Components of the Referral Code Tracking Window

Field	Action
Encounter Mode	Select this button if the referral is approved for a specific number of encounters. This button is selected by default.
Units Mode	Select this button if the referral is approved for a specific number of charge units.
Referral Code	Enter the referral number obtained from the insurance company. This field is mandatory.
Effective Date	Enter the start date for the referral. This field is mandatory.
Expiration Date	Enter the end date for the referral. This field is required
Nbr Encounters	Enter the number of encounters approved for the referral. Note: This field is not available for Units Mode referrals.
Used	This field displays 0. The number increments by 1 each time the referral is linked to an encounter. The number cannot exceed the number in the Nbr Encounters field.
Pending	This field displays 0. The number increments by 1 each time an appointment is scheduled for the patient. The number cannot exceed the number in the Nbr Encounters field.
Encounters Left	This field defaults to the number entered in the Nbr Encounters field. The number decrements by 1 each time the referral is linked to an encounter.
Rendering	Select one or more rendering providers for the referral, or leave blank if any rendering provider can be used with the referral
Location	Select a location for the referral, or leave blank if any location can be used with the referral.
Specialty	Select a rendering provider specialty for the referral, or leave blank if any provider specialty can be used with the referral
Description	Enter a text description for the referral.
ICD	Enter one or more ICD code ranges for the referral, or leave blank if any ICD code can be used with the referral.
CPT4	Enter one or more CPT4 code ranges for the referral.
Nbr Units	Enter the number of charge units approved for the referral for each CPT4 code range.
Units Left	This field defaults to the number entered in the Nbr Units field. The number decrements by 1 each time the referral is linked to an encounter with a charge that falls within the CPT4 code range.

Help Guide for NextGen® Enterprise PM 8

Components of Authorization Code Tracking window

Field Description Authorization Mode Select one of the following options: Encounter Mode - when the authorization is for the entire encounter. Units Mode - when the authorization is for units (procedures). Tracking Only - do not send on claim Select this check box to track the number of encounters or units on authorizations for internal purposes. The authorization tracking totals are not sent on the claim or the EDI file. Authorization Code Enter the authorization code provided by the insurance company. Effective Date Select the effective date from the pop-up calendar. Expiration Date Select the expiration date from the pop-up calendar. Nbr Encounters Enter the number of encounters allowed for this authorization. Used Displays the number of authorizations utilized. Pending Displays the number of non-billed authorizations linked to an encounter. Encounters Left Displays the number of authorizations remaining for the patient. Rendering Select a single provider or multiple providers to at

Help Guide for NextGen® Enterprise PM 8

Add Referral Code Tracking in the Encounters tab

Referrals can be created using ICD code ranges, CPT code ranges, encounters, or units. Multiple providers, a single specialty, or a location can be attached to a referral. You can track referrals by encounter use, pending encounters, and the number of encounters remaining on the referral. 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 Encounters, and then select the Insurance tab under it. Right-click the insurance listed on the Encounter Insurance section, and select Referral. The Referrals Listing window opens. Referral Listing window Right-click and select New Referral from the menu. The Referral Code Tracking window opens. Referral Code Tracking Window Enter the desired

Help Guide for NextGen® Enterprise PM 8

Add Authorizations Code Tracking in the Encounter tab

The Authorization Code Tracking window displays encounters which use the authorization, and appointments pending the authorization. When authorization is not required to be attached to the claim,you can track authorizations for internal purposes. Line-level and claim-level authorizations are tracked by the following: A single location A single location and a specialty A single location and one or more providers. 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 Encounters, and then select on the Insurance tab under it. Right-click the insurance listed on the Encounter Insurance section, and select Authorization. The Authorization Listing window opens. Authorization Listing Win

Help Guide for NextGen® Enterprise PM 8

Add an Isurance Referral

From the Ins/Diag tab, select the insurance for which a referral is to be added. Right-click and select New Referral from the menu. The Referral Code Tracking window opens. In the Referral Mode section, select one of the following: Encounter Mode: Select this button if the referral is approved for a specific number of encounters. This button is selected by default. Units Mode: Select this button if the referral is approved for a specific number of charge units. In the Referral Code field, enter the referral number obtained from the insurance company. This field is required. In the Effective Date field, enter the start date for the referral. This field is required. In the Expiration Date field, enter the end date for the referral. This field is required. In the Nbr Encounters field enter the number of encounters approved for the referral. This field is not available for Units Mode referrals. The Used field displays 0. The number increments by 1 each time the referral is linked to an enc

Help Guide for NextGen® Enterprise PM 8

Add an Insurance Authorization

From the Ins/Diag tab, select the insurance for which an authorization is to be added. Right-click and select New Authorization from the menu. The Authorization Code Tracking window opens. In the Authorization Mode section, select one of the following: Encounter Mode: Select this button if the authorization is approved for a specific number of encounters. This button is selected by default. Units Mode: Select this button if the authorization is approved for a specific number of charge units. If the authorization is for tracking proposes only and should not be included on claims, select the Tracking Only - Do not send on claim check box. In the Authorization Code field, enter the authorization number obtained from the insurance company. This field is required. In the Effective Date field, enter the start date for the authorization. This field is required. In the Expiration Date field, enter the end date for the authorization. This field is required. In the Nbr Encounters field enter the

Help Guide for NextGen® Enterprise PM 8

Components of the Filter Options Window

The following table lists the fields in the Filter Options window with their descriptions. Filter Description Rendering Physician Displays encounters with a specific rendering physician on the Encounter Maintenance window. Encounter Location Displays encounters with a specific service location on the Encounter Maintenance window. Primary Payer Displays encounters with a specific primary payer on the Encounter Insurance Selection window. Encounter Status Displays encounters with a specific encounter status. You can select one or more of the following: Bad Debt Billed History In Progress Rebill Unbilled Self Balance Displays encounters with a specific pat amount balance in balance control. You can select one of the following and then enter the balance amount. Equals Not Equals Greater Than Less Than Patient Type Displays encounters with a specific patient type on the Encounter Maintenance window. You can select one or more patient types. Encounter Date Displays encounters with a specific

Components of the Referral Code Tracking Window

Recommendations

Components of Authorization Code Tracking window

Add Referral Code Tracking in the Encounters tab

Add Authorizations Code Tracking in the Encounter tab

Add an Isurance Referral

Add an Insurance Authorization

Components of the Filter Options Window

Components of Authorization Code Tracking window

Add Referral Code Tracking in the Encounters tab

Add Authorizations Code Tracking in the Encounter tab

Add an Isurance Referral

Add an Insurance Authorization

Components of the Filter Options Window