Removing Insurance from an Encounter

Help Guide for NextGen® Enterprise PM 8

Delete Insurance from the Patient Chart

You can delete an insurance for a patient from the patient's chart. A few things to remember: If a patient is checked in, the insurance is attached to the encounter. If no charges have been created, you can delete the payer and add the correct one. If the claim is created, you can delete all charge lines and then delete the payer and add the correct one. If the encounter has been billed, you must go to balance control and make the amount $0.00 for each charge line for the Ins1column. You can then delete the payer and add the correct one. To delete the insurance from the patient chart, do the following: On the main toolbar, select the chart icon. The Patient Lookup window appears. Locate the appropriate patient. The patient chart displays. Select the Encounter tab and then the Insurance tab. From the Encounter section, select the appropriate encounter. In the Encounter Insurance section, right-click on the payer and select Delete. A confirmation prompts displays. Select OK. Parent topic

Help Guide for NextGen® Enterprise PM 8

Add Insurance to Encounters

You can use the Encounter Insurance Selection window to add one or more insurances to an encounter for billing or to access the Insurance Maintenance window for an insurance. A pushpin appears in columns when data exists for the category. To quickly view existing data for a category, you can hover over the pushpin icon, or select the pushpin icon to access the specific tab on the Insurance Maintenance window. For example, hover over the pushpin icon in the Card column to view the Last Card Attached Date or select the pushpin icon to access the Insurance Maintenance > Ins Cards tab. Open NextGen® Enterprise PM. On the main toolbar, select Chart or Chart Lookup.. The Patient Lookup window opens. In the Search Criteria section, enter the patient's information, and select Find. Patient records that match the search criteria, appear in the Matching Records section. Select the patient, and then select Open. The Patient Chart window opens. Select Encounters, and then select on the Insurance t

Help Guide for NextGen® Enterprise PM 8

Encounter Insurance Selection Window

The window also provides you with a pushpin icon to indicate that data exists for a category and provides you with easy access to the Insurance Maintenance window. Also, you can perform the following actions: Access a right-click menu with options for sizing columns and selecting columns to display on the window. Select the pushpin icon to access the Insurance Maintenance window and view, add, or modify information to the category. Hover over the column header to view information such as patient name, DOB, effective date, expiration date, encounters remaining, and status. Select on a column to access the corresponding tab on the Insurance Maintenance window. For example, if a pushpin icon is not present in the Card column, a select in the column will take you directly to the Ins Cards tab of the Insurance Maintenance window. Resize, move, and remove columns from the window Add Insurance to Encounters You can add one or more insurances to an encounter for billing purposes. Add Insurance

Help Guide for NextGen® Enterprise PM 8

Remove Payers from an Encounter to be Deleted

Access the Patient Chart. Select the Encounters tab, and then the General sub-tab. From the Encounters list, select the encounter to be deleted. Select the Insurance sub-tab. In the Encounter Insurance section, select a payer to be removed. Right-click and select Delete from the menu. A prompt appears asking to confirm the removal of encounter insurance. To remove the payer, select OK. One of the following occurs: If the payer is not associated with charges or claims, it is removed from the encounter. If the payer is associated with charges, the following prompt appears stating that there is a dollar amount in balance control bucket [n] and that the balance control must be updated before this payer can be deleted. If the payer is associated with claims, then a prompt appears asking if you are sure about removing insurance as the insurance is still attached to claims. Repeat from step 5 to step-7 for additional insurances to be removed. Parent topic: Delete Encounters

Help Guide for NextGen® Enterprise PM 8

Reversing Automatic Adjustments

When you remove insurance from an encounter with automatic adjustments applied to charges from an assigned contract and there are no other posted or unposted transactions applied to the encounter, the automatic adjustments are applied to the encounter for the payer. The application reverses the adjustment and removes the insurance from the encounter. Note: The application applies new adjustments to applicable charges if you attach a new payer to the encounter that has a contract with auto adjustments for the charges. You can delete a primary insurance for an encounter that has an automatic adjustment applied to its charges from an assigned contract and the encounter has no other posted or unposted transactions applied to it. You can delete it by selecting Delete on the Insurance tab on the Patient Chart window. The automatic adjustments are applied to the encounter for the payer and the application reverses the adjustment and deletes the payer from the encounter. You can also void a ch

Help Guide for NextGen® Enterprise PM 8

Reversing Adjustments When the Insurance has Changed

When a user is changing the insurance on an encounter, the application issues a prompt that enables you to reverse automatic adjustments on the encounter. To reverse the adjustments and remove the insurance, you can select Yes. To keep the original insurance attached to the encounter, you can select No. When a user deletes insurance from an encounter, the application displays a prompt that enables the user to reverse automatic adjustments on the encounter when the insurance is deleted. To reverse the adjustments and delete the insurance, you can select Yes. To keep the original insurance attached to the encounter, you can select No. Parent topic: Reversing Payments, Adjustments, and Refunds

Removing Insurance from an Encounter

Recommendations

Delete Insurance from the Patient Chart

Add Insurance to Encounters

Encounter Insurance Selection Window

Remove Payers from an Encounter to be Deleted

Reversing Automatic Adjustments

Reversing Adjustments When the Insurance has Changed

Delete Insurance from the Patient Chart

Add Insurance to Encounters

Encounter Insurance Selection Window

Remove Payers from an Encounter to be Deleted

Reversing Automatic Adjustments

Reversing Adjustments When the Insurance has Changed