Set Up Billing Options

Help Guide for NextGen® Enterprise PM 8

Set Up Claim Options

The Claim Options tab is used to configure specific parameters that affect claims for Behavioral Health charges. Options to always send unit count as 1 on claim charge lines, and to always send one line item per claim are available. On secondary and tertiary claims, charges can bill as the total sum of the roll-up charges, or as the total sum minus transactions posted from the prior payer. Also, secondary and tertiary claims can be billed as a primary claim depending on the prior payer. Open File Maintenance. Select Libraries, and then Behavioral Health Billing. The Behavioral Health Billing List window opens. Double-click to open the desired library. The Behavioral Health Billing Library Maintenance window opens. Select the Claim Options tab. Behavioral Health Billing Library Maintenance window; Claim Options tab Complete the fields to set up Claim Options. For more information on each field, see Claim Options Field Descriptions. To save changes and close the window, select OK. Claim

File Maintenance Help for NextGen® Enterprise 8

Set Up Billing Options

The Billing Options tab is used to specify which Place of Service code and ICD codes should be used on claims when multiple Behavioral Health charges on an encounter each have different codes. It also allows selection of an adjustment reason code for auto-balancing a variance amount on COB claims. Open File Maintenance. Select Libraries, and then select Behavioral Health Billing. The Behavioral Health Billing List window opens. From the list, double-click to open the desired library. The Behavioral Health Billing Library Maintenance window opens. Select the Billing Options tab. Complete the fields to set up Billing Options. For more information on each field, see Billing Options Field Descriptions. To save changes and close the window, select OK. Billing Options Field Descriptions Parent topic: Behavioral Health Billing Library

Help Guide for NextGen® Enterprise PM 8

Add or Modify a Behavioral Health Billing Library

Open File Maintenance. Select Libraries, and then Behavioral Health Billing. The Behavioral Health Billing List window opens. Do one of the following: To create a library, select open menu button and select New. To modify a library, select the library from the list, and then select open menu and select Open. The Behavioral Health Billing Library Maintenance window opens. In the Behavioral Health Billing Library field, enter a name for the library. This field is required. Complete parameters as needed on the following tabs: Charge Options, for more information see Set Up Charge Options. Claim Options, for more information see Set Up Claim Options. Billing Options, for more information see Set Up Billing Options. To save changes and close the window, select OK. Set Up Charge Options Set Up Claim Options Set Up Billing Options Parent topic: Behavioral Health Billing Library

Help Guide for NextGen® Enterprise PM 8

Set Up Billing Options

Open File Maintenance. Select Libraries, and then select Behavioral Health Billing. The Behavioral Health Billing List window opens. From the list, double-click to open the library. The Behavioral Health Billing Library Maintenance window opens. Select Billing Options. Enter theBilling Options fields to set up the billing options for behavioral health billing. Select OK. Billing Options Field Descriptions The Billing Options is used to specify which Place of Service code and ICD codes should be used on claims when multiple Behavioral Health charges on an encounter have different codes. Parent topic: Add or Modify a Behavioral Health Billing Library

File Maintenance Help for NextGen® Enterprise

Set Up Billing Options

Open File Maintenance. Select Libraries, and then select Behavioral Health Billing. The Behavioral Health Billing List window opens. From the list, double-click to open the library. The Behavioral Health Billing Library Maintenance window opens. Select Billing Options. Enter theBilling Options fields to set up the billing options for behavioral health billing. Select OK. Billing Options Field Descriptions The Billing Options is used to specify which Place of Service code and ICD codes should be used on claims when multiple Behavioral Health charges on an encounter have different codes. Parent topic: Add or Modify a Behavioral Health Billing Library

Help Guide for NextGen® Enterprise PM 8

Billing Options Field Descriptions

Use the following table to setup billing options. Field Description Select Place of Service on roll-up: Select Override Place of Service This setting determines which Place of Service (POS) code is used on claims when multiple Behavioral Health (BH) charges on an encounter with different POS codes roll-up to a single line item on the claim. Select one of the following options: Send POS from first line item: This option is selected by default. Select this option to populate claims with the POS code from the first BH charge on the encounter. Send POS from charge with highest Chg Amt: Select this option to populate claims with the POS code from the BH charge on the encounter that has the highest charge amount. Send POS from encounter Service Location: Select this option to ignore the BH charge-level POS codes, and instead populate claims with the POS code linked to the encounter-level service location. Select Default POS: Select this option to select a specific Default Place of Service to

Set Up Billing Options

Recommendations

Set Up Claim Options

Set Up Billing Options

Add or Modify a Behavioral Health Billing Library

Set Up Billing Options

Set Up Billing Options

Billing Options Field Descriptions

Set Up Billing Options

Set Up Claim Options

Set Up Billing Options

Add or Modify a Behavioral Health Billing Library

Set Up Billing Options

Set Up Billing Options

Billing Options Field Descriptions