Estimation Results in Patient Charts

Help Guide for NextGen® Enterprise PM 8

Cost Estimation Data Sources

The information for cost estimation can be retrieved from: Service Items (SIM) library A library that enables you to add SIM codes with associated CPT®4 code for each practice, along with prices. You can also group service items under one main number or name. SIM exception A library that enables you to charge different fees according to provider, location, and payer. Additional fees are referred to as exceptions, which can be set up and maintained through the SIM Library. Contract library A library that enables you to set up payers for the contract and indicates the reimbursement amount for the procedures. Contract exception A library that enables you to charge different fees based on the provider, location, and payer. Each additional fee is referred to as an exception to the contract and can be set up and maintained through the Contract library. After the exceptions are set up, you can assign a contract exception to providers at the provider, payer, or location level to apply the exce

Help Guide for NextGen® Enterprise PM 8

AutoFlow for Patient Cost Estimation

Cost estimation can be added to the series of actions in the AutoFlow for check-in and/or check-out processes. The sequential order of items in the AutoFlow is determined by the practice. When you run the AutoFlow from an encounter or an appointment, the Estimate Patient Cost window opens. Add Cost Estimation to Autoflow Your administrator can add patient cost estimation to the autoflow. Run Autoflow from an Encounter If you have configured an autoflow with cost estimation included, you can run the autoflow for a person or patient's check-in and/or check-out process from an encounter. Run Autoflow from an Appointment If you have configured an autoflow with cost estimation included, you can run the autoflow for checkin or checkout from an appointment. Parent topic: Pre-Services Cost Estimation

Help Guide for NextGen® Enterprise PM 8

Estimating Patient Cost

In NextGen® Enterprise PM, the Estimate Patient Cost window enables you to specify the inputs required for calculating the patient and insurance responsibility amounts for services planned or rendered. You can initiate cost estimation from: The People Lookup window for a person. The Patient Lookup window for a patient. The Appointment Lookup window or the appointment book for an appointment or event. The Encounter Lookup window or the Encounters tab on the Patient Chart window for an encounter. The Estimation Results in the Clinical History/Notes tab on the Patient Chart window. When you initiate the cost estimation, the Estimate Patient Cost window opens: Every time you specify and submit data on the Estimate Patient Cost window, a new cost estimation record will be created with a unique cost estimation ID. Multiple cost estimates can be created for one person, patient, appointment, or encounter. Estimate Patient Cost Fields Details are provided for the fields that define the distribu

Help Guide for NextGen® Enterprise PM 8

Pay and Print Options for Cost Estimation

The Estimate Patient Cost window enables you to: Make payments for the services submitted for cost estimation even before starting treatment. Print the cost estimate. Make Pre-Services Payment You can set an active batch and make the payment for the estimated services from the Estimate Patient Cost window. Printing Estimated Patient Cost You can print the cost estimate form in the format created in Form Enhanced. You can also print a cost estimate form that has been electronically signed and archived. Parent topic: Pre-Services Cost Estimation

Help Guide for NextGen® Enterprise PM 8

Create or Open Cost Estimations from Estimation Results

In NextGen® Enterprise PM, open the chart of the desired patient, and select the Clinical History/Notes tab. In Topics, select Estimation Results. The completed estimates for the patient are displayed. Do one of the following: To create a cost estimate, right-click the Details section, and select New. The Estimate Patient Cost window opens displaying the demographic information of the patient. To open a cost estimate, right-click the Details area, and select Open. The Estimate Patient Cost window opens displaying the cost estimation details. Specify the values, and submit them for cost estimation. A cost estimation is created with a new cost estimate ID and is added to the estimated results in the chart. Parent topic: Estimation Results in Patient Charts

Help Guide for NextGen® Enterprise PM 8

Pre-Services Cost Estimation

NextGen® Enterprise PM offers a pre-service solution that offers clear estimation for planned or completed services. You can perform patient cost estimation if you have administrator privileges to perform administration tasks for the practice. The cost estimation feature enables you to: Obtain a breakdown of financial responsibilities between the patient and insurance provider. Inform the patient about the amount payable by the patient before or after using the services and the amount that will be settled by the insurance provider. Collect timely payments from the person or patient. Print cost estimation results in customized formats. Keep plain text notes for the estimation. Associate diagnosis code for the estimation. View previous cost estimates. Visit the account profile, patient balance, and chart of the person or patient from the cost estimation. Generate and view cost estimate reports. Patient Cost Estimation Workflow After your administrator configures the library and master fi

Estimation Results in Patient Charts

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Cost Estimation Data Sources

AutoFlow for Patient Cost Estimation

Estimating Patient Cost

Pay and Print Options for Cost Estimation

Create or Open Cost Estimations from Estimation Results

Pre-Services Cost Estimation

Cost Estimation Data Sources

AutoFlow for Patient Cost Estimation

Estimating Patient Cost

Pay and Print Options for Cost Estimation

Create or Open Cost Estimations from Estimation Results

Pre-Services Cost Estimation