Bill Multiple Encounters (Batch Billing)

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

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

Help Guide for NextGen® Enterprise PM 8

The Billing Process

The billing process in NextGen® Enterprise PM takes encounters that are in Unbilled or Rebill status and runs those encounters through a claim edits process. Any encounter that passes the claim edits gets a pending claim created that can be printed or exported and then submitted to insurance for payment. You can run the billing process for an individual encounter on demand, or for multiple encounters in a batch. Billing an Individual Encounter You can bill an individual encounter. Bill Multiple Encounters (Batch Billing) You can bill multiple encounters on the Encounter Lookup window. Billing In Progress Encounters You can bill In Progress encounters after converting an In Progress encounter to an Unbilled encounter. Billing Anesthesia Encounters You can bill anesthesia encounters in File Maintenance. Recurring Rental Billing You can enable Recurring Rental Billing in NextGen® Enterprise PM. Parent topic: Billing

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

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

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

Bill Multiple Encounters (Batch Billing)

Recommendations

Bill an Individual Encounter from Encounter Lookup

Billing Process Work Flow

The Billing Process

Claim Production Status Report

Bill an Individual Encounter from the Patient Chart

Encounters Operation

Bill an Individual Encounter from Encounter Lookup

Billing Process Work Flow

The Billing Process

Claim Production Status Report

Bill an Individual Encounter from the Patient Chart

Encounters Operation