Set Up an Encounter for Regular UB Users

Help Guide for NextGen® Enterprise PM 8

Set Up Encounters for Enhanced UB Claims (After Billing)

Access the Encounter Maintenance window for the patient and encounter the UB claim was created for. In NextGen® Enterprise PM, select the Chart button on the main toolbar. The Patient Lookup window opens. Enter Search Criteria to locate the desired patient and then select Find. From the Matching Records section, double-click to open the desired patient. The Patient Chart window opens. Select the Encounters tab. Right-click the encounter, and then select Open. The Service Location field is no longer accessible once an encounter has been billed. Select the UB tab. Encounter Maintenance The fields on this window automatically default the applicable information once the encounter has been billed. Do not change any of the information on this window. Select the Occurrence Codes tab. UB The fields on this window automatically default the occurrence code information once the encounter has been billed. These occurrence codes are attached to the revenue codes, which are attached to the service i

Help Guide for NextGen® Enterprise PM 8

Set Up Encounters for Enhanced UB Claims (Before Billing)

Access the Create Encounter or Encounter Maintenance window for the patient and encounter the UB claim is being created for. In NextGen® Enterprise PM, select the Chart button on the main toolbar. The Patient Lookup window opens. Enter Search Criteria to locate the desired patient and then select Find. From the Matching Records section, double-click to open the desired patient. The Patient Chart window opens. Select the Encounters tab. Right-click the encounter, and then select Open. The Encounter Maintenance window opens. Encounter Maintenance Enter the date the patient first began experiencing symptoms, in the Onset Date field. Select a service location in the Service Location field. The service location must be the same as the service location that was selected on the UB tab of the Modify Payer Information window. Select OK. Parent topic: Setting Up UB Claims for Enhanced UB Users

Help Guide for NextGen® Enterprise PM 8

Viewing General Information in Encounters

Viewing General Information in Encounters Viewing General Information in Encounters The General tab under Encounters in the patient's chart displays general, provider, diagnosis, and guarantor information for the selected encounter. You can use the Encounters tab to do the following: Open an encounter to view the Encounter Maintenance window. Right-click an encounter to open the shortcut menu. Add or to modify an encounter. Add or modify encounter-level diagnosis codes for an encounter in the ICD-CM section. You can view the ICD-9 to ICD-10 mapping for the ICD-10 codes that have been attached to the patient for the encounter. Add or modify guarantor information for an encounter in the Guarantor section. View the existing case icon next to the encounter number in the Encounters section if Case Management has been enabled for your practice and a case is associated with the encounter. View the following if an encounter is marked as sensitive in NextGen® Enterprise EHR: The sensitive encou

Help Guide for NextGen® Enterprise PM 8

Setting Up Encounters for UB Claims

The following list outlines the areas of the Encounter Maintenance window that are important to the setup of UB claims: On the General tab, complete the Service Location field. On the UB tab, access the following sub-tabs: Condition Codes, Occurrence Codes, and Value Codes. Encounter Maintenance Note: For Enhanced UB users, the automated UB claims process only applies to payers who are considered primary. The automating of the Type of Bill field, the Occurrence codes, and the Value codes, which are explained in the following sections, only occurs for primary payers who have the required criteria. UB/General Tab UB/Condition Codes Tab UB/Occurrence Codes Tab UB/Value Codes Tab Setting Up Practice Preferences for UB Claims Parent topic: UB Claims

Help Guide for NextGen® Enterprise PM 8

Add or Modify Revenue Codes for Encounter Rate Billing

Encounter rate payers that are billed on UB/837I claims require a four-digit revenue code in Field Locator 42 for each line item on the claim. Therefore, a revenue code must be attached to all SIM codes in the Service Items library that may be billed on a UB/837I claim. Note: The Revenue Codes master file in File Maintenance is pre-installed. Items should be reviewed and modified as needed. To add or modify a revenue code for encounter rate billing, do the following: Access File Maintenance. Select System Master Files, then PM, and then Revenue Codes. The Revenue Codes List window opens. Do one of the following: To add a revenue code, select Open Menu and select New. To modify a revenue code, select the code from the list, and then select Open Menu and select Open. The Add/Modify Revenue Code Information window opens. In the Code field, enter the four-digit revenue code. This field is required. In the Description field, enter a descriptive name for the revenue code. This field is requi

Help Guide for NextGen® Enterprise PM 8

Add Benefit Information to Patient Insurance

You can record annual and lifetime benefit information to help determine patient responsibility. 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 then select Find. Patient records that match the search criteriaa ppear in the Matching Records section. Select the patient, and then select Open. The Patient Chart window opens. Select the Encounters tab. The encounters associated with the patient appear in the Encounters section. Select the Insurance tab and then select the encounter from the Encounters section. Right-click the selected insurance, and then select Open. The Insurance Maintenance window opens. Select the Benefits Info tab and then select the Eligibility and Benefits tab. To view existing benefit information, select open menu and then select New or Open. The Eligibility and Benefit Maintenance window opens. Eligibilty and Benefit Information Win

Set Up an Encounter for Regular UB Users

Recommendations

Set Up Encounters for Enhanced UB Claims (After Billing)

Set Up Encounters for Enhanced UB Claims (Before Billing)

Viewing General Information in Encounters

Setting Up Encounters for UB Claims

Add or Modify Revenue Codes for Encounter Rate Billing

Add Benefit Information to Patient Insurance