Set Up Sliding Fee Preferences for Cost Estimation

Help Guide for NextGen® Enterprise PM 8

Attach Sliding Fee to a Patient or Person

You can set up the sliding fee schedule master file and sliding fee preferences. In NextGen® Enterprise PM, on the Estimated Patient Cost window, select a patient or person who you want to perform the cost estimation for. In the Patient/Guarantor Information section, select . The Modify Patient Information window opens. Select the UDS tab. In the Sliding Fee Schedule Verification section, select the open menu , and select New. The Sliding Fee Verification window opens. Select the Sliding Fee Schedule for the patient or person. Note: The Sliding Fee Schedule list displays the schedules defined in the sliding fee schedules master file in File Maintenance. Hidden and expired sliding fee schedules are not listed. Select the effective and expiration dates for the sliding fee schedule. In the Head of Household Family Information section, select the open menu , and select New. Note: To enter family information, a head of household must be selected for the patient or person. The Family Info wi

Help Guide for NextGen® Enterprise PM 8

Sliding Fee in Cost Estimation

The sliding fee program offers differential pricing with adjustments based on the annual income and family size of a patient or person. Sliding fee schedules are attached to a patient or person or a specific encounter or chart in NextGen® Enterprise PM. When you attach a sliding fee schedule to an encounter, a percentage of the estimated amount specified on the Estimate Patient Cost window is automatically adjusted. In cost estimation, a patient or person eligible for sliding fee adjustments can only use the self-pay mode of payment. In NextGen® Enterprise PM, you can do the following: Attach sliding fee schedules at the chart level or encounter level for a person or patient. Note: The system does not combine encounter level and chart level sliding fees while judging which to apply. Encounter level sliding fee always take precedence over chart level sliding fee. Apply multiple sliding fee schedules at an encounter level or chart level for a person or patient. Note: When you add multipl

Help Guide for NextGen® Enterprise PM 8

Sliding Fee Schedules

Sliding Fee Schedules are typically used by Health Centers. They are linked to a patient or to a specific patient encounter in NextGen® Enterprise PM. Once linked, a percentage of the charge amounts entered on an encounter are automatically adjusted off. The percentage of the automatic adjustment is based on household family size and annual income. Sliding Fee Schedule adjustments are reported on the UDS Report. Multiple sliding fee schedules can be created if needed. For example, if the percentage discounts vary for medical, dental, vision and/or behavioral health services, separate schedules can be created for each. To use Sliding Fee Schedules in NextGen® Enterprise PM, the following setup must be completed: Create Transaction Codes in File Maintenance to be used for sliding fee adjustments. Create Sliding Fee Schedules in File Maintenance. Configure options in Practice Preferences > Sliding Fee to determine how sliding fee adjustments should function within the practice. Once Slidi

Help Guide for NextGen® Enterprise PM 8

Sliding Fee Schedules

Sliding Fee Schedules are typically used by Health Centers. They are linked to a patient or to a specific patient encounter inNextGen® Enterprise PM. When it is linked and you enter the percentage or charge amount on an encounter, it is automatically adjusted. The percentage of the automatic adjustment is based on householdfamily sizeandannual income. Sliding Fee Schedule adjustments are reported on the UDS Report. You can create multiple sliding fee schedules, if needed. If the percentage discounts vary for medical, dental, vision and/or behavioral health services, separate schedules can be created for each. To use Sliding Fee Schedules inNextGen® Enterprise PM, the following set up must be completed. CreateTransaction Codesin File Maintenance to be used for sliding fee adjustments. CreateSliding Fee Schedulesin File Maintenance. Configure options inPractice Preferences > Sliding Feeto determine how sliding fee adjustments should function within the practice. When Sliding Fee Schedule

Help Guide for NextGen® Enterprise PM 8

Apply Sliding Fee Adjustments to a Single Encounter

Calculating and applying a Sliding Fee Schedule to an encounter On Demand can only be done when the Insurance Amounts 1, 2 and 3 in Balance Control are equal to zero and the Patient Amount in Balance Control is greater than zero. For example, if payers are attached to an encounter, then the encounter must be billed and all payments from the payers must be posted, leaving only a patient balance. Note: The Sliding Fee Schedule must be encounter based. Open NextGen® Enterprise PM. Select the Chart button on the main toolbar. The Patient Lookup window opens. Enter Search Criteria to locate the desired patient. Select Find. From the search results, double-click to open the desired patient. The Patient Chart opens. Select the Encounters tab. Right-click on the desired encounter, and then select Sliding Fee. To view the sliding fee adjustment, select the Transactions tab. Note: If you add the sliding fee or process while the chart is open, you must close the chart and re-open it to see the cr

File Maintenance Help for NextGen® Enterprise 8

Sliding Fee Schedules

The Sliding Fee Schedule master file enables you to: Create active sliding fee schedules. Activate NextGen® Enterprise PM alerts that: Indicate when patients have an associated sliding fee schedule. Notify users when certain information pertaining to the sliding fee schedule must be re-verified. Exempt certain service items from the sliding fee schedule. In NextGen® Enterprise PM, you can: Attach sliding fee schedules to a patient's chart. Apply a sliding fee schedule discount against patient responsibility charges and automatically calculate discounts based on the active Sliding Fee Schedule. Apply more than one sliding fee schedule to an encounter. Report on the sliding fee schedule adjustment discounts. The modes of applying a sliding fee schedule to a patient’s charges are: Line item-based. Encounter-based. The Sliding Fee Schedule Practice Preferences provide additional options that you can set on a per practice basis. Line Item Based Sliding Fee Schedule Encounter-Based Sliding F

Set Up Sliding Fee Preferences for Cost Estimation

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Attach Sliding Fee to a Patient or Person

Sliding Fee in Cost Estimation

Sliding Fee Schedules

Sliding Fee Schedules

Apply Sliding Fee Adjustments to a Single Encounter

Sliding Fee Schedules

Attach Sliding Fee to a Patient or Person

Sliding Fee in Cost Estimation

Sliding Fee Schedules

Sliding Fee Schedules

Apply Sliding Fee Adjustments to a Single Encounter

Sliding Fee Schedules