Eligibility Referral Report

Help Guide for NextGen® Enterprise PM 8

Eligibility Referral Reconciliation Report

The Eligibility Referral Reconciliation report is available if your system is licensed for NextGen Eligibility Verification. You can use the report to reconcile your monthly invoices to the number of inquiry transactions submitted to payers from NextGen® Enterprise PM. For more information, go to the NextGen Healthcare Success Community and download the User Guide for NextGen® Eligibility Verification Report configuration and filter options include Create Date, Status, Inquiry Type, Response Status and Primary Payer. To access the report in NextGen® Enterprise PM, select Reports > General and then select Eligibility Referral Reconciliation. Eligibility Referral Reconciliation Report Columns Parent topic: General Reports

Help Guide for NextGen® Enterprise PM 8

Eligibility Verification Status Report

The Eligibility Verification Status report is available if your system is licensed for NextGen® Eligibility Verification. You can use the report to view status information returned by payers for patients that had an eligibility request submitted from NextGen® Enterprise PM. For more information, go to the NextGen Healthcare Success Community and download the User Guide for NextGen® Eligibility Verification Report configuration and filter options include Request Date, Appointment Date, Appointment Status,Encounter Status,Encounter Create Date, and Service Type. To access the report in NextGen® Enterprise PM, select the Reports menu and select General and then select Eligibility Verification Status. Note: This report uses enhanced reporting functionality. For more information, see Enhanced Reports in NextGen® Enterprise PM . Parent topic: General Reports

Help Guide for NextGen® Enterprise PM 8

Eligibility Verification Benefit Report

The Eligibility Verification Benefit report is available if your system is licensed for NextGen Eligibility Verification. You can use the report to view benefit information returned by payers for patients that had an eligibility request submitted from NextGen® Enterprise PM. For more information, go to the NextGen Healthcare Success Community and download the User Guide for NextGen® Eligibility Verification Report configuration and filter options include Request Date, Response Date, Service Type, Insurance Type, and Payer. To access the report in NextGen® Enterprise PM, select Reports > General and then select Eligibility Verification Benefit. Note: This report uses enhanced reporting functionality. For more information, see Enhanced Reports in NextGen® Enterprise PM . Parent topic: General Reports

Help Guide for NextGen® Enterprise PM 8

Patient Chart Demographics Report

The Patient Chart Demographics report lists patients for the selected practice(s). The report sorts by practice. You can filter the report on birth date, sex, marital status, address fields, or the Chart User-defined fields. To access the report in NextGen® Enterprise PM, select the Reports menu and select General and then select Patient Chart Demographics. From the Report Filter window, select the Info button to view the following information about the report: Logic This report produces one line for each patient with a Chart in the selected Practice(s). If multiple Practices are selected, the patient will be repeated for each Practice where a chart exists. The “Rendering” column pulls data from the Default Rendering selected on the patient chart > chart details tab. Filtering Info Create date is the date the chart was created. Common Uses Number of new patients added to the practice in a given time frame. Identify patients not seen within a given time period. Identify patients by init

Help Guide for NextGen® Enterprise PM 8

About Eligibility Verification

NextGen® Eligibility Verification is an electronic method of verifying a patient's eligibility and benefit coverage online. EV allows you to check for authorization and prior authorization, make a referral request, check referral history, and check a claim status. The rules governing eligibility and referrals are based on a patient's managed care coverage plan. The following are NextGen® Eligibility Verification features: Eligibility verification enables you to verify a patient's insurance coverage in real-time or in a batch using Background Business Processor. The results of the verification can flow directly into the patient's chart. Referral requests are made to generate a referral number, so that a primary care physician (PCP) can send a patient to an authorized specialist. Referral history enables you to view a patient's referral history. This history lists all previous referrals made for a patient. Claim status check enables you to find out the status of a claim and where it is i

System Administrator Help

Managed Care Operation

The Managed Care Operations subgroup in the System Administrator enables you to set rights for NextGen® Eligibility Verification. Subgroup Used in Description Eligibility Referral Inquiry NextGen® Enterprise PM Enables users to run the Eligibility and Referral Inquiries process to obtain results. Elig Manager NextGen® Enterprise PM Enables users to track NextGen® Eligibility Verification eligibility transactions by day and status using a user-friendly visual graph and detailed grid; allowing users to: view eligibility responses, submit or resubmit eligibility inquiries, access the Eligibility Referral Report, create tasks, manage transactions, and print. Submit Eligibility Request NextGen® Enterprise PM Enables users to submit eligibility requests. Submit Historical Authorization Request NextGen® Enterprise PM Currently not available. Submit Historical Referral Request NextGen® Enterprise PM Enables users to submit Historical Referral Requests in NextGen® Enterprise PM using RTS (Real-

Eligibility Referral Report

Recommendations

Eligibility Referral Reconciliation Report

Eligibility Verification Status Report

Eligibility Verification Benefit Report

Patient Chart Demographics Report

About Eligibility Verification

Managed Care Operation

Eligibility Referral Reconciliation Report

Eligibility Verification Status Report

Eligibility Verification Benefit Report

Patient Chart Demographics Report

About Eligibility Verification

Managed Care Operation