About Eligibility Referral Listing Report

Help Guide for NextGen® Enterprise PM 8

Eligibility Verification Benefit Report

Use the Eligibility Verification Benefit report to view patient benefit information. In addition, use the report to flag and view responses with Fiscal Intermediary (FI) or other replacement plans. This report is not available for Legacy reporting. Since it is an enhanced report there it is no asterisk ‘*’ mark against the report name. In addition, no configurations are required in preferences to differentiate between a Legacy and Enhanced report. View Eligibility Verification Benefit Report Set Filters for Eligibility Benefit Report View Eligibility Verification Status Report Set Filters for Eligibility Verification Status Report Parent topic: Reports

Help Guide for NextGen® Enterprise PM 8

Modify Eligibility Referral Listing Report

Do the following to customize the eligibility referral listing report: Click the Reports menu and then click General, and then click Eligibility Referral. The NextGen Report Filter: Eligibility Referral Listing appears. In the settings list, click Filter 1. The Filter 1 appears. The Inquiry Type section provides eligibility, referral, claim status, and authorization filters including history. Select the criteria that you want to base your report on. For example, you may want the report to show listings for the current month or for an individual rendering physician. You have the option to filter by Response Status. The options are Active, Inactive, and Mixed. Click OK to generate the report. The eligibility referral listing report appears, displaying any selected columns. Click to exit from the report. Parent topic: About Eligibility Referral Listing Report

Help Guide for NextGen® Enterprise PM 8

Reports

This section provides information on the reports used in NextGen® Eligibility Verification. These reports include: The Eligibility Referral Listing report Reconciliation Reports The Claims Requests report Go to NextGen Healthcare Success Community and download the Reports User Guide for NextGen® Enterprise PM for detailed information on Reporting. In addition, eligibility verification users have enhanced reports. Enhanced reports are not available for legacy reporting. These enhanced reports are: The Eligibility Verification Benefit report The Eligibility Inquiry Status report About Eligibility Referral Listing Report Reconciliation Reports The Reconciliation Report allows you to match the Eligibility Verification monthly invoice with the monthly transaction. This report is designed specifically for clients with a "per transaction" billing model. If you are currently being billed by the number of providers you have, this option is not designed for you. Modify Payer Listing Report Claim

Help Guide for NextGen® Enterprise PM 8

Eligibility Referral Report

The Eligibility Referral report is available if your system is licensed for NextGen Eligibility Verification. You can use the report to track referral requests submitted to payers from NextGen® Enterprise PM. For more information, go to the NextGen Healthcare Success Community and download the User Guide for NextGen® Eligibility Verification Report configuration and filter options include Create Date, Status, Inquiry Type, Response Status, Payer Subgrouping, Primary Payer, Provider Subgrouping, and Rendering Provider. To access the report in NextGen® Enterprise PM, select Reports > General and then select Eligibility Referral. Eligibility Referral Report Columns Parent topic: General Reports

Help Guide for NextGen® Enterprise PM 8

Eligibility Referral Report

The Eligibility Referral report is available if your system is licensed for NextGen Eligibility Verification. You can use the report to track referral requests submitted to payers from NextGen® Enterprise PM. For more information, go to the NextGen Healthcare Success Community and download the User Guide for NextGen® Eligibility Verification Report configuration and filter options include Create Date, Status, Inquiry Type, Response Status, Payer Subgrouping, Primary Payer, Provider Subgrouping, and Rendering Provider. To access the report in NextGen® Enterprise PM, select Reports > General and then select Eligibility Referral. Eligibility Referral Report Columns Parent topic: General Reports

Help Guide for NextGen® Enterprise PM 8

Referral History Inquiries

Do the following to submit a referral history inquiry: Right-click and select Referral History from one of the defined access paths. The Provider Referral Inquiry appears. Complete the following required fields: Patient Insurances Requesting Physician Complete the optional fields: Requesting Location (leave blank) Referred To Entity Type Code Qualifier (leave blank) ID Code (leave blank) Reference Code Qualifier (leave blank) Reference ID Code (leave blank) Notes (not sent to payer but displays on response - 255-character limit) Select OK. The inquiry is now being processed. The progress bar at the bottom of the dialog box displays under Ready to Submit. When the submission is complete, the system displays the response in the Referral Result window. View the Transaction Details, Service Provider Details, and Subscriber Details. Note: Scroll-down and view additional information; for example, Services Detail and procedure and diagnosis codes, and benefit dates. To print a copy of the eli

About Eligibility Referral Listing Report

Recommendations

Eligibility Verification Benefit Report

Modify Eligibility Referral Listing Report

Reports

Eligibility Referral Report

Eligibility Referral Report

Referral History Inquiries

Eligibility Verification Benefit Report

Modify Eligibility Referral Listing Report

Reports

Eligibility Referral Report

Eligibility Referral Report

Referral History Inquiries