Post a Payment to an Alternate Payer

File Maintenance Help for NextGen® Enterprise 8

Post a Payment to an Alternate Payer

When you post a payment for an encounter having multiple alternate payers associated with a payer, all the payers are listed in the Payer field. Note: You can apply a payment to the alternate payer even if the alternate payer was not billed during the billing process. In NextGen® Enterprise PM, selec the Posting icon. The Batch Posting window opens. Double-click an existing batch. The Payment Entry window opens. Select the applicable patient or encounter number. In the Payer field, select an alternate payer associated with a payer. Enter the payment amount and adjustment amount. Select the payment code and adjustment code. Note: If you have set up the default payment and default adjustment code in the Payers-Alt Payers master file for the alternate payer, then the payment code and adjustment code automatically appears when you enter the payment and adjustment amount. If you have not set up the default payment and default adjustment code in the Payers-Alt Payers master file, then the al

Help Guide for NextGen® Enterprise PM 8

Configuring Alternate Payers

The Alternate Payer Simultaneous Billing feature enables you to associate an alternate payer to a payer set up in the Payers master file. When you bill an encounter with a payer having multiple alternate payers, separate claims are generated simultaneously. The Alt Payer tab lists the alternate payer configurations for a payer. You can use the Alternate Payer Simultaneous Billing feature when the charges for an encounter should be billed to different payers (payer carve-out), usually on a different claim form type (1500 and UB). For example, you set up a payer to bill medical services such as an office visit (99213). Now, when you bill a behavioral health service for substance abuse therapy, the claim may go to a trading partner where the diagnosis is F11.10. But when the same substance abuse therapy is rendered for a patient with a mental health disorder, such as depression, the claim goes to the Department of Mental Health. Note: When you use the Alternate Payer Simultaneous Billing

Help Guide for NextGen® Enterprise PM 8

Set Up Default Transaction Codes for an Alternate Payer

When you are using the alternate payer functionality, you might find that the main payer on the Payer master file, and the alternate payer on the Payers-Alt Payer master file has different Default Transaction Codes. In File Maintenance, select Master Files > System > PM > Payers-Alt Payers. The Payers-Alt Payers List window opens. From the Payers-Alt Payers List window, select and open the applicable alternate payer. The Modify Alt- Payer Information - Demo Payer window opens. Select the Alt Payer Transaction Option tab. The fields under the Alt Payer Transaction Option tab appear. Select default transaction codes for the alternate payer. For more information, see Settings - default transaction codes for the alternate payer To save the changes and close the window, select OK. Note: For more information on the Payers-Alt Payers master file go to NextGen Healthcare Success Community and download the latest Claims User Guide for NextGen® Enterprise PM. Settings - default transaction codes

Help Guide for NextGen® Enterprise PM 8

Alternate Payers

The Payers-Alt Payers master file allows you to create an alternate payer and associate the alternate payer to a payer in the Payers master file. You can associate the same alternate payer to multiple payers or associate multiple alternate payers to a payer. When you bill an encounter with a payer having alternate payers, separate claims can be generated simultaneously. For example, you set up a payer to bill medical services such as an office visit (99213). Now, when you bill a behavioral health service for substance abuse therapy, the claim may go to a trading partner where the diagnosis is F11.10. But when the same substance abuse therapy is rendered for a patient with a mental health disorder, such as depression, the claim goes to the Department of Mental Health. You can also hide or show an alternate payer by selecting open menu and then selecting Hide or Un-hide. You can generate Alternate Payer Listing report from the Payers-Alt Payers master file. For more information, go to Ne

File Maintenance Help for NextGen® Enterprise 8

Alternate Payers

The Payers-Alt Payers master file allows you to create an alternate payer and associate the alternate payer to a payer in the Payers master file. You can associate the same alternate payer to multiple payers or associate multiple alternate payers to a payer. When you bill an encounter with a payer having alternate payers, separate claims can be generated simultaneously. For example, you set up a payer to bill medical services such as an office visit (99213). Now, when you bill a behavioral health service for substance abuse therapy, the claim may go to a trading partner where the diagnosis is F11.10. But when the same substance abuse therapy is rendered for a patient with a mental health disorder, such as depression, the claim goes to the Department of Mental Health. You can also hide or show an alternate payer by selecting open menu and then selecting Hide or Un-hide. You can generate Alternate Payer Listing report from the Payers-Alt Payers master file. For more information, go to Ne

Help Guide for NextGen® Enterprise PM 8

Post a Transaction on a Bad Debt Encounter

Open NextGen® Enterprise PM. Select Posting. The Batch Posting window opens. Select the batch, and then right-click the selected batch and select Open. The Payment Entry window opens. In the Source field, select Encounter. Open the desired Patient and then open a bad debt Encounter. In the Payer field, select Patient. Enter tracking information in the Tracking field, if needed. Add any additional notes or comments in the Transaction Notes field, if needed. Enter the payment amount in the Pay Amt field, and then select the appropriate bad debt Pay Code. Enter the adjustment amount in the Adj Amt field, and then select the appropriate bad debt Adj Code. The payment and adjustment amounts are automatically allocated to line items with a patient balance. Select Recalc. To save the transaction, select Save. Parent topic: Posting Transactions on Bad Debt Encounters

Post a Payment to an Alternate Payer

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