Rounding Methods Field Description

Field	Description
Base Minutes	The standard Base Minute values (15, 30, 60, and 240) are displayed in separate rows with a default rounding method as follows: 15 minutes: Down at 7, Up at 8, Less than 8 is 0 30 minutes: Down at 14, Up at 15, Less than 15 is 0 60 minutes: Down at 29, Up at 30, Less than 30 is 0 240 minutes: Down at 119, Up at 120, Less than 120 is 0 For example, if the base minutes for a SIM code is set to 15 minutes, and the 15 minute rounding method is set to the default Down at 7, Up at 8, Less than 8 is 0, then the units are calculated based on the total time entered for a charge. Charge Total Time = 7 minutes Units = 0 Charge Total Time = 8 minutes Units = 1 Charge Total Time = 15 minutes Units = 1 Charge Total Time = 22 minutes Units = 1 Charge Total Time = 23 minutes Units = 2 To customize a Base Minute Rounding Method, select the row for the desired Base Minutes and modify the fields as needed.
Down/Exact	Select one of the following for the Base Minute value: Down (default) Exact
Down At	This field is enabled only when Down is selected. Enter the number of minutes, between 1 and 999999, at which units round down for the payer and self-pay. The default value is calculated as follows: If the Base Minute value is even, then Down At = ( Base Minutes / 2) - 1 If the Base Minute value is odd, then Down At = ( Base Minutes / 2) - 1, where ( Base Minutes / 2) value is rounded off to the next value.
Up At	This field displays the number of minutes at which units round up for the payer and self-pay. The field is disabled and is updated by modifying the Down At value. The value is calculated as follows: Up At = Down At + 1
Less Than is 0	Enter the number of minutes, between 1 and 999999, at which units round down to zero for the payer and self-pay. The default value is calculated as follows: If the Base Minute value is even, then Less Than is 0 = ( Base Minutes / 2) If the Base Minute value is odd, then Less Than is 0 = ( Base Minutes / 2) - 1, where ( Base Minutes / 2) value is rounded off to the next value.
Decimal Place	This field is enabled only when Exact is selected. Select one of the following: First (default): Rounds units to the first decimal place. Second: Rounds units to the second decimal place.

Help Guide for NextGen® Enterprise PM 8

Set Up Rounding Methods for Self-Pay

Access NextGen® Enterprise PM. On the Admin menu, select Preferences, and then select Practice. The Practice Preferences window opens. From the Preference List on the left, select Charge Entry. Select the Behavioral Health Charges – Self-Pay Only tab. Set up Behavioral Health Base Minute Rounding Methods for the self-pay encounter in the practice. For more information, see Rounding Methods Field Description. The custom minutes appear in the Behavioral Health Custom Base Minute Rounding Methods section only if you set up one or more Behavioral Health SIM codes with custom base minutes in the Service Items library. Each custom base minute value is displayed in a separate row with a default rounding method for self-pay. The default Down At, Up At, and Less Than is 0 values are calculated. You can customize Behavioral Health Custom Base Minute Rounding Method for self-pay by selecting the row for the desired Base Minutes and modifying the fields. To save changes and close the window, selec

Help Guide for NextGen® Enterprise PM 8

Set Up Rounding Methods for a Payer

Access File Maintenance. Select System Master Files, then PM, and then Payers. The Payer List window opens. From the list, double-click to open the desired payer. The Modify Payer Information window opens. Select the Defaults-2 tab, and then the Rounding Rules sub-tab. In the Behavioral Health Rounding section, set up Behavioral Health Base Minute Rounding Methods for the payer. For more information, refer to Rounding Methods Field Description. The custom minutes appear in the Behavioral Health Custom Base Minute Rounding Methods section only if you set up one or more Behavioral Health SIM codes with custom base minutes in the Service Items library. Each custom base minute value is displayed in a separate row with a default rounding method for the payer. The default Down At, Up At and Less Than is 0 values are calculated. To customize Behavioral Health Custom Base Minute Rounding Method for the payer, select the row for the desired Base Minutes and modify the fields. To save changes an

