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

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 Multiple Encounters (Batch Billing)

All encounters in Unbilled or Rebill status with charges can be billed at the same time in a batch. Open NextGen® Enterprise PM. Select Encounter. The Encounter Lookup window opens. Select Bill Status, and then select Rebill and 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 encounters. Select Find. Encounters matching the search criteria appear in the Encounter List section of the window. Select Encounter List, and then select all encounters to be billed in the Enc Nbr column. Right-click the encounter and select Bill. A message appears stating that confirm bill processing for the [n] selected encounters. To continue billing the selected encounters, select OK. The encounters go through the claim edits process and the Claim Production Status report appears. Each encounter is listed o

Help Guide for NextGen® Enterprise PM 8

Charge Posting Toolbar

The toolbar on the Charge Posting window includes icons that you can use to perform a variety of actions and functions when working with charges in NextGen® Enterprise PM. The following table describes the use of each icon available on the Charge Posting toolbar. Icons Name Description View Chart Opens the Patient Chart window for the selected patient. Recall Opens the Recall Plan Maintenance window to add a recall for a patient who has no existing recalls, or the Patient Recall window for a patient who has one or more existing recall. Encounter Maintenance Opens the Encounter Maintenance window for the selected encounter to add the encounter details. Encounter Insurance Opens the Encounter Insurance Selection window for the selected encounter to add insurance to an encounter. Patient Insurance - Encounter Opens the Patient Insurance – Encounter window for the primary payer on the selected encounter. Balance Control Opens the Balance Control window for the selected encounter. Patient B

Help Guide for NextGen® Enterprise PM 8

Bill an Individual Encounter from the Charge or Payment Window

Open the Charge Posting or Payment Entry window for the desired patient encounter. From the toolbar, select the Bill Encounter button. The Encounter Bill window opens listing all charges on the encounter. If the encounter has a status of Unbilled, charges are pre-selected for billing and if the encounter has a status of Rebill, you must select the charges to be billed. To bill the selected charges, select OK. 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 encounter is listed on the report with a message in one of the following colors. Green: An informational message indicating the encounter passed all claim edits. A pending claim is created. Blue: A warning message indicating the encounter passed all claim edits, but information is included

Rebill an Encounter using Balance Control

Recommendations

Reorder Encounter Insurances using Balance Control

Balance Control

Bill an Individual Encounter from Encounter Lookup

Bill Multiple Encounters (Batch Billing)

Charge Posting Toolbar

Bill an Individual Encounter from the Charge or Payment Window

Reorder Encounter Insurances using Balance Control

Balance Control

Bill an Individual Encounter from Encounter Lookup

Bill Multiple Encounters (Batch Billing)

Charge Posting Toolbar

Bill an Individual Encounter from the Charge or Payment Window