Enable Eligibility Verification User Interface

Help Guide for NextGen® Enterprise PM 8

Enable Eligibility Verification User Interface

NextGen® Eligibility Verification supports two types of interfaces: Standard interface and Eligibility Verification Integrated User Interface (UI). Any mention of UI or User Interface refers to the NextGen® Eligibility Verification Integrated User Interface. Note: User Interface images are used in this example. The Integrated Eligibility User Interface is an option located in Practice Preferences. It can only be enabled by a user with administrator rights to Practice Preferences. In NextGen® Enterprise PM select Admin, > Preferences > Practice. The Practice Preferences window appears. From the Preference List, select Eligibility Verification. Select the Enable integrated eligibility UI check box. Select OK. Parent topic: About Eligibility Verification

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

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. 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

View Latest Successful Eligibility Response from Appointment Information

Before you begin Submit NextGen® Eligibility Verification request for a patient. Set the appointment information. For details on how to set the tooltip, see Set Scheduling Preferences for Tooltips in Layout and User Preferences Guide for NextGen Enterprise PM. You can view the latest successful response from the appointment information for pending transactions. In NextGen® Enterprise PM, select Appbook. The appointment book opens. Locate the appointment for the patient for whom you have submitted the NextGen® Eligibility Verification request and do one of the following: Select the appointment. Right-click the appointment and select Appointment Information. The tooltip displays the appointment information. The Primary Insurance Eligibility Status shows the status of the eligibility check. Select the Pending / View Latest Successful Response hyperlink. The system checks for the eligibility response for the latest successful transaction during the time period specified in the user prefere

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

Enable Eligibility Verification User Interface

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Enable Eligibility Verification User Interface

About Eligibility Verification

Eligibility Verification Benefit Report

Eligibility Verification Benefit Report

View Latest Successful Eligibility Response from Appointment Information

Eligibility Verification Status Report

Enable Eligibility Verification User Interface

Enable Eligibility Verification User Interface

About Eligibility Verification

Eligibility Verification Benefit Report

Eligibility Verification Benefit Report

View Latest Successful Eligibility Response from Appointment Information

Eligibility Verification Status Report