NextGen Knowledge Center

Behavioral Health Rounding

If Behavioral Health SIM codes with standard (15, 30, 60, 240) or custom Base Minutes are set up in the Service Items Library for billing in NextGen® Enterprise PM, then the Behavioral Health Base Minute Rounding Methods should be defined for each payer. The rounding methods affect how the units are calculated on a behavioral health charge for the payer based on the total time entered for the charge.

For more information on Behavioral Health Billing, go to the NextGen Healthcare Success Community and download the Behavioral Health Billing User Guide for NextGen® Enterprise PM.

FieldDescription
Base MinutesThe "standard"Base Minutevalues (15, 30, 60 and 240) display in separate rows with a default rounding method for the payer as follows:
  • 15 minutes:Down at 7, Up at 8, Less than 8 is 0
  • 30 minutes:Down at 14, Up at 15, Less than 15 is 0
  • 60 minutes:Down at 29, Up at 30, Less than 30 is 0
  • 240 minutes:Down at 119, Up at 120, Less than 120 is 0
For example, if the base minutes for a SIM code is set to15 minutes, and the 15 minute rounding method for the payer is set to the defaultDown at 7, Up at 8, Less than 8 is 0, then units are calculated based on the total time entered for a charge as follows:
  • Charge Total Time = 7 minutes Units = 0
  • Charge Total Time = 8 minutes Units = 1
  • Charge Total Time = 15 minutes Units = 1
  • Charge Total Time = 22 minutes Units = 1
  • Charge Total Time = 23 minutes Units = 2

To customize aBase Minute Rounding Methodfor the payer, select the row for the desiredBase Minutesand modify the following fields as needed.

Down/ExactSelect one of the following for theBase Minutevalue:
  • Down (default)
  • Exact
Down AtThis field is enabled only whenDownis selected. Enter the number of minutes, between 1 and 999999, at which units round down for the payer.

The default value is calculated as follows:

Down At= (Base Minutes/ 2) - 1

Up AtThis field displays the number of minutes at which units round up for the payer. The field is disabled and is updated by modifying theDown Atvalue.

The value is calculated as follows:

Up At=Down At+ 1

Less Than is 0Enter the number of minutes, between 1 and 999999, at which units round down to zero for the payer.

The default value is calculated as follows:

Less Than is 0=Base Minutes/ 2

Decimal PlaceThis field is enabled only whenExactis selected. Select one of the following:

First (default): Rounds units to the first decimal place.

Second: Rounds units to the second decimal place.

Behavioral Health Custom Base Minute Rounding MethodsThis additional section appears only if you have set up one or more Behavioral Health SIM codes with "custom"Base Minutesin the Service Items Library.

Each "custom"Base Minutevalue displays in a separate row with a default rounding method for the payer. The defaultDown At,Up AtandLess Than is 0values are calculated as described above.

To customize aCustom Base Minute Rounding Methodfor the payer, select the row for the desiredBase Minutesand modify the fields as described above.