Help Guide for NextGen® Enterprise PM 8

Payer and Practice Level Rounding Methods

Behavioral Health Base Minute Rounding Methods are available at the payer-level for each payer, and at the practice-level for self-pay. The rounding methods apply to Behavioral Health SIM codes that have been defined in the Service Items Library with 15, 30, 60, 240, or custom Base Minutes. The rounding methods affect how the units are calculated on a behavioral health charge for the payer based on the total time entered for the charge. Set Up Rounding Methods for a Payer Set Up Rounding Methods for Self-Pay You can set up rounding methods for self-pay for time-based billing. Rounding Methods Field Description You can select and modify the rounding methods for the payers and for self-pay. Parent topic: Behavioral Health Billing

File Maintenance Help for NextGen® Enterprise 8

Behavioral Health Rounding

If Behavioral Health SIM codes with standard (15, 30, 60, 240) or custom Base Minutes are set up in the Service Items Library for billing in NextGen® Enterprise PM, then the Behavioral Health Base Minute Rounding Methods should be defined for each payer. The rounding methods affect how the units are calculated on a behavioral health charge for the payer based on the total time entered for the charge. For more information on Behavioral Health Billing, go to the NextGen Healthcare Success Community and download the Behavioral Health Billing User Guide for NextGen® Enterprise PM. Field Description Base Minutes The "standard"Base Minutevalues (15, 30, 60 and 240) display in separate rows with a default rounding method for the payer as follows: 15 minutes:Down at 7, Up at 8, Less than 8 is 0 30 minutes:Down at 14, Up at 15, Less than 15 is 0 60 minutes:Down at 29, Up at 30, Less than 30 is 0 240 minutes:Down at 119, Up at 120, Less than 120 is 0 For example, if the base minutes for a SIM co

Help Guide for NextGen® Enterprise PM 8

Behavioral Health Rounding

If Behavioral Health SIM codes with standard (15, 30, 60, 240) or custom Base Minutes are set up in the Service Items Library for billing in NextGen® Enterprise PM, then the Behavioral Health Base Minute Rounding Methods should be defined for each payer. The rounding methods affect how the units are calculated on a behavioral health charge for the payer based on the total time entered for the charge. For more information on Behavioral Health Billing, go to the NextGen Healthcare Success Community and download the Behavioral Health Billing User Guide for NextGen® Enterprise PM. Field Description Base Minutes The "standard"Base Minutevalues (15, 30, 60 and 240) display in separate rows with a default rounding method for the payer as follows: 15 minutes:Down at 7, Up at 8, Less than 8 is 0 30 minutes:Down at 14, Up at 15, Less than 15 is 0 60 minutes:Down at 29, Up at 30, Less than 30 is 0 240 minutes:Down at 119, Up at 120, Less than 120 is 0 For example, if the base minutes for a SIM co

Help Guide for NextGen® Enterprise PM 8

Calculating Roll-Up Charge Units and Price during Billing

In NextGen® Enterprise PM, the Units and Price for each behavioral health charge is calculated during charge posting. For more information, see Calculating Charge Units and Price during Charge Posting. When multiple behavioral health charges on a single encounter have the same CPT4 code, the same modifiers, the same base minutes and the same unit price, those charges roll-up, or bundle, into a single line item on the claim. The Units and Price for a roll-up charge on claims is calculated during the billing process as follows: The total time in minutes for the roll-up charge is calculated by adding the total time from all charges included in the roll-up. Charge 1 Time + Charge 2 Time = Total Time The roll-up charge units are then calculated by dividing the total time by the base minutes defined for the SIM code. Any additional minutes are rounded using the base minute rounding method configured for the payer. Total Time / Base Minutes = Units Note: The SIM code Base Minutes is either a

Rounding Methods Field Description

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Calculating Roll-Up Charge Units and Price during Billing

Set Up Rounding Methods for Self-Pay

Set Up Rounding Methods for a Payer

Payer and Practice Level Rounding Methods

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Calculating Roll-Up Charge Units and Price during Billing