SIM Groups for Service Items

Help Guide for NextGen® Enterprise PM 8

Generate Cost Estimation

The default information appearing on the Estimate Patient Cost window depends on the source of the cost estimation. You can specify the necessary data such as provider information, service location, service type, service items, and units of service items required for estimating cost. Additionally, you can keep notes and assign diagnosis codes. In NextGen® Enterprise PM, select Est Patient Cost on the toolbar. The People Lookup window opens. Double-click to select a person. The Modify Person Information window opens. You can make necessary changes to the person record and then select Ok. The Estimate Patient Cost window opens for the selected person or patient. On the Estimate Patient Cost window, to select the payer in the Payer Selection section, do one of the following: Note: Payer Selection is a required field. If the person or patient wants to use insurance coverage for the services, select a payer from the list. Note: You can select only one payer from the list. If you select a pa

NextGen® Enterprise EHR Help

SIMs Groups in the Orders Tests Master File

When multiple procedures are performed for particular types of encounter or appointments, you can set up one Service Item Group (SIM Group) code that includes all the SIM codes and descriptions for all of the procedures. SIM Groups enable you to enter one code during charge posting for multiple procedures and their associated charges. You can then be more efficient and error-free as you enter charges for multiple procedures that are typically performed together. For example, if your practice frequently does childhood immunizations, you could set up a SIM Group called "CHIMM", which would include all the CPT4® codes and descriptions for each immunization for the office encounter. For more information on SIM Groups, go to the NextGen Healthcare Success Community, download the latest System Administrator Guide for NextGen® Enterprise and the File Maintenance Master Files Guide for NextGen® Enterprise. Assign Default SIM Pricing Region Libraries to Payers Parent topic: Using Advanced Servi

Help Guide for NextGen® Enterprise PM 8

Patient Cost Estimation Workflow

The cost estimation feature enables you to use the information within the application to provide an insight into the various costs associated with the different types of care. A practice, running in a real-time system, has a valid NextGen® Eligibility Verification license and is able to communicate with the real-time server. When an eligibility transaction is run, the system receives real-time eligibility (271) transaction file as response. A practice, running in non-real-time system, does not have a valid NextGen® Eligibility Verification license and retrieves values from the local database. If you are the administrator, you must complete the following configurations in File Maintenance. Set up payers in the payer master Set up providers in the provider master Set up the pricing for service item (SIM) codes and associate SIM codes with CPT®4 codes in the SIM library You can configure the following as needed and are not mandatory. Set up sliding fee schedules in the sliding fee schedul

NextGen® Enterprise EHR Help

Create SIM Groups in a Service Item Library

Orders module charge posting also looks at SIM Groups which are set up in File Maintenance in the Service Item Libraries. You must first define a Service Item library, and add service items to the library before you can create a SIM group. Select File Maintenance > Libraries > Service Items. Right-click the Service Item library for which you want to create a SIM Group. The Service Items List window opens. Select SIM Groups from the list. Select the open menu button, and then select New. The SIM Group Maintenance window opens. Define the SIM Group ID and Description. SIM Group. This is a numeric or alphabetic ID that you use to identify this SIM Group. Description. The description you choose for this SIM Group. Service Item #. This is the list of service items contained in this group. Select in the Service Item #. Select the SIM ID to have the focus on that parameter. Put in the SIM ID you want in the Search Criteria in the Available pane. Select the blue Right Arrow to move the item to

File Maintenance Help for NextGen® Enterprise 8

Libraries Tab - Enterprise Preferences Descriptions

The following table provides descriptions of the fields located in the Libraries Enterprise Preferences. Field Description Enable Advanced Service Item Library Mode Caution: Once you enable this feature, you cannot disable it. This check box turns on all features that enable you to set prices by configuring locations into payer-centric groupings. For example, Medicare might have different regional groupings than Aetna, and pricing would be determined accordingly. Default Pricing Region Library for Self Pay Select the appropriate SIM Pricing Regions library that defines the pricing when an encounter is self-pay. For more information, go to NextGen Healthcare Success Community and download the latest File Maintenance Libraries Guide for NextGen Enterprise. Default Pricing Region Library Select the appropriate SIM Pricing Regions library that defines the pricing for payers of this enterprise. For more information, go to NextGen Healthcare Success Community and download the latest File Mai

File Maintenance Help for NextGen® Enterprise 8

Add SIM Groups

In File Maintenance, select Libraries, and then select Service Items. The Service Items List window opens. Select the applicable library, right-click and select SIM Groups. The SIM Groups List window opens. To create a new SIM Group, select open menu button , and select New. The SIM Group Maintenance window opens. In SIM Group field, enter a short name of the SIM Group. In the Description field, enter a description of the SIM Group. To add a new SIM, select Open Folder and search for the SIM. To add the item to the group, use the blue Include arrow to move the item to the Available list. To remove a SIM item from the Available list by selecting the SIM item and then the blue Exclude arrow. The indicates the search type. If the icon is listed next to the SIM column, the system will search by SIM number. You can select the Description column, which enables you to search by the service item description. The service item must already exist in the Service Item Library before you can add it

SIM Groups for Service Items

Recommendations

Generate Cost Estimation

SIMs Groups in the Orders Tests Master File

Patient Cost Estimation Workflow

Create SIM Groups in a Service Item Library

Libraries Tab - Enterprise Preferences Descriptions

Add SIM Groups

Generate Cost Estimation

SIMs Groups in the Orders Tests Master File

Patient Cost Estimation Workflow

Create SIM Groups in a Service Item Library

Libraries Tab - Enterprise Preferences Descriptions

Add SIM Groups