Billing an Individual Encounter

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

View Eligibility Information for a Patient

Open NextGen® Enterprise PM. On the main toolbar, select Chart or Chart Lookup.. The Patient Lookup window opens. In the Search Criteria section, enter the patient's information, and select Find. Patient records that match the search criteria appear in the Matching Records section. Select the patient and then select Open. The Patient Chart window opens. Select the Encounters tab. From the Encounters list, select an encounter with a payer attached. Access the patient's chart and select the Encounters tab. Select the Insurance tab. The eligibility information is located in the Verification section of the window. Parent topic: Viewing Insurance Information in Encounters

Help Guide for NextGen® Enterprise PM 8

Enable Qualifying Encounter Billing

The Encounter Rate Billing functionality in NextGen® Enterprise PM includes logic that identifies multiple encounters for a patient on the same date of service at the same location with the same encounter rate payer. Qualifying Encounter Billing must be enabled for the practice. When enabled, the Encounter Rate Billing Status fields display on the Billing & Collections tab of the Encounter Maintenance window. These fields are used to determine which encounter to bill when a patient has multiple same-day encounters with more than one provider at the same location with the same encounter rate payer attached. Access NextGen® Enterprise PM. From the Admin menu, select Preferences, and then Practice. The Practice Preferences window opens. From the Preference List, select Claims. Select the Enable Qualifying Encounter Billing check box. To save changes and close the window, select OK. Parent topic: Practice Preferences for Encounter Rate Billing

Help Guide for NextGen® Enterprise PM 8

Viewing Financial Information

Viewing Financial Information Viewing Financial Information You can view the patient's financial history by selecting the Financial tab of the patient chart. The Financial tab lists all the encounters that are associated with the patient and provides details of the payments received according to the primary, secondary, or tertiary insurances. Double-click an encounter in the list to expand the view to the charge level. For more information on adding charges to an encounter or billing an encounter, go to NextGen Healthcare Success Community, and download the latest Billing and Collections Guide for NextGen® Enterprise PM. Financial Tab Components of the Financial Information Details of the financial information in the Financial tab of the patient chart. Filter Encounters on the Patient Chart You can use the Financial tab in the patient chart to filter encounters. Print Fee Tickets You can use the Financial tab in the patient chart to print fee tickets on demand from the patient's chart.

Help Guide for NextGen® Enterprise PM 8

View Alternate Payer Details for an Encounter

If an alternate payer is associated with an encounter insurance, then the alternate payer details appear in the Alternate Payer Details section. Open a patient chart. Select the Encounter tab and then select the Insurance sub-tab. In the Encounters list, select an encounter having an alternate payer associated with a payer. Select an encounter insurance in the Encounter Insurance section. The alternate payer details appear in the Alternate Payer Details section. Parent topic: Encounters in NextGen Enterprise PM

Help Guide for NextGen® Enterprise PM 8

Encounters in NextGen® Enterprise PM

An encounter is an interaction between a patient and a provider in the practice on a specific date and time. In NextGen® Enterprise PM, office encounters are typically created from the appointment book when each patient checks in for their appointment. Facility encounters that are not related to an appointment, such as hospital and nursing home visits, can be created from the patient's chart. Clinical information related to a specific encounter is documented by the provider in NextGen® Enterprise EHR. Financial information, such as charges, billing and transactions, is entered on that same encounter by users in NextGen® Enterprise PM. The Encounters tab on Patient Chart lists all encounters for a patient, and the Encounters Detail tab on Account Profile lists all encounters for a guarantor. For more information on encounters in NextGen® Enterprise EHR, go to the NextGen Healthcare Success Community and download the Layout and Preferences Guide for NextGen® Enterprise EHR. Encounter Sta

Billing an Individual Encounter

Recommendations

The Billing Process

View Eligibility Information for a Patient

Enable Qualifying Encounter Billing

Viewing Financial Information

View Alternate Payer Details for an Encounter

Encounters in NextGen® Enterprise PM

The Billing Process

View Eligibility Information for a Patient

Enable Qualifying Encounter Billing

Viewing Financial Information

View Alternate Payer Details for an Encounter

Encounters in NextGen® Enterprise PM