Add an Insurance Referral

Help Guide for NextGen® Enterprise PM 8

Add an Isurance Referral

From the Ins/Diag tab, select the insurance for which a referral is to be added. Right-click and select New Referral from the menu. The Referral Code Tracking window opens. In the Referral Mode section, select one of the following: Encounter Mode: Select this button if the referral is approved for a specific number of encounters. This button is selected by default. Units Mode: Select this button if the referral is approved for a specific number of charge units. In the Referral Code field, enter the referral number obtained from the insurance company. This field is required. In the Effective Date field, enter the start date for the referral. This field is required. In the Expiration Date field, enter the end date for the referral. This field is required. In the Nbr Encounters field enter the number of encounters approved for the referral. This field is not available for Units Mode referrals. The Used field displays 0. The number increments by 1 each time the referral is linked to an enc

Help Guide for NextGen® Enterprise PM 8

Add Referral Code Tracking in the Encounters tab

Referrals can be created using ICD code ranges, CPT code ranges, encounters, or units. Multiple providers, a single specialty, or a location can be attached to a referral. You can track referrals by encounter use, pending encounters, and the number of encounters remaining on the referral. 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 Encounters, and then select the Insurance tab under it. Right-click the insurance listed on the Encounter Insurance section, and select Referral. The Referrals Listing window opens. Referral Listing window Right-click and select New Referral from the menu. The Referral Code Tracking window opens. Referral Code Tracking Window Enter the desired

Help Guide for NextGen® Enterprise PM 8

Add an Insurance Authorization

Open NextGen® Enterprise PM. On the main toolbar, select ApptBook. Select the appointment. The Edit Appointment window opens. From the Ins/Diag tab, select the insurance for which an authorization is to be added. Right-click and select New Authorization from the menu. The Authorization Code Tracking window opens. In the Authorization Mode section, select one of the following: Encounter Mode: Select this button if the authorization is approved for a specific number of encounters. This button is selected by default. Units Mode: Select this button if the authorization is approved for a specific number of charge units. If the authorization is for tracking proposes only and should not be included on claims, select the Tracking Only - Do not send on claim check box. In the Authorization Code field, enter the authorization number obtained from the insurance company. This field is required. In the Effective Date field, enter the start date for the authorization. This field is required. In the

Help Guide for NextGen® Enterprise PM 8

Add an Insurance Authorization

From the Ins/Diag tab, select the insurance for which an authorization is to be added. Right-click and select New Authorization from the menu. The Authorization Code Tracking window opens. In the Authorization Mode section, select one of the following: Encounter Mode: Select this button if the authorization is approved for a specific number of encounters. This button is selected by default. Units Mode: Select this button if the authorization is approved for a specific number of charge units. If the authorization is for tracking proposes only and should not be included on claims, select the Tracking Only - Do not send on claim check box. In the Authorization Code field, enter the authorization number obtained from the insurance company. This field is required. In the Effective Date field, enter the start date for the authorization. This field is required. In the Expiration Date field, enter the end date for the authorization. This field is required. In the Nbr Encounters field enter the

Help Guide for NextGen® Enterprise PM 8

Components of the Referral Code Tracking Window

Field Action Encounter Mode Select this button if the referral is approved for a specific number of encounters. This button is selected by default. Units Mode Select this button if the referral is approved for a specific number of charge units. Referral Code Enter the referral number obtained from the insurance company. This field is mandatory. Effective Date Enter the start date for the referral. This field is mandatory. Expiration Date Enter the end date for the referral. This field is required Nbr Encounters Enter the number of encounters approved for the referral. Note: This field is not available for Units Mode referrals. Used This field displays 0. The number increments by 1 each time the referral is linked to an encounter. The number cannot exceed the number in the Nbr Encounters field. Pending This field displays 0. The number increments by 1 each time an appointment is scheduled for the patient. The number cannot exceed the number in the Nbr Encounters field. Encounters Left T

Help Guide for NextGen® Enterprise PM 8

Add Authorizations Code Tracking in the Encounter tab

The Authorization Code Tracking window displays encounters which use the authorization, and appointments pending the authorization. When authorization is not required to be attached to the claim,you can track authorizations for internal purposes. Line-level and claim-level authorizations are tracked by the following: A single location A single location and a specialty A single location and one or more providers. 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 Encounters, and then select on the Insurance tab under it. Right-click the insurance listed on the Encounter Insurance section, and select Authorization. The Authorization Listing window opens. Authorization Listing Win

Add an Insurance Referral

Recommendations

Add an Isurance Referral

Add Referral Code Tracking in the Encounters tab

Add an Insurance Authorization

Add an Insurance Authorization

Components of the Referral Code Tracking Window

Add Authorizations Code Tracking in the Encounter tab

Add an Insurance Referral

Add an Isurance Referral

Add Referral Code Tracking in the Encounters tab

Add an Insurance Authorization

Add an Insurance Authorization

Components of the Referral Code Tracking Window

Add Authorizations Code Tracking in the Encounter tab