Sliding Fee Schedules

Help Guide for NextGen® Enterprise PM 8

Creating Sliding Fee Schedules

Before a Sliding Fee Schedule can be linked to a patient or encounter in NextGen® Enterprise PM, the schedule must first be created in File Maintenance. Each sliding fee schedule is configured by family size and percentage discount based on annual income. 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. Set Up the Sliding Fee Schedule Master File Set Up the Sliding Fee Schedule Details Assign Practice Access to Sliding Fee Schedules Parent topic: Sliding Fee Schedules

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

Configure Practice Preferences for Sliding Fee Schedules

The Sliding Fee Practice Preferences include options that control how sliding fee schedules and adjustments function within a practice. To configure sliding fee options for the practice, do the following: Access File Maintenance. Select System Master Files, then PM, and then Practices. The Practice List window opens. From the list, select and open the desired practice. The Modify Practice Information window opens. Select the Preferences button. The Practice Preferences window opens. From the Preference List on the left, select Sliding Fee. Use the following table to select the desired sliding fee options for the practice. To save changes and close the window, select OK. Disable sliding fee adjustments for encounters that have insurance attached: Select this check box to disable the ability for users to perform a demand sliding fee adjustment on encounters with a remaining patient balance after insurance has paid. Note: This option affects encounter based sliding fee schedules only. Dis

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

Help Guide for NextGen® Enterprise PM 8

Sliding Fee Patient Report

The Sliding Fee Patient report in NextGen® Enterprise PM enables you to view a list of patients with Sliding Fee Schedules that have had sliding fee adjustments applied to charges. Sliding fee schedules may be used by Community Health Centers and other practices that write-off a percentage of charge amounts for patients that qualify for automatic adjustments based on their family size and annual income. This demographics-based report lists patients that meet the following criteria: The patient has a Head of Household (HOH) selected in their chart. The HOH has family information entered and a sliding fee schedule selected. The patient has one or more encounters within the date range specified on the report filter. Sliding fee auto-adjustments were applied to charges on those encounters. By default, the report includes only patient with self-pay encounters. To include other patients, select the Include patients with insurance check box on Filter 1. Note: This report is not intended to ma

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

Sliding Fee Schedules

Recommendations

Creating Sliding Fee Schedules

Sliding Fee Schedules

Configure Practice Preferences for Sliding Fee Schedules

Sliding Fee Schedules

Sliding Fee Patient Report

Sliding Fee in Cost Estimation