Dental Billing

Help Guide for NextGen® Enterprise PM 8

Billing and Collections

Billing and collections in NextGen® Enterprise PM includes the following processes: Posting charges Processing charges from NextGen® Enterprise EHR Billing and rebilling encounters and invoices with charges Posting charges from rosetta Generating statements A/R collections and follow-up Setting up budget plans Processing encounters to bad debt Collections For more information about the setup and functionality of the types of billing based on specialty, go to NextGen Healthcare Success Community and download the following user guides: Anesthesia Billing User Guide for NextGen® Enterprise PM Behavioral Health Billing User Guide for NextGen® Enterprise PM Community Health Centers User Guide for NextGen® Enterprise PM Community Health Centers include the following types of billing: Encounter Rate Billing Roll-Up Billing Dental Billing Anesthesia Billing Behavioral Health Billing Charge Posting Overview You can enter or modify Charges on the Charge Posting window. Parent topic: Billing

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

Help Guide for NextGen® Enterprise PM 8

Claim Printing Library for ADA Claims

Claim printing options can be set up for both the ADA 2006 form and the ADA 2012 form. The following tables describes the available print options for the ADA 2012 form. ADA (2012) Common Rules Tab Option Setting [2] Preauthorization Number Select one of the following: Authorization Number Authorization Number - Upper Case Blank Referral Number [8] Other Insurance Subscriber ID Select one of the following: Blank Payer Policy number Subscriber SSN [15] Subscriber ID Select one of the following: Blank Payer Policy number Subscriber SSN [20] Patient Name / Address Select one of the following: Blank None Populate patient regardless of the subscriber [23] Patient ID / Account Nbr Select one of the following: Blank Medical record number Patient control number [25] Area of Oral Cavity Select one of the following: Blank Quadrant [26] Tooth System Check to print this box on claims. Uncheck to not print this box on claims. [27] Tooth Numbers Select one of the following: Blank Tooth number [28] To

Help Guide for NextGen® Enterprise PM 8

Setting Up Claims

Before you can generate claims, you must set up options to define the following: The type of information you want to display in the various claim form fields The way you want the claim forms to print The location, payer, and provider information for a valid claim creation Specialty Billing For more information about the setup and functionality of the types of billing based on speciality, go toNextGen Healthcare Success Communityand download the following user guides: Anesthesia Billing User Guide forNextGen® Enterprise PM Behavioral Health Billing User Guide forNextGen® Enterprise PM Community Health Centers User Guide forNextGen® Enterprise PM Community Health Centers include the following types of billing: Encounter Rate Billing Roll-Up Billing Dental Billing Claim Printing Library The Claim Printing library enables you to specify options that define which information prints on claim forms. Claim Modifiers Library EDI Claim Profile Library The EDI Claim Profile library enables you to

File Maintenance Help for NextGen® Enterprise 8

Printing Preferences for Document Types

You can set up printing preferences for the following document types in NextGen® Enterprise PM. Account Receipt Anesthesia Gantt Report Appointment Reminder Letters Appointment Multi Resource Report Budget Letters Claim Images Note: You can select Claim Images to select a ADA, 1500, or UB claim type. Claims Note: You can select Claims to select a ADA, 1500, or UB claim type. Collection Letters Cost Estimate Credit Card Processing Day Timer Encounter Bills EOB Images Fee Tickets Forms Note: You can select Forms to select a specific form template. Forms Enhanced Note: You can select Forms Enhanced to select a specific enhanced form. Invoices Label Templates Note: You can select Label Templates to select a specific label. Patient Data Sheets Patient Detail Data Sheets Recall Letters Reports Statements Parent topic: Printing Practice Preferences

Help Guide for NextGen® Enterprise PM 8

Billing

Billing is the process of collecting payments for a service rendered. The patient or the patient's insurance company is billed and the respective payment is received from them. Billing and Collections NextGen® Enterprise PM billing and collections set up and processes. Enter Charges You can enter charges on the Charge Posting window. Configuring Session Settings Session settings is a feature in NextGen® Enterprise PM that enables you to select specific parameters that are used as defaults during your current login session. Co-Pays When the original charge amount breaks off into the patient amount, it is called the patient's co-pay. Charge Test Results on Electronic Claims You can charge test results on electronic claims for reimbursement. Charge Discounts You can apply discounts to the charges for an encounter from the Charge Posting window. Processing Pending NextGen Enterprise EHR Charges You can process pending NextGen® Enterprise EHR charges. National Drug Code (NDC) Information fo

Dental Billing

Recommendations

Billing and Collections

Sliding Fee Schedules

Claim Printing Library for ADA Claims

Setting Up Claims

Printing Preferences for Document Types

Billing

Billing and Collections

Sliding Fee Schedules

Claim Printing Library for ADA Claims

Setting Up Claims

Printing Preferences for Document Types

Billing