM 8
Add Authorizations Code Tracking in the Encounter tab
The Authorization Code Tracking window displays encounters which use the authorization, and appointments pending the authorization. When authorization is not required to be attached to the claim,you can track authorizations for internal purposes. Line-level and claim-level authorizations are tracked by the following: A single location A single location and a specialty A single location and one or more providers. 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 on the Insurance tab under it. Right-click the insurance listed on the Encounter Insurance section, and select Authorization. The Authorization Listing window opens. Authorization Listing Win
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
icon and then select New.
The Authorization Code Tracking window opens.