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View Eligibility Information for a Patient
Open
NextGen® Enterprise PM
.
On the main toolbar, select
Chart
or
Chart Lookup
.
.
The
Patient Lookup
window opens.
In the
Search Criteria
section, enter the patient's information, and select
Find
.
Patient records that match the search criteria appear in the
Matching Records
section.
Select the patient and then select
Open
.
The
Patient Chart
window opens.
Select the
Encounters
tab.
From the
Encounters
list, select an encounter with a payer attached.
Access the patient's chart and select the
Encounters
tab.
Select the
Insurance
tab.
The eligibility information is located in the
Verification
section of the window.
View Eligibility Information for a Patient
Help Guide for NextGen® Enterprise PM 8
Add Insurance Verification Information to an Encounter
You can enter additional information for an insurance linked to an encounter in the Patient Insurance - Encounter window. This applies to primary, secondary, and tertiary payers. Open NextGen® Enterprise PM. On the main toolbar, select Chart or Chart Lookup.. The Patient Lookup window opens. In the Search Criteria section, enter the patient's information, and select Find. Patient records that match the search criteria, appear in the Matching Records section. Select the patient, and then select Open. The Patient Chart window opens. Select the Encounters tab. From the Encounters list, select an encounter with a payer attached. Select the Insurance tab. In the Encounter Insurance section, select the payer. In the Verification section, select open record . The Patient Insurance - Encounter window opens. Patient Insurance Encounter Window Make the desired changes, and select OK. Parent topic: Viewing Insurance Information in Encounters
Help Guide for NextGen® Enterprise PM 8
Add Benefit Information to Patient Insurance
You can record annual and lifetime benefit information to help determine patient responsibility. Open NextGen® Enterprise PM. On the main toolbar, select Chart or Chart Lookup . The Patient Lookup window opens. In the Search Criteria section, enter the patient's information, and then select Find. Patient records that match the search criteriaa ppear in the Matching Records section. Select the patient, and then select Open. The Patient Chart window opens. Select the Encounters tab. The encounters associated with the patient appear in the Encounters section. Select the Insurance tab and then select the encounter from the Encounters section. Right-click the selected insurance, and then select Open. The Insurance Maintenance window opens. Select the Benefits Info tab and then select the Eligibility and Benefits tab. To view existing benefit information, select open menu and then select New or Open. The Eligibility and Benefit Maintenance window opens. Eligibilty and Benefit Information Win
Help Guide for NextGen® Enterprise PM 8
Add Insurance Verification Information to an Encounter
Open NextGen® Enterprise PM. On the main toolbar, select Chart, and then in Patient Lookup, enter your search criteria, and then select Find. Matching people and patient records appear in the search results. In Matching Records, select a patient record , and then select Open. The Patient Information tab opens in the Patient Chart window. Select the Encounters tab, and then select an encounter from the Encounters list, and then select the Insurance tab. Select the open menu icon next to Encounter Insurance, and then select New. In the Encounter Insurance Selection window, select the necessary payer, and then select OK. The insurance information is added. To add additional insurance information, select a payer attached encounter from the Encounters list, and then select an insurance from the Insurance list. In Encounter Insurance, select the payer, and then in Verification, select the open record icon. In the Verification section, you can view the patient eligibility information. In Pati
Help Guide for NextGen® Enterprise PM 8
Submit Eligibility Requests from Encounters
Before you begin When an eligibility request is submitted from an encounter, eligibility only references the insurance attached to the encounter. Open NextGen® Enterprise PM, and then select Chart. The Patient Lookup window opens. Enter the patient details, and then select OK. The Patient Chart window opens. Select Encounters, right-click the encounter, and then select Add Insurance. The Encounter Insurance Selection window opens. In the Selected Insurance section, select the payer, and then select OK. On the NextGen® Enterprise PM toolbar, Select Encounter. The Encounter Lookup window opens. Enter the encounter number. In the Encounter List section, right-click the encounter, and then select Eligibility Verification > Submit. The Eligibility Verification window opens. Note: When you submit an eligibility request for the encounter without insurance attached, a message appears stating that this patient has no eligibility verification-supported insurance. You can select Other Payer for a
Help Guide for NextGen® Enterprise PM 8
Enter an Encounter Follow-up Date
Open NextGen® Enterprise PM. Select Chart. The Patient Lookup window opens. Enter search criteria to locate the desired patient. Select Find. All existing persons and patients that match the entered search criteria display in the Matching Records section of the window. In the Matching Records list, double-click the patient. The Patient Chart window opens. Select the Encounters tab. From the Encounters list on the left, open the desired encounter. The Encounter Maintenance window opens. Select the Billing & Collections tab. In the Follow Up Date field, and then enter a future date. The Follow Up option automatically enables the encounter to include in the Collections Follow Up report. Select OK. Parent topic: Collections
Help Guide for NextGen® Enterprise PM 8
View Latest Successful Eligibility Response from Encounter
Before you begin Submit NextGen® Eligibility Verification request for a patient. See Submit Eligibility Requests. You can view the response for the latest successful transaction from the encounter on the patient chart.. In NextGen® Enterprise PM, select Encounter. The Encounter Lookup window opens. Using the search criteria, find the patient. The search result displays the list of encounters for the patient. On the Encounter Lookup window, double-click the encounter. The patient chart for the patient opens. The list of encounters for the patient is displayed in the Encounters window. On the Encounters list, right-click the encounter you want to view and select Eligibility Verification > View Latest Successful Response. The system searches for the eligibility response for the latest successful transaction occurred during the time period specified in the user preferences. If the eligibility response is available, the Real-Time Eligibility Response page opens displaying the response for t
