Contracts Library

Help Guide for NextGen® Enterprise PM 8

Contracts Library

Contracts can be set up for payers to indicate: The amount you expect to be reimbursed for procedures. When an authorization is required. When a referral is required. Other contract specific items, for example, the ability to send $0.00 claims such as capitated with contracts, you can: Attach payers to the contract. Create contract subgroupings for reporting purposes. For more information on contract subgrouping, go to NextGen Healthcare Success Community and download the latest File Maintenance Libraries Guide for NextGen® Enterprise, and refer to the Contract Subgrouping section. Access Contract Library Maintenance Set Up a Fee Schedule for Contract Payers Add or Modify Contracts Contract Exceptions Set Up Auto Charge Adjustments for Non-Participating Providers Parent topic: Setting Up Claims

File Maintenance Help for NextGen® Enterprise 8

Contracts Library

Contracts can be set up for payers to indicate: The amount you expect to be reimbursed for procedures. When an authorization is required. When a referral is required. Other contract specific items, for example, the ability to send $0.00 claims such as capitated with contracts, you can: Attach payers to the contract. Create contract subgroupings for reporting purposes. For more information on contract subgrouping, go to NextGen Healthcare Success Community and download the latest File Maintenance Libraries Guide for NextGen® Enterprise, and refer to the Contract Subgrouping section. Access Contract Library Maintenance Setup an Exception Through the Contract Library

File Maintenance Help for NextGen® Enterprise

Access Contract Library Maintenance

You can set up contracts for payers to indicate the reimbursed amount for the procedures, and for authorization or referral requirement. For other contract specific, you can attach payers to the contract or create contract subgroupings for reporting purposes. In File Maintenance, select Libraries, and then select Contract. The Contracts List window opens. Double-click the library. The Contract Library Maintenance window opens. General Information fields NextGen® Enterprise PM uses the General Information tab fields to determine the contract rules. It contains options that enable you to set informational alerts, information about co-payments, co-pay amounts, alerts, allowed and FFS/balance distribution, and automatic adjustments. Add or Modify a Contract You can add or modify a contract in the Contract Library Maintenance window. Set Up a Fee Schedule for Contract Payers The fee schedule enables you to indicate the amount that you expect to be reimbursed for specific procedures that fal

Help Guide for NextGen® Enterprise PM 8

Access Contract Library Maintenance

You can set up contracts for payers to indicate the reimbursed amount for the procedures, and for authorization or referral requirement. For other contract specific, you can attach payers to the contract or create contract subgroupings for reporting purposes. In File Maintenance, select Libraries, and then select Contract. The Contracts List window opens. Double-click the library. The Contract Library Maintenance window opens. General Tab of Contract Library Maintenance Parent topic: Contracts Library

Help Guide for NextGen® Enterprise PM 8

Set Up a Fee Schedule for Contract Payers

If the co-pay for a CPT4 code might be different from the default co-pay. The options in the Fee Schedule tab override the options in the General tab. The information entered applies when the payer attached to the contract is the primary payer for an encounter. Contractual requirements alerts can be set up to display during appointment scheduling, patient registration, and billing processes. Automatic contractual adjustments and the distribution of insurance reimbursement can be set up to be applied to patient balances. In File Maintenance, select Libraries, and then select Contract. The Contracts List window opens. Double-click the library, and then select Fee Schedule. Enter a CPT4 Code. The CPT4 codes and their descriptions that are specific to each contract display in the CPT4/Desc list box. To search for a specific code, enter the CPT4 code in the field above the CPT4/Desc column and the code is highlighted. Note: To clear the list to find another code, select the Reload CPT4s but

File Maintenance Help for NextGen® Enterprise 8

Access Contract Library Maintenance

Access the Contract Library Maintenance window, to create contract defaults, such as co-payments, deductibles, and physician referrals and authorizations. In File Maintenance, select Libraries and then Contract. The Contracts List window opens. Double-click the applicable library. The Contract Library Maintenance window opens. General Tab of Contract Library Maintenance Activate and Assign a Payer to a Practice You can limit a practice's access to certain Payers master files. Add or Modify a Contract Set Up a Fee Schedule for Contract Payers Modifier Reimbursement Tab Multiple Procedure Discounting Tab Payer/Provider Tab Contract Exceptions Parent topic: Contracts Library

Contracts Library

Recommendations

Contracts Library

Contracts Library

Access Contract Library Maintenance

Access Contract Library Maintenance

Set Up a Fee Schedule for Contract Payers

Access Contract Library Maintenance

Contracts Library

Contracts Library

Access Contract Library Maintenance

Access Contract Library Maintenance

Set Up a Fee Schedule for Contract Payers

Access Contract Library Maintenance