Batch Status in Payment Batches

Transaction Status	New Status of encounter after posting the transaction	Balance Control
Settled (if there is another payer)	R	Next Payer
Settled (if there is no other payer)	B	Patient
Rebill	R	Same Payer
Appeal	B	None
Deny	B	None
Forward to	B	Forwarded balances remain in a Billed status because while the balance moves to the next payer, the previous payer has forwarded the claim to the secondary or tertiary payer automatically - so a claim is not needed.

Help Guide for NextGen® Enterprise PM 8

Batch Status

You can use the batch Status for payment batches to indicate the flow of the line item balance. For example, if the Payer field is set to the primary payer, the charge settles to the secondary payer or to the patient if there is no secondary payer. Note: The patient responsibility date is the first date when responsibility for encounter payment falls completely in the patient bucket. In other words, you expect no payment from insurance, or insurance has already paid and the entire encounter balance is left for the patient. In addition to settling the encounter to the next payer, you can also enter a status of Rebill, Appeal, or Deny . The following table lists how each status affects the encounter status and its status in Balance Control. Transaction Status New Status of encounter after posting the transaction Balance Control Settled (if there is another payer) R Next Payer Settled (if there is no other payer) B Patient Rebill R Same Payer Appeal B None Deny B None Forward to B Forward

Help Guide for NextGen® Enterprise PM 8

Receive a Secondary Payer Payment Before the Primary Payer

When the first payment on an account is from a secondary payer, NextGen® Enterprise PM processes the payment and verifies if the Use settled up status option is selected in the Transactions list on the Practice Preferences window. When the Use settled up status is selected, the remaining dollars are settled to the patient, and NextGen® Enterprise PM displays the following message after posting the payment to the secondary payer: Message After Posting the Payment to the Secondary Payer Note: NextGen Healthcare recommends that you select the Use settled up status option. When the Use settled up status option is not selected and a secondary insurance payment is selected as the first payment on a patient's account, a negative balance is created in the Ins2 bucket and a default settlement status of None appears in the Payment Entry window. In the Payment Entry window, you can see the following: The primary insurance payment is entered after the secondary insurance payment is received and po

Help Guide for NextGen® Enterprise PM 8

Posting Transactions Overview

In NextGen® Enterprise PM, a payment is considered posted only if has gone through the posting process. You can add or modify payments for an encounter only until it is posted. The posting process is a way of telling the application that everything has been done correctly and is ready to be committed to the system. Payment posting could be manual in paper format as Explanation of Benefits (EOB) or electronically as Electronic Remittance Advice (ERA). In NextGen® Enterprise PM, there are two sources for transactions, patients or payers. Payments may come from primary, secondary or tertiary payers. Transaction Posting Process You can create a batch to enter relevant information for payments and posting the payments. Select an Active Batch You can use the Batch Posting widow to set a batch as an active batch. Add a Transaction to a Batch You can use the transactions to an active batch using the Batch Posting window. Components of the Payment Entry Window You have to enter the payment info

Help Guide for NextGen® Enterprise PM 8

Rebill a Batch for Secondary Insurance

Once you receive payment from the primary insurance, you can bill secondary and tertiary insurances. When an insurance is settled and responsibility has moved to the next bucket (i.e., primary insurance has paid and now it is time to bill secondary), the encounter reverts to a Rebill status. Then you must go through the billing process again. The system does not automatically rebill. Rebilling encounters is very similar to creating claims for the primary payer. From the main toolbar, select Encounter Lookup. In the Bill Status field, select Rebill. Follow the steps described in Billing Multiple Encounters. Note: The Include Encounters in a Billing Hold check box enables you to include or exclude encounters that are on a billing hold. For example, when searching for Rebill encounters to bill again, you may not want encounters that are being held. Therefore, you would not select this option. Parent topic: Billing Process Work Flow

Help Guide for NextGen® Enterprise PM 8

Rebill a Batch for Secondary Insurance

Once you receive payment from the primary insurance, you can bill secondary and tertiary insurances. When an insurance is settled and responsibility has moved to the next bucket (i.e., primary insurance has paid and now it is time to bill secondary), the encounter reverts to a Rebill status. Then you must go through the billing process again. The system does not automatically rebill. Rebilling encounters is very similar to creating claims for the primary payer. From the main toolbar, select the Encounter Lookup button. In the Bill Status field, select Rebill. Follow the steps described in Billing Multiple Encounters. Note: The Include Encounters in a Billing Hold check box enables you to include or exclude encounters that are on a billing hold. For example, when searching for Rebill encounters to bill again, you may not want encounters that are being held. Therefore, you would not select this option. Parent topic: Billing Process Work Flow

Help Guide for NextGen® Enterprise PM 8

Basic Overview

When In Progress Billing is enabled for a practice, new encounters created can have a status of In Progress instead of Unbilled. These encounters represent on-going work or care that has started, but that has not yet been completed. Therefore, they are held from the normal batch billing process that typically includes encounters in Unbilled and Rebill status. Charges and transactions can be entered on In Progress encounters. However, those charges and transactions will have a blank process date. Without a process date, those amounts are not officially included in the financials and receivables on reports for the practice. After the work or care is completed on an In Progress encounter, the encounter goes through a process that converts it to Unbilled status. If the encounter was billed while it was In Progress, then the process converts it to Billed status. During the conversion, a process date is associated to all charges and transactions on the encounter, and those amounts become par

Batch Status in Payment Batches

Recommendations

Batch Status

Receive a Secondary Payer Payment Before the Primary Payer

Posting Transactions Overview

Rebill a Batch for Secondary Insurance

Rebill a Batch for Secondary Insurance

Basic Overview

Batch Status

Receive a Secondary Payer Payment Before the Primary Payer

Posting Transactions Overview

Rebill a Batch for Secondary Insurance

Rebill a Batch for Secondary Insurance

Basic Overview