Creating Sliding Fee Schedules

Help Guide for NextGen® Enterprise PM 8

Sliding Fee Schedules

Sliding Fee Schedules are typically used by Health Centers. They are linked to a patient or to a specific patient encounter in NextGen® Enterprise PM. Once linked, a percentage of the charge amounts entered on an encounter are automatically adjusted off. The percentage of the automatic adjustment is based on household family size and annual income. Sliding Fee Schedule adjustments are reported on the UDS Report. Multiple sliding fee schedules can be created if needed. For example, if the percentage discounts vary for medical, dental, vision and/or behavioral health services, separate schedules can be created for each. To use Sliding Fee Schedules in NextGen® Enterprise PM, the following setup must be completed: Create Transaction Codes in File Maintenance to be used for sliding fee adjustments. Create Sliding Fee Schedules in File Maintenance. Configure options in Practice Preferences > Sliding Fee to determine how sliding fee adjustments should function within the practice. Once Slidi

Help Guide for NextGen® Enterprise PM 8

Set Up the Sliding Fee Schedule Master File

The Sliding Fee Schedule master file enables you to create a master sliding fee schedule with general parameters such as name, adjustment transaction code, effective/expiration dates, and alert notifications. Access File Maintenance. Select System Master Files > PM > Sliding Fee Schedules. The Sliding Fee Schedules List window opens. Do one of the following: To add a new sliding fee schedule master, select the Open Menu button and select New. To modify an existing sliding fee schedule master, select the item in the list, select the Open Menu button and select Open. The Sliding Fee Schedule Maintenance window opens. Sliding Fee Schedule Maintenance In the Schedule Name field, enter a descriptive name for the sliding fee schedule master. This field is required. In the Adjustment Code field, select the adjustment transaction code to be used with the sliding fee schedule master. This field is required. In the Eff Date and Exp Date fields, enter effective and expiration dates for the slidin

Help Guide for NextGen® Enterprise PM 8

Assign Practice Access to Sliding Fee Schedules

The Sliding Fee Schedules master file is a system-level table. Therefore, all sliding fee schedules can potentially be accessed by any practice in any enterprise. If your enterprise includes multiple practices, you can use the Practice Access option to define which practices have access to each sliding fee schedule. For example, Practice A and Practice B both use Sliding Fee Schedule XYZ, but Practice C does not. Therefore, only Practices A and B should have access to Sliding Fee Schedule XYZ. Access File Maintenance. Select System Master Files > PM > Sliding Fee Schedules. The Sliding Fee Schedules List window opens. From the list, select the desired sliding fee schedule and then do one of the following: Select the Open Menu button and select Practice Access. Right-click and select Practice Access. The Sliding Fee Schedule Library Access by Practice window opens. Sliding Fee Schedule Library Access by Practice From the Practice list, do the following. At least one practice must be sel

Help Guide for NextGen® Enterprise PM 8

Set Up the Sliding Fee Schedule Details

Each Sliding Fee Schedule master contains one or more detailed sliding fee schedules. Each detailed sliding fee schedule is created with specific parameters such as sliding fee mode, CPT4 code ranges, diagnosis code ranges, locations, etc. It also includes a grid that defines discount percentages based on family size and annual income. Access File Maintenance. Select System Master Files > PM > Sliding Fee Schedules. The Sliding Fee Schedules List window opens. Select the desired sliding fee schedule master, select the Open Menu button and select Open. The Sliding Fee Schedule Maintenance window opens. In the Sliding Fee Schedules section at the bottom of the window, do one of the following: To add a new sliding fee schedule, select the Open Menu button and select New. To modify an existing sliding fee schedule, select the item in the list, select the Open Menu button and select Open. The Sliding Fee Schedule Detail Maintenance window opens. Sliding Fee Schedule Detail Maintenance In th

Help Guide for NextGen® Enterprise PM 8

Sliding Fee Schedules

Sliding Fee Schedules are typically used by Health Centers. They are linked to a patient or to a specific patient encounter inNextGen® Enterprise PM. When it is linked and you enter the percentage or charge amount on an encounter, it is automatically adjusted. The percentage of the automatic adjustment is based on householdfamily sizeandannual income. Sliding Fee Schedule adjustments are reported on the UDS Report. You can create multiple sliding fee schedules, if needed. If the percentage discounts vary for medical, dental, vision and/or behavioral health services, separate schedules can be created for each. To use Sliding Fee Schedules inNextGen® Enterprise PM, the following set up must be completed. CreateTransaction Codesin File Maintenance to be used for sliding fee adjustments. CreateSliding Fee Schedulesin File Maintenance. Configure options inPractice Preferences > Sliding Feeto determine how sliding fee adjustments should function within the practice. When Sliding Fee Schedule

File Maintenance Help for NextGen® Enterprise 8

Sliding Fee Schedules

The Sliding Fee Schedule master file enables you to: Create active sliding fee schedules. Activate NextGen® Enterprise PM alerts that: Indicate when patients have an associated sliding fee schedule. Notify users when certain information pertaining to the sliding fee schedule must be re-verified. Exempt certain service items from the sliding fee schedule. In NextGen® Enterprise PM, you can: Attach sliding fee schedules to a patient's chart. Apply a sliding fee schedule discount against patient responsibility charges and automatically calculate discounts based on the active Sliding Fee Schedule. Apply more than one sliding fee schedule to an encounter. Report on the sliding fee schedule adjustment discounts. The modes of applying a sliding fee schedule to a patient’s charges are: Line item-based. Encounter-based. The Sliding Fee Schedule Practice Preferences provide additional options that you can set on a per practice basis. Line Item Based Sliding Fee Schedule Encounter-Based Sliding F

Creating Sliding Fee Schedules

Recommendations

Sliding Fee Schedules

Set Up the Sliding Fee Schedule Master File

Assign Practice Access to Sliding Fee Schedules

Set Up the Sliding Fee Schedule Details

Sliding Fee Schedules

Sliding Fee Schedules

Sliding Fee Schedules

Set Up the Sliding Fee Schedule Master File

Assign Practice Access to Sliding Fee Schedules

Set Up the Sliding Fee Schedule Details

Sliding Fee Schedules

Sliding Fee Schedules