Encounter Mode Referrals

A payer can provide a referral for the patient to have a specific number of encounters, and those encounters may occur within a date range defined by the payer. This type of referral is entered in NextGen® Enterprise PM using Encounter Mode.

From the Referral Code Tracking window, you can enter an Encounter Mode referral with the following information:

• Referral code (required)
• Effective and expiration dates (required)
• Number of encounters authorized
• Rendering provider
• Location
• Provider specialty
• Free-text description
• Valid ICD codes
• Valid CPT4 codes

On the Referral Code Tracking window for an existing referral, you can view Encounters Utilizing This Referral and Appointments Pending This Referral. These sections do not appear when you enter a new referral.