Encounter Insurance Selection Window

Help Guide for NextGen® Enterprise PM 8

Insurance Maintenance Window

The Insurance Maintenance window is used to add or update a patient's insurance information. The subscriber of the insurance may be the patient, or another person to which the patient has a relationship, such as a spouse or a parent. The Insurance Maintenance window includes the following tabs: Detail Detail-2 Insurance Cards Benefit Information Authorizations Referrals Eligibility/Referral Website External About the Detail Tab in Insurance Maintenance You can find basic information about the patient's insurance. About the Detail-2 Tab in Insurance Maintenance You can find additional information about the patient's insurance in this tab. About the Ins Cards Tab in Insurance Maintenance You can capture images of the front and back of the insurance card using a scanner or a digital camera. About the Benefit Info Tab in Insurance Maintenance You can enter eligibility and benefits information for the insurance. About the Authorizations Tab in Insurance Maintenance You to enter one or more

Help Guide for NextGen® Enterprise PM 8

Add Insurance to Encounters

You can use the Encounter Insurance Selection window to add one or more insurances to an encounter for billing or to access the Insurance Maintenance window for an insurance. A pushpin appears in columns when data exists for the category. To quickly view existing data for a category, you can hover over the pushpin icon, or select the pushpin icon to access the specific tab on the Insurance Maintenance window. For example, hover over the pushpin icon in the Card column to view the Last Card Attached Date or select the pushpin icon to access the Insurance Maintenance > Ins Cards tab. Open NextGen® Enterprise PM. On the main toolbar, select Chart or Chart Lookup.. The Patient Lookup window opens. In the Search Criteria section, enter the patient's information, and select Find. Patient records that match the search criteria, appear in the Matching Records section. Select the patient, and then select Open. The Patient Chart window opens. Select Encounters, and then select on the Insurance t

Help Guide for NextGen® Enterprise PM 8

Viewing Insurance Information in Encounters

You can view a patient's insurance information in the Insurance tab You can view insurance information for an encounter in the Insurance tab under Encounters. The Encounters section displays the list of patient encounters. The Insurance Information section displays information for the selected insurance based on the setup for the payer in the payers master file in File Maintenance. For more information on setting up payers, go to NextGen Healthcare Success Community and download the latest File Maintenance Master Files Guide for NextGen® Enterprise PM. You can do the following on the Insurance tab under Encounters: Open the Encounter Insurance Selection window for the selected encounter. Open the Insurance Maintenance window for the encounter. Remove the selected insurance from the encounter. Open the Balance Control window for the selected encounter. Open the Authorization Listing window for the selected insurance. Open the Referral Listing window for the selected insurance. Open the

Help Guide for NextGen® Enterprise PM 8

Add Benefit Information to Patient Insurance

You can record annual and lifetime benefit information to help determine patient responsibility. Open NextGen® Enterprise PM. On the main toolbar, select Chart or Chart Lookup . The Patient Lookup window opens. In the Search Criteria section, enter the patient's information, and then select Find. Patient records that match the search criteriaa ppear in the Matching Records section. Select the patient, and then select Open. The Patient Chart window opens. Select the Encounters tab. The encounters associated with the patient appear in the Encounters section. Select the Insurance tab and then select the encounter from the Encounters section. Right-click the selected insurance, and then select Open. The Insurance Maintenance window opens. Select the Benefits Info tab and then select the Eligibility and Benefits tab. To view existing benefit information, select open menu and then select New or Open. The Eligibility and Benefit Maintenance window opens. Eligibilty and Benefit Information Win

Help Guide for NextGen® Enterprise PM 8

Charge Posting Toolbar

The toolbar on the Charge Posting window includes icons that you can use to perform a variety of actions and functions when working with charges in NextGen® Enterprise PM. The following table describes the use of each icon available on the Charge Posting toolbar. Icons Name Description View Chart Opens the Patient Chart window for the selected patient. Recall Opens the Recall Plan Maintenance window to add a recall for a patient who has no existing recalls, or the Patient Recall window for a patient who has one or more existing recall. Encounter Maintenance Opens the Encounter Maintenance window for the selected encounter to add the encounter details. Encounter Insurance Opens the Encounter Insurance Selection window for the selected encounter to add insurance to an encounter. Patient Insurance - Encounter Opens the Patient Insurance – Encounter window for the primary payer on the selected encounter. Balance Control Opens the Balance Control window for the selected encounter. Patient B

Help Guide for NextGen® Enterprise PM 8

Add Insurance to Multiple Self-Pay Encounters

From the Encounter Insurance Selection window, after you add an insurance to a self-pay encounter and select OK, the Attach [Insurance] to Multiple Encounters window opens and lists other self-pay encounters for the patient. Only those encounters that meet the following criteria are listed: The encounters must be self-pay with no insurance attached. The billable date on the self-pay encounters must fall within the effective and expiration dates of the insurance. The encounters must have the status of unbilled, billed, or rebill. Access the patient chart. Select the Encounters tab. From the Encounters list, select a self-pay encounter. Right-click and select Add Insurance. The Encounter Insurance Selection window opens. From the Insurance Listing section on the left, add one or more insurances to the Selected Insurance section on the right. To save changes and close the window, select OK. The Attach [Insurance] to Multiple Encounters window opens. Other self-pay encounters for the patie

Encounter Insurance Selection Window

Recommendations

Insurance Maintenance Window

Add Insurance to Encounters

Viewing Insurance Information in Encounters

Add Benefit Information to Patient Insurance

Charge Posting Toolbar

Add Insurance to Multiple Self-Pay Encounters

Insurance Maintenance Window

Add Insurance to Encounters

Viewing Insurance Information in Encounters

Add Benefit Information to Patient Insurance

Charge Posting Toolbar

Add Insurance to Multiple Self-Pay Encounters