Set Up the Process Date for Encounter Rate SIM and Adjustments

Help Guide for NextGen® Enterprise PM 8

Process Date for Encounter Rate SIM and Adjustments

Some payers, such as Medicare for a Federally Qualified Health Center (FQHC), require that an encounter rate SIM code, or payment code, be included on claims to describe the type of visit. For example, code G0466 on a Medicare claim indicates a new patient visit, and code G0467 indicates an established patient visit. The Encounter Rate Billing library in File Maintenance can be setup for a payer to automatically insert the ER SIM code, or payment code as an additional charge line on encounters during the billing process in NextGen® Enterprise PM. With this setup, there is the potential for an ER SIM charge inserted by the system to have a process date that is different from the process dates on the original charge lines. For example, the original charges on an encounter may have been entered and processed on 2/28/17, but the encounter was not billed until 3/2/17. In this scenario, the original charges have a process date in the February accounting period, and the ER SIM charge on the s

Help Guide for NextGen® Enterprise PM 8

Practice Preferences for Encounter Rate Billing

To use encounter rate billing in NextGen® Enterprise PM, specific options must be enabled for the practice in Practice Preferences. Enable Qualifying Encounter Billing Process Date for Encounter Rate SIM and Adjustments Parent topic: Setting Up Encounter Rate Billing

Help Guide for NextGen® Enterprise PM 8

Setting Up Encounter Rate Billing

Encounter rate billing in NextGen® Enterprise PM involves the following setup in System Administrator and File Maintenance: Security Access Rights Enterprise Preferences Practice Preferences CPT4 Codes Revenue Codes Departments Service Items Library Claim Edits Library Transaction Codes Encounter Rate Billing Library Payers Set Up Security Access Rights for Encounter Rate Billing Set Up Enterprise Preferences for Encounter Rate Billing Practice Preferences for Encounter Rate Billing Add or Modify CPT4 Codes for Encounter Rate Billing Add or Modify Revenue Codes for Encounter Rate Billing Add or Modify Departments for Encounter Rate Billing Add or Modify SIM Codes for Encounter Rate Billing Set Up Claim Edits for Encounter Rate Billing Add or Modify Transaction Codes for Encounter Rate Billing Add or Modify an Encounter Rate Billing Library Set Up Payers for Encounter Rate Billing Parent topic: Encounter Rate Billing

Help Guide for NextGen® Enterprise PM 8

Add or Modify Session Settings

Open NextGen® Enterprise PM. Select Tasks, and then select Session Settings. The Session Settings window opens. In Active Batch field select an existing transaction batch or select <Create Quick Batch> to create a transaction batch for the current login session. The selected batch is used as the active batch for all transactions (payments, adjustments, and refunds) you enter during your current login session. In the Service Date field, enter a preset service date for the current login session. The preset date appears in the Billable Date field on the Create Encounter window for all new encounters you create during your current login session. The preset date also appears in the Service Date fields on the Charge Posting window for all charges you enter during your current login session. In the Process Date field, enter a preset process date for the current login session. The preset date selected, appears in the Process Date field on the Charge Posting window for all charges you enter dur

Help Guide for NextGen® Enterprise PM 8

Set Up Enterprise Preferences for Encounter Rate Billing

You must enable encounter rate billing for the enterprise. When enabled, further setup can be completed for practices within the enterprise that use encounter rate billing functionality. This also enables an Encounter Rate Billing library to be attached to the appropriate payers later in the setup. Access NextGen® Enterprise PM. From the Admin menu, select Preferences, and then Enterprise. The Enterprise Preferences window appears. Select the General tab. Select the Encounter rate billing check box. Enterprise Preferences To save changes and close the window, select OK. Parent topic: Setting Up Encounter Rate Billing

Help Guide for NextGen® Enterprise PM 8

Configuring Session Settings

You can select specific parameters that are used as defaults during your current login session. Session settings remain active for the current login session. When you log out from NextGen® Enterprise PM, the settings are cleared. You must re-enter the settings the next time you login. Note: To display the Session Settings window each time you log in to NextGen® Enterprise PM, you can select Prompt for session settings in the general user preferences. You can select a service date and service location to default to new encounters. You can use this setting while creating batches for multiple encounters for the same location that have charges with the same date of service. You can also select a process date to default to new charges. This setting is useful when entering charges for the services that took place on a previous date, to ensure those charges appear on reports for the correct financial period. Add or Modify Session Settings You can add or modify the session settings on the Sess

Set Up the Process Date for Encounter Rate SIM and Adjustments

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Process Date for Encounter Rate SIM and Adjustments

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Process Date for Encounter Rate SIM and Adjustments

Practice Preferences for Encounter Rate Billing

Setting Up Encounter Rate Billing

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Set Up Enterprise Preferences for Encounter Rate Billing

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