Batch Status

Transaction Status	New Status of encounter after posting the transaction	Balance Control
Settled (if there is another payer)	R	Next Payer
Settled (if there is no other payer)	B	Patient
Rebill	R	Same Payer
Appeal	B	None
Deny	B	None
Forward to	B	Forwarded balances remain in a Billed status because while the balance moves to the next payer, the previous payer has forwarded the claim to the secondary or tertiary payer automatically - so a claim is not needed.

Help Guide for NextGen® Enterprise PM 8

Search for Transactions

You can search for transactions from the Transaction Ledger window. Access the Batch Posting window. Select the applicable batch, right-click and then select Ledger. In the Ledger Lookup window, right-click and select Ledger Lookup. The Ledger Lookup window opens. Do the following as applicable: Enter a source identification number. Select one of the following source type: Account Budget Encounter Invoice Enter a transaction date. Enter the total amount billed. Enter the allowed amount. Enter the payment amount for a transaction. Enter the adjustment or refund amount. Select one or more of the transaction codes that you want to include in your search criteria. Enter the tracking description. Enter the last name of the patient. Clear the Include Reconciled check box if you do not want to include reconciled transactions as part of your search criteria. Clear the Include UnPosted check box if you do not want to include unposted transactions as part of your search criteria. Select Find. Pa

Help Guide for NextGen® Enterprise PM 8

Managing Batches

In NextGen® Enterprise PM, batches are sets of payment, adjustment, and refund transactions. You can create batches for each location, each day, or for each practice. For example, a batch can be created for a check-in staff to record all the transactions for the day. You can secure a batch or an enterprise batch grouping to a single user for security purposes. Any user without the appropriate security rights cannot access the transactions in the batch. You can also choose to remove an entire enterprise batch grouping from the list if none of the sub-batches are secured to the current user. You can use the Batch Maintenance window to manage batches for a given practice. Batch Status You can use the batch status for payment batches to denote the flow of line item balance. Determining the Active Batch You can only post transactions to a batch marked as active on the Batch Posting window. Balance the Batch Header Record Using Recalc Function in Payment Entry You can use the Recalc button o

Help Guide for NextGen® Enterprise PM 8

Rebill a Batch for Secondary Insurance

Once you receive payment from the primary insurance, you can bill secondary and tertiary insurances. When an insurance is settled and responsibility has moved to the next bucket (i.e., primary insurance has paid and now it is time to bill secondary), the encounter reverts to a Rebill status. Then you must go through the billing process again. The system does not automatically rebill. Rebilling encounters is very similar to creating claims for the primary payer. From the main toolbar, select the Encounter Lookup button. In the Bill Status field, select Rebill. Follow the steps described in Billing Multiple Encounters. Note: The Include Encounters in a Billing Hold check box enables you to include or exclude encounters that are on a billing hold. For example, when searching for Rebill encounters to bill again, you may not want encounters that are being held. Therefore, you would not select this option. Parent topic: Billing Process Work Flow

Help Guide for NextGen® Enterprise PM 8

Basic Overview

When In Progress Billing is enabled for a practice, new encounters created can have a status of In Progress instead of Unbilled. These encounters represent on-going work or care that has started, but that has not yet been completed. Therefore, they are held from the normal batch billing process that typically includes encounters in Unbilled and Rebill status. Charges and transactions can be entered on In Progress encounters. However, those charges and transactions will have a blank process date. Without a process date, those amounts are not officially included in the financials and receivables on reports for the practice. After the work or care is completed on an In Progress encounter, the encounter goes through a process that converts it to Unbilled status. If the encounter was billed while it was In Progress, then the process converts it to Billed status. During the conversion, a process date is associated to all charges and transactions on the encounter, and those amounts become par

Help Guide for NextGen® Enterprise PM 8

Billing Process Work Flow

After charges are applied to an encounter, you can: Bill the encounter to the guarantor (for encounters with no attached insurance) - or - Bill the encounter to a payer (for encounters with attached insurance). You can bill only those encounters with an Unbilled (U) or a Rebill (R) encounter status. To bill a single encounter, access the Chart > Encounters tab, right-click on the encounter you want to bill, and select Bill from the menu. To bill multiple encounters at once (Batch billing), access the Encounter Lookup window, enter search criteria to locate Unbilled encounters, select the encounters you want to bill from the list of matching records, right-click and select Bill from the short-cut menu. You can review the charges applied to the encounter in the Encounter Bill window. For encounters with insurance, the application generates a claim by checking the encounter against the Claim Edits that are configured in the Claim Edits library. The results of this Claim Edit check display

File Maintenance Help for NextGen® Enterprise 8

In Progress Billing Setup

The In Progress encounter status represents work or care that has not been completed and, therefore, would not be stated in the accounts receivables. For example, you could use the status to represent orthotic or prosthetic devices that are not yet completed or for pre-paid patient care that is not yet administered. When NextGen® Enterprise PM users enter charges and transactions for an In Progress encounter, those items will contain blank process dates and, therefore, cannot officially be included in the financials and cannot be part of the receivables. After a user creates an encounter in an In Progress status, a process can change the status from In Progress to Unbilled, which is the normal status for an encounter that has yet to go through billing and produce a claim. When the status changes to Unbilled, all charges and transactions entered for the In Progress encounter become posted and the system sets the processing and closing dates on the transactions and charges. If there is a

Batch Status

Recommendations

Search for Transactions

Managing Batches

Rebill a Batch for Secondary Insurance

Basic Overview

Billing Process Work Flow

In Progress Billing Setup

Search for Transactions

Managing Batches

Rebill a Batch for Secondary Insurance

Basic Overview

Billing Process Work Flow

In Progress Billing Setup