Authorizations Report

Help Guide for NextGen® Enterprise PM 8

Authorizations Report

You can track insurance authorizations by using the Authorizations report. The report filters can be set up by effective date, payer, number of encounters, number of encounters left, units, and number of units left. To access the report in NextGen® Enterprise PM, Select the Reports menu and select General and then select Authorizations. Authorizations Report Columns Parent topic: General Reports

Help Guide for NextGen® Enterprise PM 8

Eligibility Referral Report

The Eligibility Referral report is available if your system is licensed for NextGen Eligibility Verification. You can use the report to track referral requests submitted to payers from NextGen® Enterprise PM. For more information, go to the NextGen Healthcare Success Community and download the User Guide for NextGen® Eligibility Verification Report configuration and filter options include Create Date, Status, Inquiry Type, Response Status, Payer Subgrouping, Primary Payer, Provider Subgrouping, and Rendering Provider. To access the report in NextGen® Enterprise PM, select Reports > General and then select Eligibility Referral. Eligibility Referral Report Columns Parent topic: General Reports

Help Guide for NextGen® Enterprise PM 8

Add Authorization and Referral information in the Encounters tab

Authorization involves requests for payer approval for services to be provided. You can track authorizations by using a single location, a single location and a speciality, and a single location and one or more providers line-level and claim-level authorizations. When authorization is not required to attach to a claim, you can track the authorization information for internal reference. You can track referrals by encounters use, pending encounters, and the number of encounters remaining on the referral. Open NextGen® Enterprise PM. On the main toolbar, select Chart, and then in Patient Lookup, enter your search criteria, and then select Find. Matching people and patient records appear in the search results. In Matching Records, select a patient record , and then select Open. The Patient Information tab opens in the Patient Chart window. Select the Encounters tab, and then select Insurance. In Encounter Insurance, right-click a listed insurance, and then select Authorization. Optional: T

Help Guide for NextGen® Enterprise PM 8

Access Authorization Results on Patient Chart

In NextGen® Enterprise PM, open a patient's chart. From the topics list on the far left, click the Clinical History/Notes tab to expand the Chart Notes folder. From the Chart Notes folder, click Authorization Results. The patient's authorization history opens and displays details like date and time of authorization, type of authorization, status of an authorization, and so on. From the authorization details, right-click to do the following: Open - View the authorization results Resubmit - Resubmit a previously submitted authorization New Authorization - Submit a new authorization Authorization History - opens Authorization Inquiry Parent topic: Authorization Results

Help Guide for NextGen® Enterprise PM 8

Prior Authorization

The authorization request processes and records response information received from the payer. Historical tracking and reporting of the responses is done in NextGen® Enterprise PM. The new authorization entry option appears where new or lookup referral options are available. Open Authorization Lookup You can search for prior authorizations using the search criteria. New Authorization Access Points You can access authorization history from People or Patient Lookup, Encounter Lookup, Appointment List, and so on. Authorization Inquiry Add a New Authorization Entry You can use the defined access paths to add a new authorization. Authorization Results

Help Guide for NextGen® Enterprise PM 8

Open Authorization Lookup

In NextGen® Enterprise PM, click Tasks > Lookup > Authorization. The Authorization Lookup displays. Enter the search criteria and click Find. The Authorization Listing displays the authorizations as shown in the following image. Authorization Lookup Details Parent topic: Prior Authorization

Authorizations Report

Recommendations

Authorizations Report

Eligibility Referral Report

Add Authorization and Referral information in the Encounters tab

Access Authorization Results on Patient Chart

Prior Authorization

Open Authorization Lookup

Authorizations Report

Authorizations Report

Eligibility Referral Report

Add Authorization and Referral information in the Encounters tab

Access Authorization Results on Patient Chart

Prior Authorization

Open Authorization Lookup