NextGen Knowledge Center

Mark a CSC Encounter as Exempt

CSC candidate encounters can be marked exempt either manually or automatically by the system.
  • Automatic exemption of a claim occurs when the claim is suppressed as a result of File Maintenance settings.
  • Exempt encounter charges are not included in a consolidated claim.
  1. Access the Consolidated Services Claim tab under the Claims tab on the Encounter Maintenance window.
  2. To identify the responsible attending provider for claim header, complete the Primary Responsible Attending, Secondary Responsible Attending, and Tertiary Responsible Attending fields. Select one of the following options for each applicable insurer:
    • None - (default prior to billing)
    • Responsible Attending
    • Ancillary Provider
  3. To remove encounter charges from a primary, secondary, or tertiary CSC claim, select the applicable check box:
    1. Exempt from Primary Consolidated Services Claim
      An alert displays if a Primary HOLD claim is attached to the encounter: A HOLD claim exists for this encounter. Would you like to convert the HOLD claim to Pending status?
      • Yes: The system changes the HOLD claim request to Pending status. The Exempt check mark is enabled.
      • Cancel: Returns to the Consolidated Service Claim tab screen.
    2. Exempt from Secondary Consolidated Services Claim
    3. Exempt from Tertiary Consolidated Services Claim
  4. The Program and Eligibility Date Ranges are automatically populated for the payer's claim consolidation process, this applies to:
    1. To and From Dates for Primary, Secondary, and Tertiary payers.
    2. Month time-spans only - You can override the date range by manually entering the new dates for a monthly time-span in the To and From fields.
    3. Daily, weekly, and case time-frames - You cannot overwrite dates for these time-frames.
  5. To view all of the encounters for the patient for a specific time-frame, select one of the following options:
    • Same Day
    • Same Week
    • Same Month
  6. Select OK.