Setting Up Service Packages
To use Service Packages in
NextGen® Enterprise PM
, you must setup the following:
File Maintenance:
Service Package Library
Service Package Library
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Help Guide for NextGen® Enterprise PM 8
Service Package Library
The Service Package library enables you to define the various sets of packaged services that payers may authorize for patients. Each service package includes groupings of specific CPT4 code and modifier combinations with defined service unit limitations. A single library can be created and used by the practice. The library may include multiple service package configurations, each with different CPT4 and modifiers, service unit limits and service duration limits. A service package configuration is then linked to a patient's insurance in NextGen® Enterprise PM. Note: This is a practice-level library only. A library cannot be linked to specific payers in the Payers master file. You can generate the following report from the Service Package library : Service Package Library Listing Service Package Configuration Service Package Configuration Details For more information, go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM. Add or
Help Guide for NextGen® Enterprise PM 8
Working with Service Packages in NextGen® Enterprise PM
When Service Package functionality is enabled for a practice, you can utilize the following functionality in NextGen® Enterprise PM: From the Authorizations tab on the Insurance Maintenance window or Authorization Listing window, you can enter service unit authorizations for payers that authorize packaged services for patients with unit and duration limitations. From the Reports > General > Authorizations menu, you can generate a Service Unit Authorization report to review and monitor patients with service unit authorizations and determine whether they have met or exceeded the maximum number of packaged services authorized by their insurance. Service Unit Authorizations Service Unit Authorization Report Parent topic: Service Packages in NextGen Enterprise PM
Help Guide for NextGen® Enterprise PM 8
Service Packages in NextGen® Enterprise PM
Practices may provide services to their patients or clients based on the various service packages authorized by payers. Each service package includes groupings of specific CPT4 code and modifier combinations with defined service unit limitations. A patient's authorized package services may be used within a specific time frame determined by the payer. For example, in a Behavioral Health practice, a payer may authorize a patient for a package that includes the following services: Addiction counseling not to exceed 40 hours within 90 days; Individual therapy not to exceed 50 units within 180 days; Group therapy not to exceed 60 units within 180 days; Medication management not to exceed 70 hours within 180 days. The service package functionality in NextGen® Enterprise PM enables you to do the following: Set up service packages with service unit and duration limitations. Enter service unit authorizations for payers that authorize packaged services for patients. Generate reports for patients
Help Guide for NextGen® Enterprise PM 8
Setting Up Programs
To use Programs in NextGen® Enterprise PM, you must setup the following: System Administrator File Maintenance: Programs Master File Practice Preferences System Administrator for Programs Programs Master File Practice Preferences for Programs Parent topic: Programs in NextGen Enterprise PM
File Maintenance Help for NextGen® Enterprise 8
Access Enterprise Preferences
To access Enterprise Preferences, do one of the following: In NextGen® Enterprise PM, select the Admin menu. Select Preferences > Enterprise In File Maintenance, select Master Files > System > Enterprises Double-click an enterprise, and then select Preferences. The Enterprise Preferences window opens. Parent topic: Enterprise Preferences
NextGen® Background Business Processor Help 8
Configure an Automated Task
Automating NextGen® Enterprise PM tasks in the NextGen® Background Business Processor application requires three steps: Create a package. Create one or more jobs for the package. Schedule the package. Parent topic: Automate NextGen Enterprise PM Processes
