Enter an Encounter-Level Narrative for an ER SIM Code

Help Guide for NextGen® Enterprise PM 8

Enter a Charge-Level Narrative for an ER SIM Code

If the Encounter Rate Library for the payer is setup to not insert the ER SIM into Encounter Maintenance, then the ER SIM automatically inserts on the Charge Posting window as an additional charge line when the encounter is billed. The Narrative field on the Charge Posting window automatically populates for the ER SIM charge line if a pre-defined narrative is setup for the ER SIM code on the Other tab of the Service Items library. Otherwise the charge-level narrative can be manually entered for the ER SIM after the encounter is billed. Access the Charge Posting window for the desired patient and encounter. Select the charge line for the ER SIM code and then select the Open button. In the Narrative field, enter a free-text comment for the ER SIM. To save changes and close the window, select OK. The following prompt displays: Would you like to flag this charge to be rebilled? Select one of the following: To rebill the ER SIM, select Yes. The ER SIM charge line is flagged to bill with a g

Help Guide for NextGen® Enterprise PM 8

Encounter Rate SIM Narrative for Claims

The Narrative field on the Charge Posting window, or on the Encounter Rate sub-tab on the Billing & Collections tab of the Encounter Maintenance window, can be used to enter a free-text narrative, or comment, for the ER SIM code on the encounter. This populates the narrative segment for the ER SIM on claims for the primary, secondary or tertiary encounter rate payer. Charge-Level Narrative To include a charge-level narrative for an ER SIM on claims, the Encounter Rate Billing library for the payer must include the following settings on the Claims tab: Display narrative on ER SIM charge Line? = Yes From what field should the narrative data pull from? = Charge Entry If a narrative exists on the Charge Posting window for the ER SIM charge line, then it is used on the claim. If the narrative for the ER SIM charge line is blank, then the narrative for the first charge line is used on the claim. Charge Posting Encounter-Level Narrative To include an encounter-level narrative for an ER SIM on

Help Guide for NextGen® Enterprise PM 8

Enter an Encounter-Level Narrative for an ER SIM Code

If the Encounter Rate Library for the payer is setup to insert the ER SIM into encounter maintenance, then the ER SIM automatically inserts on the Encounter Rate sub-tab on the Billing & Collections tab of the Encounter Maintenance window when the encounter is billed. An encounter-level narrative can be manually entered for an Encounter SIM either before or after the encounter is billed. Access Patient Chart for the desired patient. Select the Encounters tab. Double-click to open the desired encounter. The Encounter Maintenance window appears. Select the Billing & Collections tab, and then the Encounter Rate sub-tab. In the Narrative field for the primary, secondary or tertiary encounter rate payer, enter a free-text comment for the ER SIM. The maximum is 80 characters. If the encounter is in Unbilled status prior to entering the narrative, select OK to save changes and close the window. If the encounter is in Billed status prior to entering the narrative, you get a prompt asking if yo

Help Guide for NextGen® Enterprise PM 8

Enter a Charge-Level Narrative for an ER SIM Code

If the Encounter Rate Library for the payer is setup to not insert the ER SIM into Encounter Maintenance, then the ER SIM automatically inserts on the Charge Posting window as an additional charge line when the encounter is billed. The Narrative field on the Charge Posting window automatically populates for the ER SIM charge line if a pre-defined narrative is setup for the ER SIM code on the Other tab of the Service Items library. Otherwise the charge-level narrative can be manually entered for the ER SIM after the encounter is billed. Access the Charge Posting window for the desired patient and encounter. Select the charge line for the ER SIM code and then select the Open button. In the Narrative field, enter a free-text comment for the ER SIM. To save changes and close the window, select OK. The following prompt displays: Would you like to flag this charge to be rebilled? Select one of the following: To rebill the ER SIM, select Yes. The ER SIM charge line is flagged to bill with a g

Help Guide for NextGen® Enterprise PM 8

Encounter Rate SIM Narrative for Claims

The Narrative field on the Charge Posting window, or on the Encounter Rate sub-tab on the Billing & Collections tab of the Encounter Maintenance window, can be used to enter a free-text narrative, or comment, for the ER SIM code on the encounter. This populates the narrative segment for the ER SIM on claims for the primary, secondary or tertiary encounter rate payer. Charge-Level Narrative To include a charge-level narrative for an ER SIM on claims, the Encounter Rate Billing library for the payer must include the following settings on the Claims tab: Display narrative on ER SIM charge Line? = Yes From what field should the narrative data pull from? = Charge Entry If a narrative exists on the Charge Posting window for the ER SIM charge line, then it is used on the claim. If the narrative for the ER SIM charge line is blank, then the narrative for the first charge line is used on the claim. Encounter-Level Narrative To include an encounter-level narrative for an ER SIM on claims, the En

Help Guide for NextGen® Enterprise PM 8

Set Up Encounter Rate SIM Maintenance Configurations

After you set the SIM configuration hierarchy, you must set up specific parameters for the encounter rate SIM code. Open File Maintenance. Select Libraries > Encounter Rate Billing. The Encounter Rate Billing List window opens. Select a library from the list. The Encounter Rate Billing Library Maintenance window opens. Right-click the Encounter Rate SIM grid, and then select New. The Encounter Rate SIM Maintenance window opens. Encounter Rate SIM Maintenance window Enter the service item number. Select the effective and expiration dates. Enter the co-pay amount. Select a condition code for Field Locator 18 on UB claims. Note: The Description and Amount fields are automatically filled in based on the service item description for the encounter and the corresponding dollar value from the SIM. You can modify the values. Optional: In the Required CPT4 section, select the open record button, and then select the codes. Select the payer in COB. Optional: In the Valid Primary Payers section, se

Enter an Encounter-Level Narrative for an ER SIM Code

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