Charge Posting Window

File Maintenance Help for NextGen® Enterprise 8

Charge Posting Window

The alerts message shows a $50.00 automatic adjustment, which is the difference between the charge amount and the allowed amount specified in the contract for this CPT4 code. Select . The Charge Posting window opens with the automatic adjustment. Parent topic: Set Up Auto Charge Adjustments for Non-Participating Providers

Help Guide for NextGen® Enterprise PM 8

Example of an Auto Adjustment for a Non-Participating Provider

This example shows the contract set up to automatically adjust the charge to 70% for the primary insurance and 30% for the guarantor. Contract Automatic Adjustment Charge Posting Window Parent topic: Set Up Auto Charge Adjustments for Non-Participating Providers

Help Guide for NextGen® Enterprise PM 8

Automatic Adjustments Overview

You can apply automatic adjustments at the time of charge posting to adjust the difference between the charge amount for a procedure and the allowed amount for the payer. Charge Amount - Allowed Amount = Adjustment Amount When you enter and save a charge on the Charge Posting window, the Contract can be linked to the payer (insurance) on the charge. If there is a contract linked to the payer, the CPT4 code for the charge is included in the Fee Schedule set up within the contract and the Automatically adjust charges option is enabled in the setup of the contract, then the automatic adjustment is applied to the charge. Automatic Adjustments - Additional Information You can use some additional information while working with automatic adjustments. Contract Automatic Adjustment Contract Adjustments on Charges with Calculated Amounts Reversing Automatic Adjustments You can reverse automatic adjustments on the Reverse Automatic Adjustments window. Reverse and Correct Auto-Adjustments after a

Help Guide for NextGen® Enterprise PM 8

Contract Automatic Adjustment

When you enter a charge for SIM code with a price for a patient and primary insurance, the contract linked to the insurance specifies that the allowed amount is for the CPT4 code. You can create an automatic adjustment when the Automatically adjust charges option is enabled for the contract. Charge Amount - Allowed Amount = Adjustment Amount The automatic adjustment displays in the Adjustment column in the charge ledger section of the Charge Posting window. You can view the summary information for the adjustment transaction on the Transactions sub-tab of the Patient Chart > Encounters tab. You can view the transaction details on the Payment Entry window. Parent topic: Automatic Adjustments Overview

Help Guide for NextGen® Enterprise PM 8

Contract Exceptions

When comparing the contractual amounts to the actual amounts in the Adjustment Amount subcategory, the following three columns are analyzed: The Cont Adj Amt (Contract Adjustment Amount) The values that display in the Cont Adj Amt (Contract Adjustment Amount) column are derived from a calculation generated by the application. To calculate the Cont Adj Amt, use the following equation: Cont Allowed Amt (minus [–]) Reimbursement (equals [=]) Cont Adj Amt For this example, the following Contract values are used: Cont Allowed Amt: $55.00 Reimbursed: $49.50 Cont Adj Amt: $5.50 The Act Adj Amt (Actual Adjustment Amount) The values that display in the Act Adj Amt (Actual Adjustment Amount) column come from Adjustments field on the Charge Posting window where adjustments are automatically calculated by the application, based on the contract information. Note: The Act Adj Amt (Actual Adjustment Amount) that displays on the Charge Posting window and the Contractual Analysis report is a negative d

Help Guide for NextGen® Enterprise PM 8

Contracts

When comparing the contractual amounts to the actual amounts in the Adjustment Amount subcategory, the following three columns are analyzed: The Cont Adj Amt (Contract Adjustment Amount) The values that display in the Cont Adj Amt (Contract Adjustment Amount) column are derived from a calculation generated by the application. To calculate the Cont Adj Amt, use the following equation: Cont Allowed Amt (minus [–]) Reimbursement (equals [=]) Cont Adj Amt For this example, the following Contract values are used: Cont Allowed Amt: $55.00 Reimbursed: $49.50 Cont Adj Amt: $5.50 The Act Adj Amt (Actual Adjustment Amount) The values that display in the Act Adj Amt (Actual Adjustment Amount) column come from Adjustments field on the Charge Posting window where adjustments are automatically calculated by the application, based on the contract information. Note: The Act Adj Amt (Actual Adjustment Amount) that displays on the Charge Posting window and the Contractual Analysis report is a negative d

Charge Posting Window

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