Recalculation Results Report

Help Guide for NextGen® Enterprise PM 8

Recalculation Results Report

The Recalculation Results report displays messages related to encounters that may have been evaluated for recalculation of new charge prices based on changes made. The report has two purposes: To show SIM price derivation. To let users know if there was a problem that caused recalculation to fail. Recalculation happens when the following events take place: An In Progress encounter is manually recalculated by using the Recalc Enc button on the Charge Posting window, or the Recalculate ‘In Progress’ Encounter menu option. An In Progress encounter is converted to Unbilled. The encounter change process is performed. Encounter insurances are re-ordered. The Prorate button is selected on the Balance Control window. Changes are made to an unprocessed charge, such as date of service, place of service or location that could result in a different SIM library or price derivation. To access the report in NextGen® Enterprise PM, select the Reports menu and select General and then select Person Empl

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

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

System Administrator User Guide

Encounters Operation

Subgroup Used in Description Add Patient Encounter NextGen® Enterprise PM & NextGen® Enterprise EHR Enables users to create encounters. Convert In Progress Batch Process NextGen® Enterprise PM Enables users to change the status of multiple encounters from "In Progress" to "Unbilled". Convert In Progress Demand Process NextGen® Enterprise PM Enables users to change the status of an encounter from "In Progress" to "Unbilled". Convert In Progress Indicator NextGen® Enterprise PM &NextGen® Enterprise EHR Enables users to modify (select or clear) the Convert In Progress check box on the Encounter Maintenance window. Delete Encounter Rate SIM and Rate NextGen® Enterprise PM Enables users to delete an encounter rate SIM and encounter rate amount from Encounter Maintenance. Delete Patient Encounter NextGen® Enterprise PM &NextGen® Enterprise EHR Enables users to delete patient encounters. Demand Bill NextGen® Enterprise PM Enables users to access the Bill toolbar button or right-click menu to

System Administrator Help

Encounters Operation

Subgroup Used in Description Add Patient Encounter NextGen® Enterprise PM & NextGen® Enterprise EHR Enables users to create encounters. Convert In Progress Batch Process NextGen® Enterprise PM Enables users to change the status of multiple encounters from "In Progress" to "Unbilled". Convert In Progress Demand Process NextGen® Enterprise PM Enables users to change the status of an encounter from "In Progress" to "Unbilled". Convert In Progress Indicator NextGen® Enterprise PM &NextGen® Enterprise EHR Enables users to modify (select or clear) the Convert In Progress check box on the Encounter Maintenance window. Delete Encounter Rate SIM and Rate NextGen® Enterprise PM Enables users to delete an encounter rate SIM and encounter rate amount from Encounter Maintenance. Delete Patient Encounter NextGen® Enterprise PM &NextGen® Enterprise EHR Enables users to delete patient encounters. Demand Bill NextGen® Enterprise PM Enables users to access the Bill toolbar button or right-click menu to

Help Guide for NextGen® Enterprise PM 8

Retrieving Charge Amount in Cost Estimation

Charge amount is the amount a healthcare provider sets for the rendering services before applying any discounts. The pricing for a service depends on whether the place of service is a facility or non-facility location. If you are the administrator, you can set the Non-Facility Price and Facility Price fields for a specific SIM code in the SIM library and SIM exception. For information on setting up the pricing for a service item in File Maintenance, go to the NextGen Healthcare Success Community and download the File Maintenance Libraries Guide forNextGen®Enterprise. When you estimate the patient cost, the value for the charge amount is returned as follows: If the charge amount is set in the SIM exception and SIM library, the value in the SIM exception returns. If the charge amount is set in the SIM exception only, the value in the SIM exception returns. If the charge amount is set in the SIM library only, the value in the SIM library returns. If the charge amount is not set in the SIM

Recalculation Results Report

Recommendations

Recalculation Results Report

Rebill an Encounter using Balance Control

Rebill an Encounter using Balance Control

Encounters Operation

Encounters Operation

Retrieving Charge Amount in Cost Estimation

Recalculation Results Report

Recalculation Results Report

Rebill an Encounter using Balance Control

Rebill an Encounter using Balance Control

Encounters Operation

Encounters Operation

Retrieving Charge Amount in Cost Estimation