Claims Consolidated Services Claim Sub-Tab

Help Guide for NextGen® Enterprise PM 8

Exempting CSC Encounters

CSC options can be set manually on the Consolidated Services Claim tab under the Claims tab on the Encounter Maintenance window. The options set on this tab override the rules in the Consolidated Services Claims library. On the Consolidated Services Claim sub-tab, you can you can do the following: Identify the responsible attending physician to display in the claim header for primary, secondary, and tertiary payers. Identify specific encounters to be exempt from a consolidated services claim. If there is an eligibility overlap during billing, the application displays the following error in the Claim Production Status report: CSC Eligibility Dates overlap with HOLD claims for encounter(s). Correct Eligibility. Parent topic: Claims Consolidated Services Claim Sub-Tab Parent topic: Consolidated Service Claims

File Maintenance Help for NextGen® Enterprise 8

Consolidated Services Claim Library Reports

The following File Maintenance reports are available for the Consolidated Services Claim library: Consolidated Services Claim Library Listing Report CSC Library with Timespan Details Report Consolidated Services Claim Library Listing Reports CSC Library with Timespan Details Report Parent topic: File Maintenance Library Reports

Help Guide for NextGen® Enterprise PM 8

Consolidated Services Claim Library

The Consolidated Services Claim (CSC) library enables you to establish rules for consolidating multiple encounter charges into a single consolidated services claim (CSC). The purpose of this library is to configure billing and claim form type rules for payers. This section includes the following topics: Security rights for user groups Consolidated Services Claim library CSC configuration rules for the consolidation of daily, weekly, monthly, and case related claims Provider hierarchy for claim headers Bill for eligible patient days You can generate the Consolidated Services Claim Library Listing report and the CSC Library with Timespan Details report from the Consolidated Services Claim library. For more information go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM. Set Up Security Access Rights for Consolidated Services Claims Consolidated Services Claim Library Setup Create a CSC Library Access a Consolidated Services Cla

Help Guide for NextGen® Enterprise PM 8

CSC Terms

The following table provides a list of terms associated with the consolidation process of claims. Term Description TS Time Span - claims that occur on the same date, week, month, or case. The time-span is identified in the CSC library. CCCP Case Claim Consolidation Program – The program rules established in the Consolidated Services Claim library to consolidate all claims attached to a Case. CCR Consolidated Claims Rules CSC Consolidated Services Claim CSC Candidate Encounter When a patient has multiple encounters per day. Each encounter can be a CSC candidate encounter. CSC Hold Claims These are the claims created after billing a CSC Candidate Encounter but prior to running the CSC process. Consolidated Claim After the charges from the CSC Hold Claims are consolidated into a CSC, the CSC Hold Claims become Consolidated claims. Claim-Header Encounter The claim header details are derived from this encounter. Primary Attending is selected in the Primary Responsible Attending field from t

File Maintenance Help for NextGen® Enterprise 8

Consolidated Services Claim Library

The Consolidated Services Claim (CSC) library enables you to establish rules for consolidating multiple encounter charges into a single consolidated services claim (CSC). The purpose of this library is to configure billing and claim form type rules for payers. This section includes the following topics: Security rights for user groups Consolidated Services Claim library CSC configuration rules for the consolidation of daily, weekly, monthly, and case related claims Provider hierarchy for claim headers Bill for eligible patient days You can generate the Consolidated Services Claim Library Listing report and the CSC Library with Timespan Details report from the Consolidated Services Claim library. For more information go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM. Set Up Security Access Rights for Consolidated Services Claims Consolidated Services Claim Library Setup Create a CSC Library Access a Consolidated Services Cla

Help Guide for NextGen® Enterprise PM 8

Consolidated Services Claim Library Setup

The Consolidated Services Claim Maintenance library window is organized by the following tabs: Claims Consolidation Rules tab enables you to set options to consolidate claims based on claim form types. Claim Header Rules tab enables you to set options for the claim header based on the provider specialty. Parent topic: Consolidated Services Claim Library

Claims Consolidated Services Claim Sub-Tab

Recommendations

Exempting CSC Encounters

Consolidated Services Claim Library Reports

Consolidated Services Claim Library

CSC Terms

Consolidated Services Claim Library

Consolidated Services Claim Library Setup

Exempting CSC Encounters

Consolidated Services Claim Library Reports

Consolidated Services Claim Library

CSC Terms

Consolidated Services Claim Library

Consolidated Services Claim Library Setup