Limitations on Encounters with Pending Approval

Help Guide for NextGen® Enterprise PM 8

Significant Events for Encounters

Once enabled, significant event messages are recorded in the Patient Chart > Clinical History/Notes tab when the event occurs. Significant Event messages for encounters include the following: Encounter Accessed Encounter Alternate Diagnosis Mapped Encounter Bad Debt Status has reached $0 Balance Encounter Bill Printed Encounter Charge Alternate Diagnosis Mapped Encounter Charge Deleted Encounter Collections Agency Change Encounter Deleted Encounter Diagnosis Viewed Encounter Field Modified Encounter Guarantor Changed Encounter Insurance Deleted Encounter Insurance Re-Ordered Encounter Locked Encounter Lookup Criteria Encounter Rate Adjustment Reversed Encounter Rate SIM and Amount Removed Encounter Status Change Encounter Unlocked Enable Significant Events for Encounters There may be modifications made to patient encounters. To track these modifications, you must enable the appropriate significant events. View Significant Events for Encounters Significant events are enabled to view mod

Help Guide for NextGen® Enterprise PM 8

Bad Debt Process

When you move one or more encounters on a guarantor's account to bad debt, there is no need to adjust balances off from the Accounts Receivable (A/R). NextGen® Enterprise PM maintains a Regular A/R and a Bad Debt A/R. Before encounters can be moved to a Bad Debt status, they must first be added to a pre-list, which means the encounters are placed on the Encounters Pending Bad Debt report. When encounters on the report are reviewed and approved for collections, the pre-listed encounters are then processed for Bad Debt, and any outstanding balances are transferred to the Bad Debt A/R. Adding Encounters to the Pre-List for Bad Debt You can add encounters to the pre-list for bad debt. Reviewing Encounters on the Pre-List for Bad Debt You can review encounters on the pre-list for bad debt in Encounters Pending Bad Debt report. Modify Encounters on the Pre-List for Bad Debt You can modify encounters on the pre-list for bad debt on the Pre-List Encounter window. Removing Encounters from the P

Help Guide for NextGen® Enterprise PM 8

Encounter Mode Authorizations

A payer can provide an authorization 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 authorization is entered in NextGen® Enterprise PM using Encounter Mode. From the Authorization Code Tracking window, you can enter an Encounter Mode authorization with the following information: Authorization 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 Additional administration information Additional free-text notes On the Authorization Code Tracking window for an existing authorization, you can view Encounters Utilizing This Authorization and Appointments Pending This Authorization. These sections do not appear when you enter a new authorization. Parent topic: About the Authorizations Tab in Insurance Maintenance

Help Guide for NextGen® Enterprise PM 8

Practice Preferences for Encounter Rate Billing

To use encounter rate billing in NextGen® Enterprise PM, specific options must be enabled for the practice in Practice Preferences. Enable Qualifying Encounter Billing Process Date for Encounter Rate SIM and Adjustments Parent topic: Setting Up Encounter Rate Billing

Help Guide for NextGen® Enterprise PM 8

Enable Qualifying Encounter Billing

The Encounter Rate Billing functionality in NextGen® Enterprise PM includes logic that identifies multiple encounters for a patient on the same date of service at the same location with the same encounter rate payer. Qualifying Encounter Billing must be enabled for the practice. When enabled, the Encounter Rate Billing Status fields display on the Billing & Collections tab of the Encounter Maintenance window. These fields are used to determine which encounter to bill when a patient has multiple same-day encounters with more than one provider at the same location with the same encounter rate payer attached. Access NextGen® Enterprise PM. From the Admin menu, select Preferences, and then Practice. The Practice Preferences window opens. From the Preference List, select Claims. Select the Enable Qualifying Encounter Billing check box. To save changes and close the window, select OK. Parent topic: Practice Preferences for Encounter Rate Billing

Help Guide for NextGen® Enterprise PM 8

Set Up Enterprise Preferences for Encounter Rate Billing

You must enable encounter rate billing for the enterprise. When enabled, further setup can be completed for practices within the enterprise that use encounter rate billing functionality. This also enables an Encounter Rate Billing library to be attached to the appropriate payers later in the setup. Access NextGen® Enterprise PM. From the Admin menu, select Preferences, and then Enterprise. The Enterprise Preferences window appears. Select the General tab. Select the Encounter rate billing check box. Enterprise Preferences To save changes and close the window, select OK. Parent topic: Setting Up Encounter Rate Billing

Limitations on Encounters with Pending Approval

Recommendations

Significant Events for Encounters

Bad Debt Process

Encounter Mode Authorizations

Practice Preferences for Encounter Rate Billing

Enable Qualifying Encounter Billing

Set Up Enterprise Preferences for Encounter Rate Billing

Significant Events for Encounters

Bad Debt Process

Encounter Mode Authorizations

Practice Preferences for Encounter Rate Billing

Enable Qualifying Encounter Billing

Set Up Enterprise Preferences for Encounter Rate Billing