Submit Eligibility From Appointment Scheduling

Help Guide for NextGen® Enterprise PM 8

Submit NextGen® Eligibility Verification While Adding or Editing an Appointment

Perform the following steps to submit eligibility inquiries for a patient from the Edit Appointment window. From the Appointment Book, access the Edit Appointment window. Select the Ins/Diag tab. Right-click in the Insurance Information section, and then select Eligibility Verification > Submit Request. The patient's eligibility response appears. Parent topic: Eligibility Requests

Help Guide for NextGen® Enterprise PM 8

Submit Eligibility Requests

There are several ways to submit eligibility inquiries: NextGen® Eligibility Verification Submission NextGen® Eligibility Verification Batch Submission Scheduled Batch through NextGen® Background Business Processor NextGen® Eligibility Verification transactions are submitted from different NextGen® Enterprise PM access points. The access points are Patient Lookup Appointment Book Appointment List Encounter Lookup From any of these access points, a NextGen® Eligibility Verification request can be submitted for a single patient by right-clicking on the patient, appointment, or encounter, and then selecting Eligibility Verification. Regardless of the access point, the user interface is the same. Several inquiries can be submitted at one time using batch mode. Manually submitting a batch of eligibility inquiries can be done from the appointment lookup and encounter lookup. This manual batch was referred to as Real Time batch. (Long time RTS users also know this as pseudo-batch.) Finally, b

Help Guide for NextGen® Enterprise PM 8

NextGen® Eligibility Verification Submission

The user interface of NextGen® Eligibility Verification is the same irrespective of where it is accessed from. The following table lists the access points for Eligibility. From the… Use this access path People or Patient Lookup Tasks > Lookup > People. After you enter the search criteria, select Find and right-click on the applicable person. Encounter Lookup Select Tasks menu, then select Lookup, and then select Encounters. Enter search criteria and then select Find. Right-click the applicable encounter Appointment List Select the appointment list icon. Enter search criteria and then select Find. Right-click the applicable appointment Patient Chart From a patient's chart, select the Encounters tab and then right-click on the applicable encounter From a patient's chart, select the Financial tab. Right-click the applicable encounter. Appointment Book ( Daily, Weekly List, Weekly Schedule, or Multi-View view) Right-click the applicable appointment. Insurance Listing Select Tasks menu, the

Help Guide for NextGen® Enterprise PM 8

Eligibility for Unattached Payers

Eligibility inquiries can be submitted for a payer without first attaching it to a patient’s chart. In the case of Medicare or Medicaid replacements, this process can occur multiple times per patient. This feature enables you to submit NextGen® Eligibility Verification for a payer that is not attached to a patient’s chart. If active coverage is obtained, then the payer can be attached to the patient with a single selection. This feature is optional and enabled in Practice Preferences. Enable Eligibility Preferences in Practice Preferences You must enable eligibility submission for unattached payers in Practice Preferences to be able to submit eligibility inquiries. Submit Eligibility for an Unattached Payer You can submit eligibility inquiries for a payer that is not attached to a patient's chart. Parent topic: Eligibility Requests

Help Guide for NextGen® Enterprise PM 8

Eligibility Requests

When a NextGen® Eligibility Verification is submitted from the NextGen® Enterprise PM application, it is electronically sent to the transaction server, and then the inquiry is sent to a designated trading partner. The trading partner sends the response back through NextGen® Eligibility Verification where the inquiry results are saved in the patient's chart on the Clinical History/Notes tab under Chart Notes and in the patient’s insurance maintenance on the Elig/Ref tab. If a chart does not exist, the results are saved until a chart is created. Once the chart is created, the results are automatically attached to the patient's chart. Note: Only users who have security rights for this function can submit inquiries. Submit Eligibility Requests You can submit inquires regarding a patient's eligibility and benefit coverage. NextGen Eligibility Verification Submission You can access NextGen® Eligibility Verification from multiple points within NextGen® Enterprise PM. Submit Eligibility in Bat

Help Guide for NextGen® Enterprise PM 8

View Latest Successful Eligibility Response from Appointment Information

Before you begin Submit NextGen® Eligibility Verification request for a patient. See Submit Eligibility Requests for more information. Set the appointment information. For details on how to set the tooltip, see Set Scheduling Preferences for Tooltips in Layout and User Preferences Guide for NextGen Enterprise PM. You can view the latest successful response from the appointment information for pending transactions. In NextGen® Enterprise PM, select Appbook. The appointment book opens. Locate the appointment for the patient for whom you have submitted the NextGen® Eligibility Verification request and do one of the following: Select the appointment. Right-click the appointment and select Appointment Information. The tooltip displays the appointment information. The Primary Insurance Eligibility Status shows the status of the eligibility check. Select the Pending / View Latest Successful Response hyperlink. The system checks for the eligibility response for the latest successful transactio

Submit Eligibility From Appointment Scheduling

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Submit NextGen® Eligibility Verification While Adding or Editing an Appointment

Submit Eligibility Requests

NextGen® Eligibility Verification Submission

Eligibility for Unattached Payers

Eligibility Requests

View Latest Successful Eligibility Response from Appointment Information