Transaction Codes for UDS

Help Guide for NextGen® Enterprise PM 8

Information Needed for the UDS Report

Although some data required for the UDS Report is more readily (or only) available from a general ledger or other external system, much of the data can be reported directly from NextGen® Enterprise PM. Several demographic fields required by Health Centers for the UDS report are available on the UDS tab of the Add/Modify Patient Information window. Additional fields are available for use by IHS practices. To display the UDS tab, enable the Display person UDS fields check box in Enterprise Preferences > UDS. Demographic Information for UDS Demographic Information for IHS Transaction Codes for UDS Family Information for UDS Parent topic: Uniform Data System (UDS) Report

Help Guide for NextGen® Enterprise PM 8

Add or Modify Transaction Codes for Encounter Rate Billing

Transaction codes can be used in the Encounter Rate Billing library to auto-adjust charges for payers using encounter rate billing. Having unique transaction codes assists in differentiating encounter rate adjustments from other types of adjustments on the UDS report. It also assists in either including or excluding encounter rate adjustments on financial reports in NextGen® Enterprise PM. If encounter rate billing is used for more than one payer, create a separate transaction code for each payer. For example: Medicare Enc Rate Adjustment Medicaid Enc Rate Adjustment To add or modify a transaction code for encounter rate billing, do the following: Access File Maintenance. Select System Master Files, then PM, and then Transaction Codes. The Transaction Codes List window opens. Do one of the following: To add a transaction code, select Open Menu and select New. To modify a transaction code, select the code from the list, and then select Open Menu and select Open. The Add/Modify Transacti

Help Guide for NextGen® Enterprise PM 8

Sliding Fee Schedule Verification Information

In the Sliding Fee Schedule Verification section of the UDS tab, you can enter sliding fee schedules for a person or patient. These are typically used by Community Health Centers to automatically adjust a portion of the charges entered on encounters for a qualifying patient. The percentage of the automatic adjustment is based on household Family Size and Annual Income. Sliding fee auto-adjustments are reported on the UDS Report. Multiple sliding fee schedules can be created if needed. For example, if the percentage discounts vary for medical, dental, vision or behavioral health services, separate schedules can be created for each. Sliding fee schedule information is stored at the practice level; therefore, each practice can enter and maintain different information for a person or patient. The Sliding Fee Schedule Verification section of the UDS tab is available as follows: Window: NextGen® Enterprise EHR NextGen® Enterprise PM NextGen® Optical Management Person Information Yes Yes N/A

NextGen® Enterprise EHR Help

Sliding Fee Schedule Verification Information

In the Sliding Fee Schedule Verification section of the UDS tab, you can enter sliding fee schedules for a person or patient. These are typically used by Community Health Centers to automatically adjust a portion of the charges entered on encounters for a qualifying patient. The percentage of the automatic adjustment is based on household Family Size and Annual Income. Sliding fee auto-adjustments are reported on the UDS Report. Multiple sliding fee schedules can be created if needed. For example, if the percentage discounts vary for medical, dental, vision or behavioral health services, separate schedules can be created for each. Sliding fee schedule information is stored at the practice level; therefore, each practice can enter and maintain different information for a person or patient. The Sliding Fee Schedule Verification section of the UDS tab is available as follows: Window: NextGen® Enterprise EHR NextGen® Enterprise PM NextGen® Optical Management Person Information Yes Yes N/A

Help Guide for NextGen® Enterprise PM 8

Do's and Don'ts for the UDS Report

Invoices Invoices should only be used for charges that are not considered face-to-face encounters with a provider. For example, attorney fees, medical records fees, etc. Invoice charges cannot be reported on the UDS report because there is no encounter associated to an invoice. Unapplied Credits Encounter-level unapplied credits can be used since they can be tied to a provider and location in NextGen® Enterprise PM and can therefore be reported correctly on the UDS report. Account-level unapplied credits should not be used because they cannot be tied to a Provider and Location in NextGen® Enterprise PM and therefore cannot be reported correctly on the UDS Report. To prevent users from entering patient payments as account-level unapplied credits, security access in System Administrator can be setup for the appropriate user groups as follows: Operations > Transactions > Unapplied Account Payment Addition = No Operations > Transactions > Unapplied Encounter Payment Addition = Yes Primary

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 in NextGen® Enterprise PM. Once linked, a percentage of the charge amounts entered on an encounter are automatically adjusted off. The percentage of the automatic adjustment is based on household family size and annual income. Sliding Fee Schedule adjustments are reported on the UDS Report. 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. To use Sliding Fee Schedules in NextGen® Enterprise PM, the following setup must be completed: Create Transaction Codes in File Maintenance to be used for sliding fee adjustments. Create Sliding Fee Schedules in File Maintenance. Configure options in Practice Preferences > Sliding Fee to determine how sliding fee adjustments should function within the practice. Once Slidi

Transaction Codes for UDS

Recommendations

Information Needed for the UDS Report

Add or Modify Transaction Codes for Encounter Rate Billing

Sliding Fee Schedule Verification Information

Sliding Fee Schedule Verification Information

Do's and Don'ts for the UDS Report

Sliding Fee Schedules

Information Needed for the UDS Report

Add or Modify Transaction Codes for Encounter Rate Billing

Sliding Fee Schedule Verification Information

Sliding Fee Schedule Verification Information

Do's and Don'ts for the UDS Report

Sliding Fee Schedules