General Information about Patient Encounter
The General tab on the Encounter Maintenance window includes high-level information about the patient's encounter, which is used for general reporting purposes and, specifically, for billing and claim purposes.
| Field Name | Description |
|---|---|
| Patient Type | Displays the types of patients available in the master list on the Master Lists window in File Maintenance. |
| Condition Related to Employment | Indicates that the encounter of the patient is related to the patient's employment. This option populates box 10a on the CMS 1500 paper claim form. |
| Remarks | Displays additional information related to the patient encounter. |
| Same/Similar Date | Displays the date when the patient first experienced the same or similar symptoms. This option populates box 15 on the CMS 1500 paper claim forms. |
| Complaints | Displays the text complaints for the patient encounter, up to 40 alpha-numeric characters. |
| Date Last Seen | Displays the date of encounter on which the patient was last seen for the same or similar symptoms or condition. This option populates box 19 on the CMS 1500 paper claim form. |
| Practice Specifics | Displays extra free text columns for encounter information. You can create up to four additional encounter-level custom fields by setting the user defined fields in the Encounters preferences by entering a caption or label for one or more of the user-defined four fields. You can then enter free texts in these custom fields for an encounter. |
| Admit Date | Displays the admission date of the patient for the current symptoms or condition. This option populates box 18 on the CMS 1500 paper claim form. |
| Admit Time | Displays the admission time of the patient in the HH:MM format.
|
| Initial Treatment Date | Displays the initial date of treatment for the patient’s current symptom or condition. This is used with chiropractic billing. On the electronic 837 claims, the date populates the 2300 loop, DTP02 segment. |
| Discharge Date | Displays the discharge date of the patient for the current symptoms or condition. This option populates box 18 on the CMS 1500 paper claim form. |
| Discharge Time | Displays the discharge time of the patient in the HH:MM format.
|
| Discharge Status | Displays the reason for the patient's discharge based on the last two digits of the Type of Bill (TOB). This is used for institutional claims. On the electronic 837I claims, the status populates the 2300 CL103 segment. On paper UB04 claims, the status populates the FL 17 box. When the Discharge Status on an encounter is blank, by default 01 is used on claims, which indicates the patient was discharged to home or self-care (routine charge). |
| Facility | Displays the facility name where the patient’s encounter took place if other than an office setting. This option populates box 32 on CMS 1500 paper claim form. |
| Encounter Types | Displays the types of encounters. When you create an encounter in NextGen® Enterprise PM, by default Billable is selected as the encounter type. In NextGen® EnterpriseClinical is the selected as the default encounter type, and in NextGen® Optical Management, either Billable or Optical is the default encounter type. |
| Case | Displays the case attached to the encounter, if any. |
| Case Date | Displays the onset date of the attached case. You can select the open menu |
| Print Encounter On Statements | Displays the encounter on the statement as a separate line item. By default, this check box is enabled for all new encounters. It is assumed that every encounter should print on a patient’s statement if there is a balance on the encounter for which the patient is financially responsible. |
| Patient is Home bound | Indicates that the patient is required to stay in self-care. |
| Exempt from Outsourcing | Exempts the patient from outsourcing to an external collections agency. |
| Initial Enc in Series | Indicates that the encounter is the first in a series of encounters for the patient’s symptom or condition. |
| Homeless Status | Displays patient's homeless status at the time of the encounter. Homeless status is typically set up at the patient-level on the UDS tab of the Patient Information window. The patient-level status defaults to the homeless status field on the General tab of the Encounter Maintenance window on all new encounters created for the patient. You can change the encounter-level homeless status for a specific encounter, if needed. |
| Service Type | Displays the types of services represented by the provider. The encounter-level service type is used with Uniform Data System (UDS) reporting and ryan white reporting.
This option includes the following types of services available in Master List on the Master List Lists window in File Maintenance:
|
| Program | Displays the program to which a patient is enrolled. The Program field appears only if you enable the Enable Programs check box on the Programs preference in Practice Preferences.
You can link the encounter to a program by selecting the program from the drop-down list. Only programs meeting the following conditions are listed and available for selection:
|
| Rendering | Displays the rendering physician's name. The rendering physician is captured when an encounter is created and reflects the provider that rendered services on the encounter. If the encounter is created from the appointment book check-in process, the provider defaults from the appointment rendering physician. If the encounter is created from the patient chart, the provider defaults from the default rendering physician in the chart on Chart Details tab in Patient Information . You can modify the provider if necessary. This populates box 31 on CMS 1500 paper claims. |
| Referring | Displays the referring physician's name. The referring physician is captured when an encounter is created and reflects the referred provider for the encounter. If the encounter is created from the appointment book check-in process, the provider defaults from the appointment referring physician. If the encounter is created from the patient chart, the provider defaults from the default rendering physician in the chart on the Chart Details tab in Patient Information. You can modify the provider if necessary. This option populates box 17 on the CMS 1500 paper claim form. |
| Referring Facility | Displays the referring provider's associated facility name. |
| Admitting | Displays admitting provider's name, who previously admitted the patient to the hospital.
|
| First Consulting | Displays counselling provider's name who first consulted the patient for the current symptoms or condition.
|
| Second Consulting | Displays counselling provider's name who next consulted the patient for the current symptoms or condition.
|
| Ordering | Displays ordering provider's name who ordered the services on the encounter.
|
| Supervisor | Displays mid-level provider's name who rendered the services to the patient. Supervising billing is necessary when the mid-level provider is not authorized with the payer to bill for his or her services.
Before you use supervisor billing, you must:
|
| MD Anesthesia | Displays the Medical Director (MD) of Anesthesia for the encounter.
|
| Service Location | Displays the location where the services were rendered. The service location is captured when an encounter is created and reflects the location at which the patient was seen for the encounter. If the encounter is created from the appointment book check-in process, the location defaults from the appointment service location. If the encounter is created from the patient chart, the location is a required entry. This option populates box 32 on the CMS 1500 paper claim form. |
| Incident-To Bill Encounter | Bills the encounter using the supervising provider's name on the claim, even though the mid-level rendering provider is set to normally bill for the payer on the encounter. |