Set up Payers for Charge Discounts

Help Guide for NextGen® Enterprise PM 8

Enable Charge Discounts in Practice Preferences

Open NextGen® Enterprise PM. From the Admin menu, select Preferences, and then Practice. The Practice Preferences window opens. Note: This setting affects the patient discount calculation while using an adjustment transaction code when source is a patient. Insurance discount using an adjustment transaction code when source is the third party is calculated based on the total charge amount, regardless of this setting. In the Preference List, select Charge Entry, and then select the Charges tab. Select Enable discounts in charge entry to enable charge discounts in the Charge Posting window. Note: The Discounts icon becomes available on the Charge Posting toolbar, and the Discounts Criteria section in the Transaction Codes window. Select Apply patient discount to patient balance only to calculate patient discounts using the Patient Amount on each charge and not the Original Charge Amount. Do not select Apply patient discount to patient balance only to calculate patient discounts using the

Help Guide for NextGen® Enterprise PM 8

Set up Transaction Codes for Charge Discounts

When Charge Discounts are enabled in Practice Preferences, Discount Criteria section becomes available in the setup of Transaction Codes. You can set up specific adjustment transaction codes that are used for calculating charge discounts. You can create separate transaction codes to differentiate discount adjustments entered from the Charge Posting window and from other types of adjustments entered from the Payment Entry window. To set up adjustment Transaction Codes for charge discounts, do the following: Open File Maintenance. Select System Master Files, and then PM. Select Transaction Codes. The Transaction Codes List window opens. Do one of the following: To add a new transaction code, select the Open Menu icon and select New. To modify an existing transaction code, select the transaction code from the list, select Open Menu and select Open. The Add Transaction Code Information window opens. Enter a descriptive name for the code in the Transaction Description field. This is a requi

Help Guide for NextGen® Enterprise PM 8

Setting Up Charge Discounts

The Charge Discounts functionality in NextGen® Enterprise PM involves the following setup: Enable discounts for a practice in the Practice Preferences window. flag payers as either contracted or non-contracted for discounts in the Payers window. Create adjustment transaction codes for discounts in the Transaction Codes window. Enable tracking of discounts within a practice in the Significant Events window. Set up user security access rights for discounts in System Administration. Enable Charge Discounts in Practice Preferences You can enable charge discounts on the Charges tab in the Practice Preferences window. Set up Payers for Charge Discounts You can set up payers for charge discounts on the Modify Payer Information window. Set up Transaction Codes for Charge Discounts You can set up transaction codes on the Transaction Code List window for charge discounts. Significant Events for Charge Discounts You can enable significant events to track user activity related to charge discounts

Help Guide for NextGen® Enterprise PM 8

Apply Line Item Level Discounts

To apply charge discounts at the line-item level ensure the Discounts icon is available on the Charge Posting window by selecting Enable discounts in charge entry on the Charge Entry tab in the Practice Preferences window. Open NextGen® Enterprise PM. Select Charges. The Charge Posting window opens. Select the desired patient and encounter, and then enter and save charges. Select Discounts on the charge posting toolbar to apply charge discount. The Discounts window opens. Select the adjustment transaction code in the Discount Adjustment Code field. The transaction codes available for selection are determined by the following: If the primary payer on the encounter is flagged as a Contracted Payer, the transaction codes are selected as Contracted Payers or <None> for Discount Application, when Discount is enabled in the Discount Criteria section. If the primary payer on the encounter is flagged as a Non-Contracted Payer, then the transaction codes selected as Discount with a Discount App

Help Guide for NextGen® Enterprise PM 8

Apply Encounter Level Discounts

To apply charge discounts at the encounter-level using a percentage or dollar amount, do the following: Open NextGen® Enterprise PM. Select Charges. The Charge Posting window opens. Select the desired patient and encounter. Enter and save charges on the encounter. Select the Discounts icon on the charge posting toolbar. The Discounts window opens. Select the adjustment transaction code in the Discount Adjustment Code field. You can determine the transaction codes available for selection by the following: If the primary payer on the encounter is flagged as a Contracted Payer, then the transaction codes are derived from Contracted Payers or <None> for Discount Application when Discount is enabled in the Discount Criteria section. If the primary payer on the encounter is flagged as a Non-Contracted Payer, then the transaction codes are derived from Non-Contracted Payers or <None> for Discount Application when Discount is enabled in the Discount Criteria section. If there is no primary pay

Help Guide for NextGen® Enterprise PM 8

Modify Discounts on Charges

To modify discounts on charges, do the following: Open NextGen® Enterprise PM. Select Charges. The Charge Posting window opens. Select the desired patient and encounter. Select Discounts on the Charge Posting toolbar. The Discounts window opens. Edit the desired fields to modify discounts on charges. Select OK. The application reverses the original discount adjustments from the parent charge and tax charges. It then applies new discounts to the parent charges and their associated tax charges using the selected Non-In Progress discount adjustment code. After the new adjustments are posted to the system-generated transaction batch, the application checks to see if any of the discounts need to be approved. When the adjustments are then approved, the new adjustments become finalized within the A/R: Adjustments display in financial reports. Adjustments display in black ink within the patient chart. Patient Statements generated display the new discount adjustments. Parent topic: Charge Disco

Set up Payers for Charge Discounts

Recommendations

Enable Charge Discounts in Practice Preferences

Set up Transaction Codes for Charge Discounts

Setting Up Charge Discounts

Apply Line Item Level Discounts

Apply Encounter Level Discounts

Modify Discounts on Charges

Enable Charge Discounts in Practice Preferences

Set up Transaction Codes for Charge Discounts

Setting Up Charge Discounts

Apply Line Item Level Discounts

Apply Encounter Level Discounts

Modify Discounts on Charges