Co-Pays on Charges with Calculated Amounts

Is charge Quantity >1?	Is charge Override price entered?	Is charge Extended amount recalculated?	Is Co-Pay applied to charge?
No	No	No	Yes
Yes	No	Yes	Yes
No	Yes	Yes	Yes
Yes	Yes	Yes	Yes

Help Guide for NextGen® Enterprise PM 8

Contract Adjustments on Charges with Calculated Amounts

When entering charges, the Quantity field defaults to 1, the Unit field displays the price per unit for the selected SIM code from the Service Items library, and the Override field defaults to the price per unit. The Extended field displays the total amount for the charge, calculated as follows: Quantity x Override = Extended If the user enters a Quantity greater than 1 or enters an override price per unit in the Override field, then the Extended amount is recalculated for the charge. The following chart shows various charge scenarios and whether a contract auto-adjustment will be applied to the charge: Is charge Quantity >1? Is charge Override price entered? Is charge Extended amount recalculated? Is Contract Adjustment applied to charge? No No No Yes Yes No Yes Yes No Yes Yes Yes (see Note 2) Yes Yes Yes (see Note 1) Yes (see Note 2) Note: When the charge Quantity is >1 and an Override price is entered, the Extended amount is recalculated only if the Calculate extended amount on over

Help Guide for NextGen® Enterprise PM 8

Field Descriptions for Entering a Charge

Use the following table to complete the fields for each charge entered on the encounter. Field Description Svc Dates Defaults to the Billable Date found on the Encounter Maintenance window. The From and To dates can be modified, by entering the date (MM/DD/YYYY) or by selecting the date from the Calendar button. Note: The encounter Billable Date and the charge Service Date are typically the same. Svc Item You can do one of the following: Enter or select the SIM code from the list. Enter or select the SIM description from the list. You can leave this field blank and press the Tab key to move to the SIM description field on the right. Note: The Service Item code is not sent on claims. CPT4 Shows the CPT4 code linked to the selected SIM code. This field cannot be modified. Note: The CPT4 code is sent on claims. Modifiers 1 - 4 In the Modifier fields to the right of CPT4, you can enter up to four 2-digit modifiers for the charge, if needed. Quantity Defaults to 1 and can be modified, if ne

Help Guide for NextGen® Enterprise PM 8

Retrieving Charge Amount in Cost Estimation

Charge amount is the amount a healthcare provider sets for the rendering services before applying any discounts. The pricing for a service depends on whether the place of service is a facility or non-facility location. If you are the administrator, you can set the Non-Facility Price and Facility Price fields for a specific SIM code in the SIM library and SIM exception. For information on setting up the pricing for a service item in File Maintenance, go to the NextGen Healthcare Success Community and download the File Maintenance Libraries Guide forNextGen®Enterprise. When you estimate the patient cost, the value for the charge amount is returned as follows: If the charge amount is set in the SIM exception and SIM library, the value in the SIM exception returns. If the charge amount is set in the SIM exception only, the value in the SIM exception returns. If the charge amount is set in the SIM library only, the value in the SIM library returns. If the charge amount is not set in the SIM

Help Guide for NextGen® Enterprise PM 8

Enter Dental Charges

Open NextGen® Enterprise PM, and then select Charges. The Charge Posting window opens. Select the desired patient and encounter. Do one of the following: To add a charge, select New. To modify a charge, select the charge and then select Open. In the Svc Dates fields, enter the service date range for the charge. These fields default to the Billable Date, when you select it on the Encounter Maintenance window. Select Svc Item, and then enter the applicable dental service item. The Unit and Override fields default to the price from the SIM Library. The Extended field is calculated as (Quantity x Override = Extended) and displays the total price for the charge. Select Modifier, and then enter up to four modifiers for the charge. Select Quantity, and then enter the desired quantity. The Quantity field defaults to 1. The Unit and Override fields default to the price from the SIM Library. The Extended field displays the total price for the charge. (Quantity x Override = Extended) Select Tooth

Help Guide for NextGen® Enterprise PM 8

Charge Posting Additional Fields

When enabled, additional fields appear on the Charge Posting window. One or more of these fields may be needed for specific types of billing. The following additional fields are available. Field Description Settings Tooth Selects a tooth for a dental charge. Practice Preferences > Charge Entry > Display tooth, surface, quadrant. Surface Selects one or more tooth surfaces for a dental charge. Practice Preferences > Charge Entry > Display tooth, surface, quadrant. Quadrant Selects an area of the mouth for a dental charge. Practice Preferences > Charge Entry > Display tooth, surface, quadrant. Batch You can enter a free-text batch description for each charge. Practice Preferences > Charge Entry > Display batch information. Additional Provider Selects an additional provider for a charge, such as a nurse. Practice Preferences > Charge Entry > Addtl prov. MD Anesthesia Selects a Medical Director of Anesthesia provider for an anesthesia charge. Anesthesia Library > All Medical Directors will

Help Guide for NextGen® Enterprise PM 8

Service Item Summary - Extended Amount and Transactions Report

This charge-based report retrieves all charges that fall into a selected date range. It then brings over all (or date-specified) transactions attached to those charges such as adjustments, payments, and refunds. It is sorted by practice, location name, and service item. To access the report in NextGen® Enterprise PM, select the Reports menu and select Monthly, then select Service Item Summary, and then select Extended Amount and Transactions. Note: This report can be enabled to use enhanced reporting functionality. For more information, see Enhanced Reports in NextGen® Enterprise PM. From the Report Filter window, select the Info button to view the following information about the report: Logic: All charges and transactions are tracked to the primary payer on the encounter. All transactions are tracked back to the original charge: If only a charge date range is entered; all charges within the specified date range are displayed and all transactions associated to those charges, regardless

Co-Pays on Charges with Calculated Amounts

Recommendations

Contract Adjustments on Charges with Calculated Amounts

Field Descriptions for Entering a Charge

Retrieving Charge Amount in Cost Estimation

Enter Dental Charges

Charge Posting Additional Fields

Service Item Summary - Extended Amount and Transactions Report

Contract Adjustments on Charges with Calculated Amounts

Field Descriptions for Entering a Charge

Retrieving Charge Amount in Cost Estimation

Enter Dental Charges

Charge Posting Additional Fields

Service Item Summary - Extended Amount and Transactions Report