Service Unit Authorizations

Help Guide for NextGen® Enterprise PM 8

Service Unit Authorization Report

The Service Unit Authorization report in NextGen® Enterprise PM enables you to review and monitor patients with service unit authorizations to determine whether they have met or exceeded the maximum number of packaged services authorized by their insurance, and whether those services were provided within the time frame authorized by the payer. You can also use the report to determine if patients with upcoming appointments are nearing their service limit so an authorization for additional units or days can be requested and obtained from their insurance. This encounter-based report is available only if a Service Package Library is selected in Practice Preferences > Libraries. For more information on Service Packages and Service Unit Authorization, go to the NextGen Healthcare Success Community and download the Behavioral Health Billing User Guide for NextGen® Enterprise PM The Service Unit Authorization report includes patients with a service unit authorization that have encounters with

Help Guide for NextGen® Enterprise PM 8

Working with Service Packages in NextGen® Enterprise PM

When Service Package functionality is enabled for a practice, you can utilize the following functionality in NextGen® Enterprise PM: From the Authorizations tab on the Insurance Maintenance window or Authorization Listing window, you can enter service unit authorizations for payers that authorize packaged services for patients with unit and duration limitations. From the Reports > General > Authorizations menu, you can generate a Service Unit Authorization report to review and monitor patients with service unit authorizations and determine whether they have met or exceeded the maximum number of packaged services authorized by their insurance. Service Unit Authorizations Service Unit Authorization Report Parent topic: Service Packages in NextGen Enterprise PM

Help Guide for NextGen® Enterprise PM 8

Access Authorizations for a Patient's Insurance

You can access authorizations for a patient's insurance from the following areas in NextGen® Enterprise PM: Modify Patient Information window Insurance sub-tab Case Management sub-tab Encounter Insurance Selection window Insurance Maintenance window Access Authorization from Modify Patient Information Window Access Authorization from Insurance Sub-Tab Access Authorization from Case Management Sub-Tab Access Authorization from Encounter Insurance Selection Window Access Authorization from Insurance Maintenance Window Parent topic: Service Unit Authorizations

Help Guide for NextGen® Enterprise PM 8

Service Unit Authorizations

A payer can provide an authorization for the patient to have a specific service package with unit limitations, and those packaged services may be rendered within a date range defined by the payer. This type of authorization is entered in NextGen® Enterprise PM as a service unit authorization. From the Service Unit Limitation Maintenance window, you can enter a service unit authorization with the following information: Free-text description Authorization code (required) Start and stop dates (required) Assessment date Package (required) Add-on packages Additional free-text notes Note: Service Unit Authorizations are available only if a Service Package Library is selected in Practice Preferences > Libraries. For more information on Service Packages and Service Unit Authorizations, NextGen® Enterprise EHR, go to the NextGen Healthcare Success Community and download the Behavioral Health Billing User Guide forNextGen® Enterprise PM. Parent topic: About the Authorizations Tab in Insurance Ma

Help Guide for NextGen® Enterprise PM 8

Add or Modify Service Unit Authorization

Access authorizations for a patient's insurance. The Authorization Listing window opens. To add a service unit authorization, select open menu and then select New > Service Unit Authorization. The Service Unit Limitation Maintenance window opens. Do the following: Enter a description for the service unit authorization. Enter the authorization code obtained from the payer. Point to the Information to view tool tip information stating that the authorization code is for tracking purposes only and is not sent on claims. Enter the start and end date for the authorization. Enter the date when the patients needs and strengths were last assessed. Select a service package for the authorization. Note: The Add On Packages field is disabled for a new authorization. The Level of Need field and the Adult or Child options are updated from the selected package. These fields cannot be modified. The Service Configurations section lists all the configurations within the selected package. For information

Help Guide for NextGen® Enterprise PM 8

Delete a Service Unit Authorization

A service unit authorization can be deleted, if needed. For example, if you entered an authorization under the wrong insurance for a patient, you can delete it and then add it under the correct insurance. Access authorizations for a patient's insurance. The Authorization Listing window opens. To delete a service unit authorization, select it from the list and then do one of the following: Select Open Menu and then select Delete. Right-click and then select Delete. The following prompt displays: Confirm delete of the Service Unit Authorization code [Number]? To delete the service unit authorization, select Yes. The service unit authorization is deleted and removed from the list of authorizations for the patient's insurance. Parent topic: Service Unit Authorizations

Service Unit Authorizations

Recommendations

Service Unit Authorization Report

Working with Service Packages in NextGen® Enterprise PM

Access Authorizations for a Patient's Insurance

Service Unit Authorizations

Add or Modify Service Unit Authorization

Delete a Service Unit Authorization

Service Unit Authorization Report

Working with Service Packages in NextGen® Enterprise PM

Access Authorizations for a Patient's Insurance

Service Unit Authorizations

Add or Modify Service Unit Authorization

Delete a Service Unit Authorization