Add Authorization and Referral information in the Encounters tab

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

Add Insurance for Patients and Persons

You can add insurance information for a patient or other person by using the Insurance Maintenance window. The system administrator manages the list of insurers in File Maintenance in the Payers master file. From the main toolbar in NextGen® Enterprise PM, select Chart. In the Patient Lookup window, enter search criteria, and then select Find. In Matching Records, right-click the patient record, and then select Open.The Demographics tab opens in the Modify Patient Information window. In Insurance Listing, select the open menu icon, and then select New Insurance. In the Payer Lookup window, enter search criteria for the payer, and then select Find. In Payer List, double-click the applicable payer. In the Insurance Maintenance window, select the Detail tab, and then enter the health insurance claim or policy number in HIC/Policy Nbr. Optional: Enter any additional information required by your practice. Select OK. Note: In the Insurance Listing section of the Demographics tab, you can hid

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

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 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 Referral

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 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 availa

Add Authorization and Referral information in the Encounters tab

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