Bill an Individual Encounter from Encounter Lookup

Help Guide for NextGen® Enterprise PM 8

Bill an Individual Encounter from the Charge or Payment Window

Open the Charge Posting or Payment Entry window for the desired patient encounter. From the toolbar, select the Bill Encounter button. The Encounter Bill window opens listing all charges on the encounter. If the encounter has a status of Unbilled, charges are pre-selected for billing and if the encounter has a status of Rebill, you must select the charges to be billed. To bill the selected charges, select OK. A message appears stating that do you want to bill this self-pay encounter. Select Yes. The encounter status changes from Unbilled or Rebill to Billed. If the encounter has insurance attached, the encounter goes through the claim edits process and the Claim Production Status report appears. The encounter is listed on the report with a message in one of the following colors. Green: An informational message indicating the encounter passed all claim edits. A pending claim is created. Blue: A warning message indicating the encounter passed all claim edits, but information is included

Help Guide for NextGen® Enterprise PM 8

Bill an Individual Encounter from the Patient Chart

Open the Patient Chart for the desired patient. Select the Encounters tab. From the Encounters list, select the encounter to be billed. Do one of the following: From the main toolbar, select Bill. From the Tasks menu, select Demand, and then Demand Bill. Right-click and select Bill. The Encounter Bill window opens listing all charges on the encounter. If the encounter has a status of Unbilled, charges are pre-selected for billing and if the encounter has a status of Rebill, charges to be billed must be selected. To bill the selected charges, select OK. A message appears stating that do you want to bill this self-pay encounter. Select Yes. The encounter status changes from Unbilled or Rebill to Billed. If the encounter has insurance attached, the encounter goes through the claim edits process and the Claim Production Status report appears. The encounter is listed on the report with a message in one of the following colors. Green: An informational message indicating the encounter passed

Help Guide for NextGen® Enterprise PM 8

Bill Multiple Encounters (Batch Billing)

All encounters in Unbilled or Rebill status with charges can be billed at the same time in a batch. Open NextGen® Enterprise PM. Select Encounter. The Encounter Lookup window opens. Select Bill Status, and then select Rebill and Unbilled. Note: Encounters with a status of Bad Debt, Billed or History have already been billed. Clear the Include records without charges check box to exclude encounters that do not have charges. Enter additional Search Criteria to locate the desired encounters. Select Find. Encounters matching the search criteria appear in the Encounter List section of the window. Select Encounter List, and then select all encounters to be billed in the Enc Nbr column. Right-click the encounter and select Bill. A message appears stating that confirm bill processing for the [n] selected encounters. To continue billing the selected encounters, select OK. The encounters go through the claim edits process and the Claim Production Status report appears. Each encounter is listed o

Help Guide for NextGen® Enterprise PM 8

Claim Production Status Report

The Claim Production Status report is automatically generated when one or more encounters are billed in NextGen® Enterprise PM. After the claim edits process completes for all encounters, the report generates and appears on screen. The report identifies whether the encounters passed or failed claim edits by displaying each encounter in one of the following text colors: Green: Indicates the encounter passed all claim edits and a pending claim is created for the payer. Self-pay encounters also display in green if the Include Self-Pay Encounters In Claim Billing Report option is enabled in Practice Preferences > Claims. Blue: Indicates the encounter failed one or more claim edits that are set up in the Claim Edits Library with Severity = Warning, and a pending claim is created for the payer. Red: Indicates the encounter failed one or more claim edits that are set up in the Claim Edits Library with Severity = Build, Critical or Required, and a pending claim is not created for the payer. To

System Administrator Help

Encounters Operation

Subgroup Used in Description Add Patient Encounter NextGen® Enterprise PM & NextGen® Enterprise EHR Enables users to create encounters. Convert In Progress Batch Process NextGen® Enterprise PM Enables users to change the status of multiple encounters from "In Progress" to "Unbilled". Convert In Progress Demand Process NextGen® Enterprise PM Enables users to change the status of an encounter from "In Progress" to "Unbilled". Convert In Progress Indicator NextGen® Enterprise PM &NextGen® Enterprise EHR Enables users to modify (select or clear) the Convert In Progress check box on the Encounter Maintenance window. Delete Encounter Rate SIM and Rate NextGen® Enterprise PM Enables users to delete an encounter rate SIM and encounter rate amount from Encounter Maintenance. Delete Patient Encounter NextGen® Enterprise PM &NextGen® Enterprise EHR Enables users to delete patient encounters. Demand Bill NextGen® Enterprise PM Enables users to access the Bill toolbar button or right-click menu to

Help Guide for NextGen® Enterprise PM 8

Rebill an Encounter using Balance Control

Encounters that have already been billed to insurance can be rebilled for a variety of reasons. For example, a new charge can be added to the encounter, an existing charge can be corrected and modified, or insurance has not responded to the initial claim. Balance Control is used to flag one or more charges on an encounter to be rebilled to insurance. To flag all the charges to be rebilled, do the following: Open NextGen® Enterprise PM. Select Charges. The Charge Posting window opens. Select the desired patient and encounter, and then select the Balance Control icon. The Balance Control window opens. Right-click in the R (Release to Bill) column for the payer to be rebilled. Select Select All Ins. All line items show check mark in the R (Release to Bill) column, the encounter status changes to Rebill, and the Rebill Encounter check box is automatically selected. To save changes and close the window, select OK. To flag specific charges to be rebilled, do the following: Open the Balance C

Bill an Individual Encounter from Encounter Lookup

Recommendations

Bill an Individual Encounter from the Charge or Payment Window

Bill an Individual Encounter from the Patient Chart

Bill Multiple Encounters (Batch Billing)

Claim Production Status Report

Encounters Operation

Rebill an Encounter using Balance Control

Bill an Individual Encounter from the Charge or Payment Window

Bill an Individual Encounter from the Patient Chart

Bill Multiple Encounters (Batch Billing)

Claim Production Status Report

Encounters Operation

Rebill an Encounter using Balance Control