The Billing Process

Help Guide for NextGen® Enterprise PM 8

Billing and Collections

Billing and collections in NextGen® Enterprise PM includes the following processes: Posting charges Processing charges from NextGen® Enterprise EHR Billing and rebilling encounters and invoices with charges Posting charges from rosetta Generating statements A/R collections and follow-up Setting up budget plans Processing encounters to bad debt Collections For more information about the setup and functionality of the types of billing based on specialty, go to NextGen Healthcare Success Community and download the following user guides: Anesthesia Billing User Guide for NextGen® Enterprise PM Behavioral Health Billing User Guide for NextGen® Enterprise PM Community Health Centers User Guide for NextGen® Enterprise PM Community Health Centers include the following types of billing: Encounter Rate Billing Roll-Up Billing Dental Billing Anesthesia Billing Behavioral Health Billing Charge Posting Overview You can enter or modify Charges on the Charge Posting window. Parent topic: Billing

Help Guide for NextGen® Enterprise PM 8

Anesthesia Concurrency Billing

Anesthesia Concurrency Billing in NextGen® Enterprise PM can be setup and used by practices that must meet specific requirements on professional claims for anesthesia services that occur at the same time, or concurrently. Concurrency billing is typically used when the practice submits 837P/1500 claims for numerous anesthesia procedures that are administered in a hospital surgery department setting by Anesthesiologists and medically directed Certified Registered Nurse Anesthetists (CRNA). An Anesthesiologist can personally administer anesthesia to a patient. They can also oversee the administration of anesthesia by Certified Registered Nurse Anesthetists (CRNA) and Anesthesiologist Assistants (AA). When an anesthesiologist oversees up to four concurrent cases, it is considered "medical direction". In NextGen® Enterprise PM, an Anesthesia Concurrency Audit process is run prior to billing and creating claims. The audit looks at encounters with charges that were rendered by anesthesia prov

Help Guide for NextGen® Enterprise PM 8

Basic Anesthesia Billing

Basic Anesthesia Billing in NextGen® Enterprise PM can be setup and used by practices that bill for time-based anesthesia services on professional claims. Basic billing is typically used when the practice submits 837P/1500 claims for a limited number of anesthesia procedures that are administered in an Ambulatory Surgery Center (ASC) setting by an Anesthesiologist, or by a Certified Registered Nurse Anesthetist (CRNA) without medical direction by an anesthesiologist. Setting Up Basic Anesthesia Billing Parent topic: Billing

Help Guide for NextGen® Enterprise PM 8

Bill Multiple Encounters (Batch Billing)

All encounters in Unbilled or Rebill status with charges can be billed at the same time in a batch. Open NextGen® Enterprise PM. Select Encounter. The Encounter Lookup window opens. Select Bill Status, and then select Rebill and Unbilled. Note: Encounters with a status of Bad Debt, Billed or History have already been billed. Clear the Include records without charges check box to exclude encounters that do not have charges. Enter additional Search Criteria to locate the desired encounters. Select Find. Encounters matching the search criteria appear in the Encounter List section of the window. Select Encounter List, and then select all encounters to be billed in the Enc Nbr column. Right-click the encounter and select Bill. A message appears stating that confirm bill processing for the [n] selected encounters. To continue billing the selected encounters, select OK. The encounters go through the claim edits process and the Claim Production Status report appears. Each encounter is listed o

Help Guide for NextGen® Enterprise PM 8

Enable Qualifying Encounter Billing

The Encounter Rate Billing functionality in NextGen® Enterprise PM includes logic that identifies multiple encounters for a patient on the same date of service at the same location with the same encounter rate payer. Qualifying Encounter Billing must be enabled for the practice. When enabled, the Encounter Rate Billing Status fields display on the Billing & Collections tab of the Encounter Maintenance window. These fields are used to determine which encounter to bill when a patient has multiple same-day encounters with more than one provider at the same location with the same encounter rate payer attached. Access NextGen® Enterprise PM. From the Admin menu, select Preferences, and then Practice. The Practice Preferences window opens. From the Preference List, select Claims. Select the Enable Qualifying Encounter Billing check box. To save changes and close the window, select OK. Parent topic: Practice Preferences for Encounter Rate Billing

Help Guide for NextGen® Enterprise PM 8

Billing In Progress Encounters

In Progress encounters must be converted to an Unbilled encounter status before you can bill the encounter. There are two ways to convert In Progress encounters to Unbilled encounters. Demand Batch Note: When you convert an In Progress encounter to an Unbilled encounter, a process date (closing date) is assigned to all charges and transactions on the encounter. Any transactions that reside in an un-posted batch retain blank process dates and are not affected by the conversion. Convert In Progress Encounters on Demand You can convert an In Progress encounter to an Unbilled encounter. Converting In Progress Encounters in a Batch You can convert In Progress encounters in a batch in NextGen® Background Business Processor. Parent topic: The Billing Process

The Billing Process

Recommendations

Billing and Collections

Anesthesia Concurrency Billing

Basic Anesthesia Billing

Bill Multiple Encounters (Batch Billing)

Enable Qualifying Encounter Billing

Billing In Progress Encounters

The Billing Process

Billing and Collections

Anesthesia Concurrency Billing

Basic Anesthesia Billing

Bill Multiple Encounters (Batch Billing)

Enable Qualifying Encounter Billing

Billing In Progress Encounters