Hide a Payer

Help Guide for NextGen® Enterprise PM 8

Activate and Assign a Payer to a Practice

When you select Practice access for payer master file, the payers can be defined at the practice level, and you can restrict which practices have access to them. After all the practices have been set up with or without access to the selected payer, specific areas in the application where that practice, depending on their access, will or will not see the payer: File Maintenance The Group Information window in File Maintenance NextGen® Enterprise PM The Payer Lookup window The Eligibility Referral Lookup window The Claim Request Lookup window The Add/Modify Provider Information window The following areas of the application show all the payers in the enterprise regardless of the practice's access settings: Reports Service Item Library Maintenance Activate Practice Access to the Payer Master File Assign a Practice to a Payer You can assign access to practices for a payer. Parent topic: Payers Master File

File Maintenance Help for NextGen® Enterprise 8

Hide a Payer

The payers hidden at the Payers master level in File Maintenance can now be hidden at the person/patient level for encounters in NextGen® Enterprise PM. This helps you associate only unhidden payers with encounters and avoid billing errors. To hide a payer, select the payer from the list, select open menu , and then select Hide. A message appears asking you to confirm if the payer should be hidden. Select Yes. The Hide Payer window opens showing the number of person/patient records associated with the payer. The Hide Payer window provides the following options: Yes: To hide the payer in the payer master record in File Maintenance and on the associated person/patient records in NextGen® Enterprise PM. No: To hide the payer in the payer master record in File Maintenance only. Parent topic: Payers Master File

Help Guide for NextGen® Enterprise PM 8

Payers Master File

Payers are the third-party entities, other than guarantors or employers, that you expect to receive reimbursement from. Some examples of payers are commercial insurance companies, Medicaid, and Medicare. In the Payers master file, you can specify the contract associated with the payer, the participating providers, how to submit claims, and other general payer information. You can generate Payers Master File reports from the Payers master file. For more information, go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM. Auditing Payers Master File Add or Modify a Payer Payer Defaults - 1 Tab Defaults - 2 Tab System Tab Practice Tab Configuring Alternate Payers You an use the Alternate Payer Simultaneous Billing feature to associate an alternate payer to a payer. External Tab for Payer Information Co-Pays Tab Changing the Payer Address and Associated Patient Records Activate and Assign a Payer to a Practice You can limit a practi

File Maintenance Help for NextGen® Enterprise 8

Hide a Program

You can hide a program in File Maintenance. When hidden, the program is not available for selection in NextGen® Enterprise PM. For example, if your practice has discontinued their participation in a program, you can hide the program to prevent users from enrolling patients and linking encounters to the program. When you hide a program, all existing patient enrollments and encounter associations are retained and are available for reporting in NextGen® Enterprise PM. Access File Maintenance. Select System Master Files, then PM, and then Programs. The Programs List window opens. From the list, select a program to hide and then do one of the following: Select Open Menu and then select Hide. Right-click and then select Hide. Double-click to open the program, then select the Hide check box, and then select OK. A prompt appears asking you to confirm hiding the program. To confirm the hide, select Yes. The program is hidden and removed from the list. View Hidden Programs Unhide a Program Paren

Help Guide for NextGen® Enterprise PM 8

Hide a Program

You can hide a program in File Maintenance. When hidden, the program is not available for selection in NextGen® Enterprise PM. For example, if your practice has discontinued their participation in a program, you can hide the program to prevent users from enrolling patients and linking encounters to the program. When you hide a program, all existing patient enrollments and encounter associations are retained and are available for reporting in NextGen® Enterprise PM. Access File Maintenance. Select System Master Files, then PM, and then Programs. The Programs List window opens. From the list, select a program to hide and then do one of the following: Select Open Menu and then select Hide. Right-click and then select Hide. Double-click to open the program, then select the Hide check box, and then select OK. A prompt appears asking you to confirm hiding the program. To confirm the hide, select Yes. The program is hidden and removed from the list. View Hidden Programs Unhide a Program Paren

Help Guide for NextGen® Enterprise PM 8

Change the Payer Address in the Payer Master File

To change a payer address: From the Master Files - System list, select Payers. The Payers List window opens. Select the payer you want to modify, select the open menu button, and then select Open or double-click the payer. The Modify Payer Information window opens. On the Payer Defaults - 1 tab, enter the new address in the Address field. Select OK. If any person or patient records have this payer with the old address, a message states how many records will be affected. Select Yes to update all the records. If you select No, the records will keep the old address. Note: The application searches all fields for an exact match. This message displays only if the information in all fields of the patient record match all the fields in the Payer master record. If there are any discrepancies, the record is not be included in the update. Select Yes to update all of the matching records with the new payer address. The new address displays in NextGen® Enterprise PM on the Insurance Maintenance dia

Hide a Payer

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Activate and Assign a Payer to a Practice

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Change the Payer Address in the Payer Master File