Configuring Practice Preferences for Allowed Amount

Help Guide for NextGen® Enterprise PM 8

Configuring Practice Preferences for Coinsurance

The Search for Coinsurance tab in the Pre-Service practice preferences enables you to select the source for coinsurance for cost estimation. The source for coinsurance can be one of the following: Real-Time Transaction. The system fetches the coinsurance amount from the response of a real-time transaction. This option is available for a practice working in a real-time system. Transaction Details. The system fetches the coinsurance amount from details in the previous transaction. You must specify the date range. The system fetches the latest coinsurance amount from the transactions made within the specified date range. By default, the coinsurance amount is considered from the transactions made in the current year. This option is available for practices working in real-time and non-real-time systems. Contract. The system fetches the coinsurance amount from the settings made in the contract library. This option is available for practices working in real-time and non-real-time systems. All

Help Guide for NextGen® Enterprise PM 8

Set Preference to Search for Allowed Amounts in Contracts

You can retrieve allowed amounts from contract library, by setting Contract as the source for allowed amounts. Open NextGen® Enterprise PM. From the Admin menu, select Preferences > Practice. The Practice Preferences window opens. select Pre-Services in the preference list and open the Search for Allowed Amount tab. Select Contract as the source for allowed amounts. Select OK. Parent topic: Configuring Practice Preferences for Allowed Amount

Help Guide for NextGen® Enterprise PM 8

Set Preference to Search for Allowed Amounts in Transaction History

You can retrieve allowed amounts from transaction history by setting Transaction History as the source for allowed amounts. Open NextGen® Enterprise PM. In the Admin menu, select Preferences > Practice. The Practice Preferences window opens. Select Pre-Services in the preference list and open the Search for Allowed Amount tab. Select Transaction History. A message appears stating that when transaction history is selected, the application ignores the allowed amount in the contract library. Select OK. Set the transaction history date range by selecting the period from the list and the start and end dates. Select one of the following allowed amount options. Average of all allowed amounts. To get the average of the allowed amounts obtained from the transaction history. Latest allowed amount. To get the latest allowed amount from the transaction history. To exclude transactions with allowed amounts equating to zero dollars, select Exclude zero dollar amounts from Transaction History. Select

Help Guide for NextGen® Enterprise PM 8

Set Preference to Search for Allowed Amounts in Transaction History and Contract

You can search for allowed amounts in transaction history and contract library by setting Both as the source for allowed amounts. Open NextGen® Enterprise PM. From the Admin menu, select Preferences > Practice. The Practice Preferences window opens. Select Pre-Services in the preference list and open the Search for Allowed Amount tab. Select Both as the source of the allowed amount. A message appears stating that when transaction history is selected, the application ignores the allowed amount in contract library. From the following options, select the sequence of sources to fetch the allowed amount. Contract, then Transaction History. To search contract library first. If not found, then transaction history is searched. Transaction History, then Contract. To search transaction history first. If not found, then contract library is searched. Note: A message appears stating that the application ignores the allowed amount in contract library when transaction history is selected. Set the tra

Help Guide for NextGen® Enterprise PM 8

Configuring Pre-Services Practice Preferences

Before you perform or complete the cost estimation in NextGen® Enterprise PM, your administrator can set the preferences for Pre-Services in the Practice Preferences window. However, setting the practice preferences is not mandatory. If you are an administrator, your preferred selections for pre-services determine the following values in cost estimation: Percentage of payment that the patient agrees to pay in advance Co-pay or deductible values in the patient's insurance information Allowed amount Coinsurance amount For descriptions of the fields for the Pre-Services preferences, go to the NextGen Healthcare Success Community and download the File Maintenance Preferences Guide forNextGen®Enterprise. Set Payment Preferences for Pre-Services Your administrator can set payment preferences that determines the amount the patient can pay in advance and update the insurance information. Configuring Practice Preferences for Allowed Amount The allowed amount can be retrieved from contracts and

Help Guide for NextGen® Enterprise PM 8

Retrieving Allowed Amount in Cost Estimation

Allowed amount is the amount expected to be paid by the insurance provider and patient for an individual service. The allowed amount for a service can be retrieved from the transaction history or contract library and contract exception (collectively known as contract). If you are the administrator, you can select the source for the allowed amount in the practice preferences and get the allowed amount as follows: If you select contract, the allowed amount is retrieved from the contract library or contract exception. If you select transaction history, the allowed amount is retrieved from the transaction history based on the date range you select. If found, the allowed amount is calculated based on your selection of the following options: Average of all amounts: Returns the average of the allowed amounts for a service. Latest allowed amount: Returns the allowed amount from the latest transaction. If you select both, the system looks for the allowed amount in both sources. You can also sel

Configuring Practice Preferences for Allowed Amount

Recommendations

Configuring Practice Preferences for Coinsurance

Set Preference to Search for Allowed Amounts in Contracts

Set Preference to Search for Allowed Amounts in Transaction History

Set Preference to Search for Allowed Amounts in Transaction History and Contract

Configuring Pre-Services Practice Preferences

Retrieving Allowed Amount in Cost Estimation

Configuring Practice Preferences for Coinsurance

Set Preference to Search for Allowed Amounts in Contracts

Set Preference to Search for Allowed Amounts in Transaction History

Set Preference to Search for Allowed Amounts in Transaction History and Contract

Configuring Pre-Services Practice Preferences

Retrieving Allowed Amount in Cost Estimation