Behavioral Health Billing for Programs with Thresholds

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

Enable In Progress Billing

Access NextGen® Enterprise PM. From the Admin menu, select Preferences, and then Practice. The Practice Preferences window opens. From the Preference List, select Encounters. To enable In Progress Billing for the practice, select the Enable In Progress billing status check box. A prompt appears stating that allowing 'In Progress' status cannot be undone once it is turned on. To continue and enable this feature, select Yes. The following additional Practice Preference options related to In Progress Billing become available: Default all new encounters to In Progress (see Default New Encounters to In Progress Status) Allow Execution of NextGen® Enterprise EHR procedure Trigger against locked encounter Use Convert In Progress Indicator Enable Recurring Rental Billing For more information on the above options related to In Progress Billing, go to the NextGen Healthcare Success Community and download the File Maintenance Preferences Guide for NextGen® Enterprise. To save changes and close th

Help Guide for NextGen® Enterprise PM 8

In Progress Billing Status

The Enable In Progress billing status option in Practice Preferences > Encounters activates specific features and functionality in NextGen Enterprise PM as described below. Basic Overview Behavioral Health Billing for Programs with Thresholds Enable In Progress Billing Default New Encounters to In Progress Status Parent topic: Practice Preferences for Programs

Help Guide for NextGen® Enterprise PM 8

Behavioral Health Billing Library

The Behavioral Health Billing library defines parameters for “variance” charges which can be calculated and added to encounters during the billing process for specific payers. The library also defines other claim and billing parameters that may be needed when billing Behavioral Health services to specific payers. A single library can be created and linked to the practice to be used for all payers. Or payer-specific libraries can be created and linked only to those payers. You can generate the Behavioral Health Billing report from the Behavioral Health Billing library , go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM. Add or Modify a Behavioral Health Billing Library Parent topic: Behavioral Health Billing

File Maintenance Help for NextGen® Enterprise 8

Behavioral Health Billing Library

The Behavioral Health Billing library defines parameters for “variance” charges which can be calculated and added to encounters during the billing process for specific payers. The library also defines other claim and billing parameters that may be needed when billing Behavioral Health services to specific payers. A single library can be created and linked to the practice to be used for all payers. Or payer-specific libraries can be created and linked only to those payers. You can generate the Behavioral Health Billing report from the Behavioral Health Billing library , go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM. Add or Modify a Behavioral Health Billing Library Set Up Charge Options Set Up Claim Options Set Up Billing Options

Help Guide for NextGen® Enterprise PM 8

Practice Preferences for Programs

To use Programs in NextGen® Enterprise PM, you must first enable programs for the practice in Practice Preferences. When enabled, the following program-related functionality is available: On the Patient Information tab in the Patient Chart, a Programs sub-tab appears. From this sub-tab, you can enroll a patient in one or more programs. On the Encounter Maintenance window, a Program field appears on the General tab. From this field, you can link an encounter to a program. On the Encounters tab in the Patient Chart, the Program name displays for encounters linked to a program under the General sub-tab. If your practice uses In Progress Billing, you can enable the Limit to Valid Programs option in Practice Preferences to ensure new encounters created in NextGen® Enterprise PM that are linked to a specific program automatically default to In Progress status. For example, you can default new encounters linked to Program ABC to In Progress status, so they are held from the billing and claims

Behavioral Health Billing for Programs with Thresholds

Recommendations

Basic Overview

Enable In Progress Billing

In Progress Billing Status

Behavioral Health Billing Library

Behavioral Health Billing Library

Practice Preferences for Programs

Basic Overview

Enable In Progress Billing

In Progress Billing Status

Behavioral Health Billing Library

Behavioral Health Billing Library

Practice Preferences for Programs