Change in AR w/o Enc Rate Report

Help Guide for NextGen® Enterprise PM 8

Change in AR w/o Enc Rate Report

The Change in A/R w/o Enc Rate by encounter report allows health centers to view charges and adjustments related to their encounter rate billing. The report is a modified version of the Monthly Changes in A/R by Encounter report. It can be used for specific payers using encounter rate billing. With encounter rate billing, total charges are inflated if the Encounter Rate Library is configured to add the Encounter Rate SIM code as an additional charge onto each encounter during the billing process. Note: Charges are not inflated if the Encounter Rate Billing library is configured to insert the Encounter Rate SIM code in Encounter Maintenance > Billing & Collections tab. Total adjustments can also be inflated if the Encounter Rate Billing library is configured to auto-adjust charges during the billing process, or if a contract for the encounter rate payer exists to auto-adjust charges during charge posting. The report has filters that identify encounter rate payers (Enc Rate Payers) and e

Help Guide for NextGen® Enterprise PM 8

Enter an Encounter-Level Narrative for an ER SIM Code

If the Encounter Rate Library for the payer is setup to insert the ER SIM into encounter maintenance, then the ER SIM automatically inserts on the Encounter Rate sub-tab on the Billing & Collections tab of the Encounter Maintenance window when the encounter is billed. An encounter-level narrative can be manually entered for an Encounter SIM either before or after the encounter is billed. Access Patient Chart for the desired patient. Select the Encounters tab. Double-click to open the desired encounter. The Encounter Maintenance window appears. Select the Billing & Collections tab, and then the Encounter Rate sub-tab. In the Narrative field for the primary, secondary or tertiary encounter rate payer, enter a free-text comment for the ER SIM. The maximum is 80 characters. If the encounter is in Unbilled status prior to entering the narrative, select OK to save changes and close the window. If the encounter is in Billed status prior to entering the narrative, you get a prompt asking if yo

Help Guide for NextGen® Enterprise PM 8

Enter an Encounter-Level Narrative for an ER SIM Code

If the Encounter Rate Library for the payer is setup to insert the ER SIM into encounter maintenance, then the ER SIM automatically inserts on the Encounter Rate sub-tab on the Billing & Collections tab of the Encounter Maintenance window when the encounter is billed. An encounter-level narrative can be manually entered for an Encounter SIM either before or after the encounter is billed. Access Patient Chart for the desired patient. Select the Encounters tab. Double-click to open the desired encounter. The Encounter Maintenance window appears. Select the Billing & Collections tab, and then the Encounter Rate sub-tab. In the Narrative field for the primary, secondary or tertiary encounter rate payer, enter a free-text comment for the ER SIM. The maximum is 80 characters. If the encounter is in Unbilled status prior to entering the narrative, select OK to save changes and close the window. If the encounter is in Billed status prior to entering the narrative, you get a prompt asking if yo

Help Guide for NextGen® Enterprise PM 8

Encounter Rate SIM Narrative for Claims

The Narrative field on the Charge Posting window, or on the Encounter Rate sub-tab on the Billing & Collections tab of the Encounter Maintenance window, can be used to enter a free-text narrative, or comment, for the ER SIM code on the encounter. This populates the narrative segment for the ER SIM on claims for the primary, secondary or tertiary encounter rate payer. Charge-Level Narrative To include a charge-level narrative for an ER SIM on claims, the Encounter Rate Billing library for the payer must include the following settings on the Claims tab: Display narrative on ER SIM charge Line? = Yes From what field should the narrative data pull from? = Charge Entry If a narrative exists on the Charge Posting window for the ER SIM charge line, then it is used on the claim. If the narrative for the ER SIM charge line is blank, then the narrative for the first charge line is used on the claim. Charge Posting Encounter-Level Narrative To include an encounter-level narrative for an ER SIM on

Help Guide for NextGen® Enterprise PM 8

Add or Modify SIM Codes for Encounter Rate Billing

In the Service Items library, you must create an Encounter Rate SIM code for each Encounter Rate CPT4 code. To add or modify a SIM code for encounter rate billing, do the following: Access File Maintenance. Select Libraries, and then Service Items. The Service Items List window opens. From the list, select a library and then select Open Menu and select Open. The Service Item Library Maintenance window opens. Do one of the following: To add an Encounter Rate SIM code, select Open Menu and select New. To modify an Encounter Rate SIM code, search for the code and then select the code from the list on the left. Service Item Library Maintenance In the CPT4 Code field, enter the encounter rate CPT4 code and then press Tab. In the two Modifier fields, press Tab to leave the fields blank. The Service Item # field automatically defaults to the encounter rate CPT4 code. Press Tab. The Description field automatically defaults to the description for the encounter rate CPT4 code. Press Tab. On the

Help Guide for NextGen® Enterprise PM 8

Add or Modify SIM Codes for Encounter Rate Billing

In the Service Items library, you must create an Encounter Rate SIM code for each Encounter Rate CPT4 code. To add or modify a SIM code for encounter rate billing, do the following: Access File Maintenance. Select Libraries, and then Service Items. The Service Items List window opens. From the list, select a library and then select Open Menu and select Open. The Service Item Library Maintenance window opens. Do one of the following: To add an Encounter Rate SIM code, select Open Menu and select New. To modify an Encounter Rate SIM code, search for the code and then select the code from the list on the left. Service Item Library Maintenance In the CPT4 Code field, enter the encounter rate CPT4 code and then press Tab. In the two Modifier fields, press Tab to leave the fields blank. The Service Item # field automatically defaults to the encounter rate CPT4 code. Press Tab. The Description field automatically defaults to the description for the encounter rate CPT4 code. Press Tab. On the

Change in AR w/o Enc Rate Report

Recommendations

Change in AR w/o Enc Rate Report

Enter an Encounter-Level Narrative for an ER SIM Code

Enter an Encounter-Level Narrative for an ER SIM Code

Encounter Rate SIM Narrative for Claims

Add or Modify SIM Codes for Encounter Rate Billing

Add or Modify SIM Codes for Encounter Rate Billing

Change in AR w/o Enc Rate Report

Change in AR w/o Enc Rate Report

Enter an Encounter-Level Narrative for an ER SIM Code

Enter an Encounter-Level Narrative for an ER SIM Code

Encounter Rate SIM Narrative for Claims

Add or Modify SIM Codes for Encounter Rate Billing

Add or Modify SIM Codes for Encounter Rate Billing