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Set Up for Eligible Number of Patient Days Billing
Access
File Maintenance
.
Select
Libraries
, and then
Consolidated Services Claim
library.
The
Consolidated Services Claim List
window opens.
Double-click to open the desired library.
The
Consolidated Services Claim Library Maintenance
window opens.
Select the open menu button
.
The
Consolidated Services Claim Maintenance
window opens.
Complete the following fields:
Effective Date
Expiration Date
Description
Add the Valid Payers
Select the
Claim Consolidation Rules
tab and then select the open menu button
and select
New
.
The
CSC Timespan Rules
window opens.
Complete the following fields:
In the
Length of Timespan
field, select
Consolidate Monthly Claims
.
In the
Description
field, enter a description for this type of billing.
In the
Rollup Encounter Rate Service Line
field, select
Yes
.
In the
Encounter Rate SIM Quantity
field, select
Number of Eligible Days
.
In the
Encounter Rate Service Line Amount
field, select
Eligible Patient Days times Original Charge Amount
.
Select
OK
.
Set Up for Eligible Number of Patient Days Billing
File Maintenance Help for NextGen® Enterprise 8
Set Up for Eligible Number of Patient Days Billing
Access File Maintenance. Select Libraries, and then Consolidated Services Claim library. The Consolidated Services Claim List window opens. Double-click to open the desired library. The Consolidated Services Claim Library Maintenance window opens. Select the open menu button . The Consolidated Services Claim Maintenance window opens. Complete the following fields: Effective Date Expiration Date Description Add the Valid Payers Select the Claim Consolidation Rules tab and then select the open menu button and select New. The CSC Timespan Rules window opens. Complete the following fields: In the Length of Timespan field, select Consolidate Monthly Claims. In the Description field, enter a description for this type of billing. In the Rollup Encounter Rate Service Line field, select Yes. In the Encounter Rate SIM Quantity field, select Number of Eligible Days. In the Encounter Rate Service Line Amount field, select Eligible Patient Days times Original Charge Amount. Select OK. Parent topic:
Help Guide for NextGen® Enterprise PM 8
Add Claim Consolidation Rules to a CSC Library
To enable claims consolidation, you must select the form types that you want to consolidate. Then you can choose to consolidate only encounter rate claims and/or claims with the same encounter rate SIM. These rules will apply to all of the payers in the Valid Payers list. Access the Consolidated Services Claim Maintenance window for the applicable library. Note: To access a CSC library, refer to the Accessing a Consolidated Services Claim Library procedure. After opening the Consolidated Services Claim Maintenance window, select a valid payer for the claim, then Claim Consolidation Rules. From the Claims Consolidation Rules tab, select a Claim Consolidation Rules row (CCR row) and open by doing one of the following: Right-click the library and select Open. Select the open menu button and select Open. The CSC Timespan Rules window opens for the library you selected. Complete the timespan rules. Note: When creating a new library, the Claim Consolidation Rules row (CCR row) is not require
File Maintenance Help for NextGen® Enterprise 8
Add Claim Consolidation Rules to a CSC Library
To enable claims consolidation, you must select the form types that you want to consolidate. Then you can choose to consolidate only encounter rate claims and/or claims with the same encounter rate SIM. These rules will apply to all of the payers in the Valid Payers list. Access the Consolidated Services Claim Maintenance window for the applicable library. Note: To access a CSC library, refer to the Accessing a Consolidated Services Claim Library procedure. After opening the Consolidated Services Claim Maintenance window, select a valid payer for the claim, then Claim Consolidation Rules. From the Claims Consolidation Rules tab, select a Claim Consolidation Rules row (CCR row) and open by doing one of the following: Right-click the library and select Open. Select the open menu button and select Open. The CSC Timespan Rules window opens for the library you selected. Complete the timespan rules. Note: When creating a new library, the Claim Consolidation Rules row (CCR row) is not require
Help Guide for NextGen® Enterprise PM 8
Set Up Rules for Consolidation of Case Claims
To set up rules for consolidation of claim on a case basis, you can choose the claim form type, rollup encounter rate service lines, and identify dates of services for encounters. In File Maintenance, select Libraries > Consolidated Services Claim and then double-click the applicable library. The Consolidated Services Claim Library window opens. Select open menu , and then select New or Open. The Consolidated Services Claim Maintenance window opens. To access the Payers window, select the Valid Payer folder icon, and then select the valid payers for case consolidation of claims. To access the CSC Timespan Rules window, on the Claim Consolidation Rules tab, Select open menu . In the Length of Timespan field, select Consolidate Case Claims. In the Description field, enter a description for the consolidation of case claims. Use the following table as a reference to add or modify case claim consolidation rules: Note: The claim consolidation rules are applied to all payers in the Valid Paye
Help Guide for NextGen® Enterprise PM 8
Create a CSC Library
This feature enables you to create a new Consolidated Services Claim (CSC) library. To create a new library, you must add the library name, effective date, expiration date, library description, and one or more payers. In File Maintenance, select Libraries > Consolidated Services Claim library. The Consolidated Services Claim List window opens. Select open menu button and select New. The Consolidated Services Claim Library Maintenance window opens. In the Consolidated Services Claim Library Name field, enter the name of the new library. Select open menu button and select New. The Consolidated Services Claim Maintenance window opens. Enter the following: Effective Date - The date the library is to become active. Expiration Date - The date the library becomes inactive. Description - The description for the new library. Double-click Open Folder . The Payers window opens. You must add one or more payers to the Included list to create a new CSC library. To filter valid payers by Financial Cl
File Maintenance Help for NextGen® Enterprise 8
Create a CSC Library
This feature enables you to create a new Consolidated Services Claim (CSC) library. To create a new library, you must add the library name, effective date, expiration date, library description, and one or more payers. In File Maintenance, select Libraries > Consolidated Services Claim library. The Consolidated Services Claim List window opens. Select open menu button and select New. The Consolidated Services Claim Library Maintenance window opens. In the Consolidated Services Claim Library Name field, enter the name of the new library. Select open menu button and select New. The Consolidated Services Claim Maintenance window opens. Enter the following: Effective Date - The date the library is to become active. Expiration Date - The date the library becomes inactive. Description - The description for the new library. Double-click Open Folder . The Payers window opens. You must add one or more payers to the Included list to create a new CSC library. To filter valid payers by Financial Cl
