Payments and Adjustments

Help Guide for NextGen® Enterprise PM 8

Understanding Payment Responsibility

In NextGen® Enterprise PM, a figurative concept called buckets is used to describe the movement of payment responsibility. For example, if there is insurance attached to an encounter, the payment responsibility falls into the primary insurance, secondary insurance, and so on. Finally, the remaining payment responsibility falls into the patient bucket to pay the amount not covered by insurance or to be written off. Patient Responsibility Buckets Buckets have been used to describe the un-applied credit process in this guide. Parent topic: Transaction Posting Process

Help Guide for NextGen® Enterprise PM 8

Payments and Adjustments

Payments, and adjustments can increase or decrease the amount due on a patient's account. Payment A payment can be made by the guarantor or a third party payer. In NextGen® Enterprise PM, a payment is applied into the guarantor’s ledger as a negative (-) amount that decreases the balance. Note: A payment can also be positive, such as with payment reversals, which would raise the balance. Adjustment An adjustment can have a positive or negative effect on the ledger. When insurance does not pay the full amount, an adjustment is made to increase the amount due by the patient. Parent topic: Transaction Posting Process

Help Guide for NextGen® Enterprise PM 8

Reversing Payments, Adjustments, and Refunds

Before user can reverse payments, adjustments, or refunds, the users must be assigned the following rights in System Administrator: Reverse Adjustment to enable users to reverse adjustments from the Transactions tab on the patient's chart. Reverse Auto Adjustments - Batch to enable users to reverse automatic adjustments by using the Reverse Automatic Adjustments process in NextGen® Enterprise PM. To access the Reverse Automatic Adjustments window, select File > Processes > Reverse Auto Adjustments. Reverse Auto Adjustments - Encounter to enable users to reverse automatic adjustments by right-clicking an encounter on the patient's chart and selecting Reverse Auto Adjustment. Reverse Payment to enable users to reverse payments from the Transactions tab in the patient's chart. Reverse Refund enable users to reverse refunds from the Transactions tab in the patient's chart. Reversing Adjustments When the Insurance has Changed Reversing Adjustments when Voiding a Charge Retroactively Correct

Help Guide for NextGen® Enterprise PM 8

Set Up a Payment Spread for a patient

When a payment is received and a patient has several line items with amounts due, NextGen® Enterprise PM applies payments to line items using the selected spread options. Open NextGen® Enterprise PM. On the main toolbar, select Posting . The Batch Posting window opens. Double-click the batch header record. The Payment Entry window opens. Enter the encounter number in Enc/Clm#. The account guarantor, patient, medical record number, and the billed account displays in the Payment Entry window. Select Open. The Payment Entry window is available for modifications. In Pay Amt and Adj Amt, enter the payment and adjustment amount respectively. Select the line items to apply the spread amount.` Right-click, and select Spread, and then select one of the following options: FIFO FIFO - Pat Resp Date Weight Distribution Select Save. The selected payment spread is applied to the given line item. Parent topic: Payments Spread Overview

Help Guide for NextGen® Enterprise PM 8

Reversing Payments, Adjustments, and Refunds

Before you can reverse payments, adjustments, or refunds, you must have the following rights assigned in System Administrator: Reverse Adjustment to enable users to reverse adjustments from the Transactions tab on the patient's chart. Reverse Auto Adjustments - Batch to enable users to reverse automatic adjustments by using the Reverse Automatic Adjustments process in NextGen® Enterprise PM. You can access the Reverse Automatic Adjustments window by selecting File > Processes > Reverse Auto Adjustments. Reverse Auto Adjustments - Encounter to enable users to reverse automatic adjustments by right-clicking an encounter on the patient's chart and selecting Reverse Auto Adjustment. Reverse Payment to enable users to reverse payments from the Transactions tab in the patient's chart. Reverse Refund enable users to reverse refunds from the Transactions tab in the patient's chart. Different Scenarios for Reversing Adjustments You can manage and reverse the adjustments from NextGen® Enterprise

Help Guide for NextGen® Enterprise PM 8

Using Recalc Function in Payment Entry

In NextGen® Enterprise PM, you can use the Recalc option on the Payment Entry window to adjust the information entered in Payment and Adjustment for a transaction. The Recalc option recalculates the payments and adjustments in the following ways: If you enter payments in the Payment and Adjustment fields on the Payment Entry window, selecting Recalc adjusts the transaction detail line-items according to the Default Transaction Spreading options selected on the Transactions tab of the Practice Preferences window. If you manually enter the payments and adjustments on each line-item in the ledger section of the Payment Entry window, selecting Recalc automatically adjusts the Payment and Adjustment fields. Parent topic: Posting Transactions Overview

Payments and Adjustments

Recommendations

Understanding Payment Responsibility

Payments and Adjustments

Reversing Payments, Adjustments, and Refunds

Set Up a Payment Spread for a patient

Reversing Payments, Adjustments, and Refunds

Using Recalc Function in Payment Entry

Payments and Adjustments

Understanding Payment Responsibility

Payments and Adjustments

Reversing Payments, Adjustments, and Refunds

Set Up a Payment Spread for a patient

Reversing Payments, Adjustments, and Refunds

Using Recalc Function in Payment Entry