Encounter Incident-To Billing

Help Guide for NextGen® Enterprise PM 8

Setup an Encounter for Incident-To Billing

Access the Patient Chart. Select the Encounters tab. From the Encounters list, open the desired encounter. The Encounter Maintenance window appears. In the Rendering field, select the mid-level rendering provider. In the Supervisor field, select the supervising provider. Select the Incident-To Bill Encounter check box. To save changes and close the window, select OK. Parent topic: Encounter Incident-To Billing

File Maintenance Help for NextGen® Enterprise 8

Supervisor Billing

You can create encounters that require that a supervisor is billed instead of a mid-level rendering provider. To set up this type of billing, you must do the following: Supervisor Billing is enabled by default for all payers, but you can disable it for payers that do not need it. Enable supervisor billing so that a supervisor is always required for a specific provider at the current practice. If necessary, enable or disable supervisor billing in the specific payer rows in the provider master file. The payer row setting overrides the practice-level setting on the Practice tab for just that provider/payer combination. The payer-level settings are available for payer rows at either the Default location (which will apply to all locations) or a specific location (which will only apply for that location). Make the Supervisor field available on the Encounter Maintenance window in NextGen® Enterprise PM. Disable Supervisor Billing for a Payer Enable Supervisor Billing at the Provider/Practice

Help Guide for NextGen® Enterprise PM 8

Supervisor Billing

You can create encounters that require that a supervisor is billed instead of a mid-level rendering provider. To set up this type of billing, you must do the following: Supervisor Billing is enabled by default for all payers, but you can disable it for payers that do not need it. Enable supervisor billing so that a supervisor is always required for a specific provider at the current practice. If necessary, enable or disable supervisor billing in the specific payer rows in the provider master file. The payer row setting overrides the practice-level setting on the Practice tab for just that provider/payer combination. The payer-level settings are available for payer rows at either the Default location (which will apply to all locations) or a specific location (which will only apply for that location). Make the Supervisor field available on the Encounter Maintenance window in NextGen® Enterprise PM. Disable Supervisor Billing for a Payer Enable Supervisor Billing at the Provider/Practice

File Maintenance Help for NextGen® Enterprise 8

Add the Supervisor Field on the Encounter Maintenance Window

By default, the Supervisor field does not display on the General tab of the Encounter Maintenance window. To allow users to select a supervising provider for an encounter, you must make the Supervisor field display on the window. To add the Supervisor field to the Encounter Maintenance window: From the Master Files > System list, select Practice. The Practices List window displays. Double-click the appropriate practice. The Modify Practice Information window displays. Select Preferences. The Practice Preferences window displays. Select the Encounters preferences. In the Providers section: Select the Supervisor check box to add the Supervisor field to Encounter Maintenance. If you want to make the Supervisor field required, select the Require Supervisor check box. Select OK. Parent topic: Supervisor Billing

Help Guide for NextGen® Enterprise PM 8

Set Up and Bill an Initial Encounter

When creating an encounter for recurring billing, you must set up the encounter to activate the automated billing for the initial encounter. On the Patient's Chart highlight the initial encounter and double-click. The Encounter Maintenance window opens. Enter the date the illness/injury began in the Onset Date field. This is a required field for the initial encounter for recurring billing. On the General tab, under the Encounter Types field, enable the Initial Enc in Series check box. Note: This field displays only when the Type of Facility and Bill Classification fields are set up in Practice Preferences. Select OK. Add the appropriate charges. Note: The revenue codes, which are attached to service items, must be set up before posting charges on the Charge Posting window in order for recurring UB billing to be recognized. Bill the encounter. After the billing process is complete, the first claim in a series is generated. Parent topic: Initial Encounter in a Series

Help Guide for NextGen® Enterprise PM 8

Set Up Claim Break Options for a Payer

Access File Maintenance. Select System Master Files, then PM, and then Payers. The Payers List window opens. Double-click to open the desired payer. The Modify Payer Information window opens. Select the Practice tab, and then the Other sub-tab. Modify Payer Information window; Practice tab; Other sub-tab If applicable, select the Disable rendering claim break check box and select one of the following options in the drop-down field: Use Encounter Rendering: The claim will use the Rendering provider entered on the Encounter Maintenance window. Note: Supervisor billing occurs if the rendering provider on the encounter has a supervisor. Use Provider from the First Charge Line on the Claim: The claim will use the Rendering provider entered on the Charge Posting window for the first charge. Note: Supervisor billing occurs if the rendering provider on the first charge has a supervisor. Use the Provider with the Greatest Total Charge Amount: The claim will use the Rendering provider with the g

Encounter Incident-To Billing

Recommendations

Setup an Encounter for Incident-To Billing

Supervisor Billing

Supervisor Billing

Add the Supervisor Field on the Encounter Maintenance Window

Set Up and Bill an Initial Encounter

Set Up Claim Break Options for a Payer

Encounter Incident-To Billing

Setup an Encounter for Incident-To Billing

Supervisor Billing

Supervisor Billing

Add the Supervisor Field on the Encounter Maintenance Window

Set Up and Bill an Initial Encounter

Set Up Claim Break Options for a Payer