Set Up Rounding Methods for Self-Pay

Help Guide for NextGen® Enterprise PM 8

Set Up Rounding Methods for a Payer

Access File Maintenance. Select System Master Files, then PM, and then Payers. The Payer List window opens. From the list, double-click to open the desired payer. The Modify Payer Information window opens. Select the Defaults-2 tab, and then the Rounding Rules sub-tab. In the Behavioral Health Rounding section, set up Behavioral Health Base Minute Rounding Methods for the payer. For more information, refer to Rounding Methods Field Description. The custom minutes appear in the Behavioral Health Custom Base Minute Rounding Methods section only if you set up one or more Behavioral Health SIM codes with custom base minutes in the Service Items library. Each custom base minute value is displayed in a separate row with a default rounding method for the payer. The default Down At, Up At and Less Than is 0 values are calculated. To customize Behavioral Health Custom Base Minute Rounding Method for the payer, select the row for the desired Base Minutes and modify the fields. To save changes an

Help Guide for NextGen® Enterprise PM 8

Rounding Methods Field Description

The following table describes the rounding methods for the payers and for self-pay. Field Description Base Minutes The standard Base Minute values (15, 30, 60, and 240) are displayed in separate rows with a default rounding method as follows: 15 minutes: Down at 7, Up at 8, Less than 8 is 0 30 minutes: Down at 14, Up at 15, Less than 15 is 0 60 minutes: Down at 29, Up at 30, Less than 30 is 0 240 minutes: Down at 119, Up at 120, Less than 120 is 0 For example, if the base minutes for a SIM code is set to 15 minutes, and the 15 minute rounding method is set to the default Down at 7, Up at 8, Less than 8 is 0, then the units are calculated based on the total time entered for a charge. Charge Total Time = 7 minutes Units = 0 Charge Total Time = 8 minutes Units = 1 Charge Total Time = 15 minutes Units = 1 Charge Total Time = 22 minutes Units = 1 Charge Total Time = 23 minutes Units = 2 To customize a Base Minute Rounding Method, select the row for the desired Base Minutes and modify the fi

Help Guide for NextGen® Enterprise PM 8

Payer and Practice Level Rounding Methods

Behavioral Health Base Minute Rounding Methods are available at the payer-level for each payer, and at the practice-level for self-pay. The rounding methods apply to Behavioral Health SIM codes that have been defined in the Service Items Library with 15, 30, 60, 240, or custom Base Minutes. The rounding methods affect how the units are calculated on a behavioral health charge for the payer based on the total time entered for the charge. Set Up Rounding Methods for a Payer Set Up Rounding Methods for Self-Pay You can set up rounding methods for self-pay for time-based billing. Rounding Methods Field Description You can select and modify the rounding methods for the payers and for self-pay. Parent topic: Behavioral Health Billing

File Maintenance Help for NextGen® Enterprise 8

Behavioral Health Rounding

If Behavioral Health SIM codes with standard (15, 30, 60, 240) or custom Base Minutes are set up in the Service Items Library for billing in NextGen® Enterprise PM, then the Behavioral Health Base Minute Rounding Methods should be defined for each payer. The rounding methods affect how the units are calculated on a behavioral health charge for the payer based on the total time entered for the charge. For more information on Behavioral Health Billing, go to the NextGen Healthcare Success Community and download the Behavioral Health Billing User Guide for NextGen® Enterprise PM. Field Description Base Minutes The "standard"Base Minutevalues (15, 30, 60 and 240) display in separate rows with a default rounding method for the payer as follows: 15 minutes:Down at 7, Up at 8, Less than 8 is 0 30 minutes:Down at 14, Up at 15, Less than 15 is 0 60 minutes:Down at 29, Up at 30, Less than 30 is 0 240 minutes:Down at 119, Up at 120, Less than 120 is 0 For example, if the base minutes for a SIM co

Help Guide for NextGen® Enterprise PM 8

Behavioral Health Rounding

If Behavioral Health SIM codes with standard (15, 30, 60, 240) or custom Base Minutes are set up in the Service Items Library for billing in NextGen® Enterprise PM, then the Behavioral Health Base Minute Rounding Methods should be defined for each payer. The rounding methods affect how the units are calculated on a behavioral health charge for the payer based on the total time entered for the charge. For more information on Behavioral Health Billing, go to the NextGen Healthcare Success Community and download the Behavioral Health Billing User Guide for NextGen® Enterprise PM. Field Description Base Minutes The "standard"Base Minutevalues (15, 30, 60 and 240) display in separate rows with a default rounding method for the payer as follows: 15 minutes:Down at 7, Up at 8, Less than 8 is 0 30 minutes:Down at 14, Up at 15, Less than 15 is 0 60 minutes:Down at 29, Up at 30, Less than 30 is 0 240 minutes:Down at 119, Up at 120, Less than 120 is 0 For example, if the base minutes for a SIM co

File Maintenance Help for NextGen® Enterprise 8

Payer Listing Behavioral Health Rounding Rules Report

The Payer Listing Behavioral Health Rounding Rules report includes information from the Payers master file in File Maintenance. Information on the report pulls from the Modify Payer Information window for payers with Behavioral Health Base Minute Rounding Rules defined. Note: This report uses enhanced reporting functionality. For more information, go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM and see Enhanced Reports. The report includes the following information: Column Name Description Data Populates From Payer Name Payer Name Payer Name field of the Payer Defaults-1 tab Payer Alias Payer Alias Payer Alias Name field Payer Defaults-1 tab BH Base Minutes Behavioral Health Base Minutes Behavioral Health Base Minutes (15, 30, 60, 240) and Behavioral Health Custom Base Minutes fields of the Defaults-2 > Rounding RulesStandard and custom minutes are sorted in ascending order for each payer. Note: Custom minutes (other than

Set Up Rounding Methods for Self-Pay

Recommendations

Set Up Rounding Methods for a Payer

Rounding Methods Field Description

Payer and Practice Level Rounding Methods

Behavioral Health Rounding

Behavioral Health Rounding

Payer Listing Behavioral Health Rounding Rules Report

Set Up Rounding Methods for a Payer

Rounding Methods Field Description

Payer and Practice Level Rounding Methods

Behavioral Health Rounding

Behavioral Health Rounding

Payer Listing Behavioral Health Rounding Rules Report