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IHS Setup Requirements
Required Setup:
Encounter Rate Billing (or Roll-Up Billing) for Medicare/Medicaid
Patient Information:
Tribal Affiliation
Blood Quantum
IHS Eligibility Status
Classification/Beneficiary
Descendancy
Optional Setup:
Sliding Fee Schedules
Other Custom Reports
Proprietary Claim Formats
Reports available from NextGen Technical Consulting Services:
GPRA (Government Performance and Results Act)
CHRS (Contract Health Referral System)
NDW (National Data Warehouse)
DAR (Diabetic Audit Report)
IHS Setup Requirements
Help Guide for NextGen® Enterprise PM 8
CHC Setup Requirements
Required Setup: Sliding Fee Schedules Encounter Rate Billing (or Roll-Up Billing) for Medicare/Medicaid UDS Reporting Optional Setup: Custom Reports Proprietary Claim Formats Parent topic: Health Center Setup Requirements
Help Guide for NextGen® Enterprise PM 8
FQHC Setup Requirements
Required Setup: Sliding Fee Schedules Encounter Rate Billing (or Roll-Up Billing) for Medicare/Medicaid UDS Reporting Optional Setup: Custom Reports Proprietary Claim Formats Parent topic: Health Center Setup Requirements
Help Guide for NextGen® Enterprise PM 8
RHC Setup Requirements
Required Setup: Encounter Rate Billing (or Roll-Up Billing) for Medicare/Medicaid UDS Reporting Optional Setup: Sliding Fee Schedules Custom Reports Parent topic: Health Center Setup Requirements
Help Guide for NextGen® Enterprise PM 8
CHC Look-a-Like Setup Requirements
Optional Setup: Sliding Fee Schedules Proprietary Claim Formats (For example, Planned Parenthood in Texas is required to use a proprietary form for filing their family planning claims to the state.) Encounter Rate Billing (or Roll-up Billing) UDS Reporting (required if federally funded) Title X Report (California) Other Custom Reports Parent topic: Health Center Setup Requirements
Help Guide for NextGen® Enterprise PM 8
Health Center Setup Requirements
This section provides instructions on configuring NextGen® Enterprise PM to accommodate the specialized needs of Health Centers. CHC Setup Requirements FQHC Setup Requirements RHC Setup Requirements IHS Setup Requirements CHC Look-a-Like Setup Requirements Setting Up Master Lists for Health Centers Set Up Client Defined Fields for Health Centers
Help Guide for NextGen® Enterprise PM 8
State-Specific Reports
Many states have proprietary reports that Health Centers are required to submit to keep their state funding. For example, many state Medicaid plans have special reporting requirements. If these reports cannot be produced by use of the standard reports within NextGen® Enterprise PM, then they may require a custom report. Below is a list of reports that may be required in some states: California Office of Statewide Health Planning and Development (OSHPD)* Title X Family Planning Annual Report* Massachusetts Health Safety Net Organization Texas Title X Family Planning Annual Report* Title XX Below is a list of reports that may be required by IHS practices: Government Performance and Results Act (GPRA)* National Data Warehouse (NDW) Diabetic Audit Report (DAR)* Contract Health Referral System (CHRS)* Note: Reports indicated with an asterisk (*) are available from NextGen Technical Consulting Services. State-Specific Billing Forms Parent topic: Health Center Reporting
