Rebill an Encounter using Balance Control

Help Guide for NextGen® Enterprise PM 8

Reorder Encounter Insurances using Balance Control

When the wrong insurance is attached to an encounter, or the correct insurance is attached to an encounter but in the wrong order, the incorrect insurance can be billed. You can use Balance Control to reorder encounter insurances, so the correct insurance is billed. To reorder encounter insurances using balance control, do the following: Open NextGen® Enterprise PM. Select Charges. The Charge Posting window opens. Select the desired patient and encounter, and then select the Balance Control icon. The Balance Control window opens. Select the payer to be reordered. Do one of the following: Select the blue down arrow button to move the payer to a lower order. Select the blue up arrow button to move the payer to a higher order. A confirmation message appears stating that the insurance amount follows payer to the next selected bucket. Do one of the following: Select No to leave the charge balances in the current Ins Amt bucket. Select Yes to move the charge balances out of the current Ins A

Help Guide for NextGen® Enterprise PM 8

Rebill an Encounter using Balance Control

Encounters that have already been billed to insurance can be rebilled for a variety of reasons. For example, a new charge can be added to the encounter, an existing charge can be corrected and modified, or insurance has not responded to the initial claim. Balance Control is used to flag one or more charges on an encounter to be rebilled to insurance. To flag all the charges to be rebilled, do the following: Open NextGen® Enterprise PM. Select Charges. The Charge Posting window opens. Select the desired patient and encounter, and then select the Balance Control icon. The Balance Control window opens. Right-click in the R (Release to Bill) column for the payer to be rebilled. Select Select All Ins. All line items show check mark in the R (Release to Bill) column, the encounter status changes to Rebill, and the Rebill Encounter check box is automatically selected. To save changes and close the window, select OK. To flag specific charges to be rebilled, do the following: Open the Balance C

Help Guide for NextGen® Enterprise PM 8

Balance Control

Balance Control performs the following: Rebill encounter Reorder encounter insurances Add encounter insurance Reassign encounter balances Prorate charge balances Note: Access to Balance Control is dependent on security access rights in System Administrator > Group Rights > Modules > Transactions > Balance Control. If you attach the initial Balance Control for an unbilled encounter with primary and secondary insurances and enter the charges on the encounter, all charges are flagged with a check mark on the R (Release to Bill) column for billing to primary insurance. The patient is responsible for a co-pay amount on the first charge, and primary insurance is responsible for the remaining charge balances. When the encounter has gone through the billing process and a claim is successfully created for the primary insurance, the check marks on the R (Release to Bill) column disappear. You can view Balance Control Tips window by selecting the Charge Information icon. The window provides infor

Help Guide for NextGen® Enterprise PM 8

Bill an Individual Encounter from Encounter Lookup

Open NextGen® Enterprise PM. Select Encounter. The Encounter Lookup window opens. In the Bill Status field, select Rebill or Unbilled. Note: Encounters with a status of Bad Debt, Billed or History have already been billed. Clear the Include records without charges check box to exclude encounters that do not have charges. Enter additional Search Criteria to locate the desired encounter. Select Find. Encounters matching the search criteria display in the Encounter List section of the window. Select Encounter List, and then select the encounter to be billed in the Enc Nbr column. Right-click the encounter, and then select Bill. If the encounter is a self-pay encounter with no insurance attached, a message appears stating that do you want to bill this self-pay encounter. Select Yes. The encounter status changes from Unbilled or Rebill to Billed. If the encounter has insurance attached, the encounter goes through the claim edits process and the Claim Production Status report appears. The en

Help Guide for NextGen® Enterprise PM 8

Bill an Individual Encounter from Encounter Lookup

Open NextGen® Enterprise PM. Select Encounter. The Encounter Lookup window opens. In the Bill Status field, select Rebill or Unbilled. Note: Encounters with a status of Bad Debt, Billed or History have already been billed. Clear the Include records without charges check box to exclude encounters that do not have charges. Enter additional Search Criteria to locate the desired encounter. Select Find. Encounters matching the search criteria display in the Encounter List section of the window. Select Encounter List, and then select the encounter to be billed in the Enc Nbr column. Right-click the encounter, and then select Bill. If the encounter is a self-pay encounter with no insurance attached, a message appears stating that do you want to bill this self-pay encounter. Select Yes. The encounter status changes from Unbilled or Rebill to Billed. If the encounter has insurance attached, the encounter goes through the claim edits process and the Claim Production Status report appears. The en

Help Guide for NextGen® Enterprise PM 8

Balance Control

Balance Control performs the following: Rebill encounter Reorder encounter insurances Add encounter insurance Reassign encounter balances Prorate charge balances Note: Access to Balance Control is dependent on security access rights in System Administrator > Group Rights > Modules > Transactions > Balance Control. If you attach the initial Balance Control for an unbilled encounter with primary and secondary insurances and enter the charges on the encounter, all charges are flagged with a check mark on the R (Release to Bill) column for billing to primary insurance. The patient is responsible for a co-pay amount on the first charge, and primary insurance is responsible for the remaining charge balances. When the encounter has gone through the billing process and a claim is successfully created for the primary insurance, the check marks on the R (Release to Bill) column disappear. You can view Balance Control Tips window by selecting the Charge Information icon. The window provides infor

Rebill an Encounter using Balance Control

Recommendations

Reorder Encounter Insurances using Balance Control

Rebill an Encounter using Balance Control

Balance Control

Bill an Individual Encounter from Encounter Lookup

Bill an Individual Encounter from Encounter Lookup

Balance Control

Rebill an Encounter using Balance Control

Reorder Encounter Insurances using Balance Control

Rebill an Encounter using Balance Control

Balance Control

Bill an Individual Encounter from Encounter Lookup

Bill an Individual Encounter from Encounter Lookup

Balance Control