Limitations on Encounters with Pending Approval

Help Guide for NextGen® Enterprise PM 8

Significant Events for Encounters

Once enabled, significant event messages are recorded in the Patient Chart > Clinical History/Notes tab when the event occurs. Significant Event messages for encounters include the following: Encounter Accessed Encounter Alternate Diagnosis Mapped Encounter Bad Debt Status has reached $0 Balance Encounter Bill Printed Encounter Charge Alternate Diagnosis Mapped Encounter Charge Deleted Encounter Collections Agency Change Encounter Deleted Encounter Diagnosis Viewed Encounter Field Modified Encounter Guarantor Changed Encounter Insurance Deleted Encounter Insurance Re-Ordered Encounter Locked Encounter Lookup Criteria Encounter Rate Adjustment Reversed Encounter Rate SIM and Amount Removed Encounter Status Change Encounter Unlocked Enable Significant Events for Encounters There may be modifications made to patient encounters. To track these modifications, you must enable the appropriate significant events. View Significant Events for Encounters Significant events are enabled to view mod

Help Guide for NextGen® Enterprise PM 8

Limitations on Encounters with Pending Approval

When an encounter is pending approval, you cannot: Void charges Enter charges in normal mode Change the encounter information Change the financial information Pre-list the encounter for Bad Debt Add new discounts Parent topic: Encounters in NextGen Enterprise PM

Help Guide for NextGen® Enterprise PM 8

Encounters in NextGen® Enterprise PM

An encounter is an interaction between a patient and a provider in the practice on a specific date and time. In NextGen® Enterprise PM, office encounters are typically created from the appointment book when each patient checks in for their appointment. Facility encounters that are not related to an appointment, such as hospital and nursing home visits, can be created from the patient's chart. Clinical information related to a specific encounter is documented by the provider in NextGen® Enterprise EHR. Financial information, such as charges, billing and transactions, is entered on that same encounter by users in NextGen® Enterprise PM. The Encounters tab on Patient Chart lists all encounters for a patient, and the Encounters Detail tab on Account Profile lists all encounters for a guarantor. For more information on encounters in NextGen® Enterprise EHR, go to the NextGen Healthcare Success Community and download the Layout and Preferences Guide for NextGen® Enterprise EHR. Encounter Sta

Help Guide for NextGen® Enterprise PM 8

Bad Debt Process

When you move one or more encounters on a guarantor's account to bad debt, there is no need to adjust balances off from the Accounts Receivable (A/R). NextGen® Enterprise PM maintains a Regular A/R and a Bad Debt A/R. Before encounters can be moved to a Bad Debt status, they must first be added to a pre-list, which means the encounters are placed on the Encounters Pending Bad Debt report. When encounters on the report are reviewed and approved for collections, the pre-listed encounters are then processed for Bad Debt, and any outstanding balances are transferred to the Bad Debt A/R. Adding Encounters to the Pre-List for Bad Debt You can add encounters to the pre-list for bad debt. Reviewing Encounters on the Pre-List for Bad Debt You can review encounters on the pre-list for bad debt in Encounters Pending Bad Debt report. Modify Encounters on the Pre-List for Bad Debt You can modify encounters on the pre-list for bad debt on the Pre-List Encounter window. Removing Encounters from the P

Help Guide for NextGen® Enterprise PM 8

Encounter Mode Authorizations

A payer can provide an authorization for the patient to have a specific number of encounters, and those encounters may occur within a date range defined by the payer. This type of authorization is entered in NextGen® Enterprise PM using Encounter Mode. From the Authorization Code Tracking window, you can enter an Encounter Mode authorization with the following information: Authorization code (required) Effective and expiration dates (required) Number of encounters authorized Rendering provider Location Provider specialty Free-text description Valid ICD codes Valid CPT4 codes Additional administration information Additional free-text notes On the Authorization Code Tracking window for an existing authorization, you can view Encounters Utilizing This Authorization and Appointments Pending This Authorization. These sections do not appear when you enter a new authorization. Parent topic: About the Authorizations Tab in Insurance Maintenance

Help Guide for NextGen® Enterprise PM 8

Encounter Mode Authorizations

A payer can provide an authorization for the patient to have a specific number of encounters, and those encounters may occur within a date range defined by the payer. This type of authorization is entered in NextGen® Enterprise PM using Encounter Mode. From the Authorization Code Tracking window, you can enter an Encounter Mode authorization with the following information: Authorization code (required) Effective and expiration dates (required) Number of encounters authorized Rendering provider Location Provider specialty Free-text description Valid ICD codes Valid CPT4 codes Additional administration information Additional free-text notes On the Authorization Code Tracking window for an existing authorization, you can view Encounters Utilizing This Authorization and Appointments Pending This Authorization. These sections do not appear when you enter a new authorization. Parent topic: About the Authorizations Tab in Insurance Maintenance

Limitations on Encounters with Pending Approval

Recommendations

Significant Events for Encounters

Limitations on Encounters with Pending Approval

Encounters in NextGen® Enterprise PM

Bad Debt Process

Encounter Mode Authorizations

Encounter Mode Authorizations

Significant Events for Encounters

Limitations on Encounters with Pending Approval

Encounters in NextGen® Enterprise PM

Bad Debt Process

Encounter Mode Authorizations

Encounter Mode Authorizations