Do's and Don'ts for the UDS Report
Invoices
Invoices should only be used for charges that are not considered face-to-face encounters with a provider. For example, attorney fees, medical records fees, etc. Invoice charges cannot be reported on the UDS report because there is no encounter associated to an invoice.
Unapplied Credits
Encounter-level unapplied credits can be used since they can be tied to a provider and location in NextGen® Enterprise PM and can therefore be reported correctly on the UDS report.
Account-level unapplied credits should not be used because they cannot be tied to a Provider and Location in NextGen® Enterprise PM and therefore cannot be reported correctly on the UDS Report.
To prevent users from entering patient payments as account-level unapplied credits, security access in System Administrator can be setup for the appropriate user groups as follows:
- = No
- = Yes
Primary Diagnosis
All charges must have the primary diagnosis listed first. This is the only diagnosis code that is counted on the UDS report.
Sex
All patients must have a sex of M (Male) or F (Female) entered in their demographics, not U (Unknown) or O (Undifferentiated) for gender on the UDS report.
Family Information
All patients must have the following Family Information entered, even if they do not qualify for a sliding fee discount:
- Family Size
- Annual Income
Qualifying Encounters
Carefully review all codes in the SIM library. Any code that is considered to be a face-to-face encounter must have the three qualifying encounter options below selected on the General tab in the Service Items library.
- Self pay Qualifying Encounter
- Sliding Fee Qualifying Encounter
- Qualifying Encounter for all payers
Encounter Rendering Provider
Ensure the correct provider is always selected as Rendering on the Encounter Maintenance window. The encounter-level rendering provider is reported on the UDS report. The charge level rendering provider is not referenced and is therefore not reported on the UDS report.
Encounter Non-Billable Rendering Provider
Any non-billable rendering providers that provide ancillary services on an encounter, such as nurses, dental assistants, case workers, etc., must be set up in the Providers master file as a supervised rendering provider using a generic name such as Nurse or Dental Assistant or Enabling Services.
The actual provider (e.g. Jessica Johnson, RN) must be set up in the Providers master file as a non-rendering provider.
When creating encounters for patients that are seen by a non-billable provider, the providers are selected as follows on the Encounter Maintenance window:
- Rendering: Select the generic rendering provider.
- First Consulting: Select the name of the non-billable rendering provider.
- Supervisor: Select the name of the supervising provider.
Multiple Same Day Encounters
Make sure that separate encounters are created for services that are performed on the same day with different providers from different UDS staffing categories. For example, if there is an encounter with a Family Practitioner and also an encounter with a Mental Health Practitioner for the same patient on the same day, two encounters must be created and each encounter should be flagged as a qualifying encounter for the UDS report.