Bill an Individual Encounter from the Patient Chart

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 Encounter Lookup

Open NextGen® Enterprise PM. Select Encounter. The Encounter Lookup window opens. In the Bill Status field, select Rebill or 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 encounter. Select Find. Encounters matching the search criteria display in the Encounter List section of the window. Select Encounter List, and then select the encounter to be billed in the Enc Nbr column. Right-click the encounter, and then select Bill. If the encounter is a self-pay encounter with no insurance attached, 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 en

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

Help Guide for NextGen® Enterprise PM 8

Working with the Report

This Claim Production Status report displays claim errors and the status of the encounters you have billed. The text displays in colors. These colors indicate the following: Green text indicates that the claim is clean and a pending claim request has been successfully created. Note: Self-pay encounters may display here as well depending on your practice preferences. Blue text indicates items that you flagged as warnings in the Claim Edits library. A pending claim request has been successfully created. Red text indicates an error that is required to be corrected. Items with red error messages will not create claim requests. Black text typically indicates that no charges have been selected for billing. This could occur under the following circumstances: If you try to bill records without charges If an encounter is in a rebill or unbilled status, but no line items were errors, review the error to determine the field to be corrected. The following are examples of errors and where the error

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

Bill an Individual Encounter from the Patient Chart

Recommendations

Bill an Individual Encounter from the Charge or Payment Window

Bill an Individual Encounter from Encounter Lookup

Bill Multiple Encounters (Batch Billing)

Claim Production Status Report

Working with the Report

Billing Process Work Flow

Bill an Individual Encounter from the Charge or Payment Window

Bill an Individual Encounter from Encounter Lookup

Bill Multiple Encounters (Batch Billing)

Claim Production Status Report

Working with the Report

Billing Process Work Flow