Practice Preferences for Encounter Rate Billing

Help Guide for NextGen® Enterprise PM 8

Set Up Enterprise Preferences for Encounter Rate Billing

You must enable encounter rate billing for the enterprise. When enabled, further setup can be completed for practices within the enterprise that use encounter rate billing functionality. This also enables an Encounter Rate Billing library to be attached to the appropriate payers later in the setup. Access NextGen® Enterprise PM. From the Admin menu, select Preferences, and then Enterprise. The Enterprise Preferences window appears. Select the General tab. Select the Encounter rate billing checkbox. To save changes and close the window, select OK. Parent topic: Setting Up Encounter Rate Billing

Help Guide for NextGen® Enterprise PM 8

Set Up Payers for Encounter Rate Billing

Once the Encounter Rate Billing library has been created, it must be attached to the appropriate encounter rate payers. Attaching the Encounter Rate Billing library ensures that during the billing process in NextGen® Enterprise PM, the ER SIM code is inserted onto the encounter and the claim is configured correctly to meet the ER payer's specific requirements. Access File Maintenance. Select System Master Files, then PM, and then Payers. The Payers List window opens. From the list, select an ER payer, and then select Open Menu and select Open. The Modify Payer Information window opens. Select the Practice tab, and then select the Libraries sub-tab. In the Encounter Rate Library field, select the Encounter Rate Billing library for the payer. To save changes and close the window, select OK. Parent topic: Setting Up Encounter Rate Billing

Help Guide for NextGen® Enterprise PM 8

Practice Preferences for Encounter Rate Billing

To use encounter rate billing in NextGen® Enterprise PM, specific options must be enabled for the practice in Practice Preferences. Enable Qualifying Encounter Billing Process Date for Encounter Rate SIM and Adjustments Parent topic: Setting Up Encounter Rate Billing

Help Guide for NextGen® Enterprise PM 8

Enable Qualifying Encounter Billing

The Encounter Rate Billing functionality in NextGen® Enterprise PM includes logic that identifies multiple encounters for a patient on the same date of service at the same location with the same encounter rate payer. Qualifying Encounter Billing must be enabled for the practice. When enabled, the Encounter Rate Billing Status fields display on the Billing & Collections tab of the Encounter Maintenance window. These fields are used to determine which encounter to bill when a patient has multiple same-day encounters with more than one provider at the same location with the same encounter rate payer attached. Access NextGen® Enterprise PM. From the Admin menu, select Preferences, and then Practice. The Practice Preferences window opens. From the Preference List, select Claims. Select the Enable Qualifying Encounter Billing check box and then select OK. Parent topic: Practice Preferences for Encounter Rate Billing

Help Guide for NextGen® Enterprise PM 8

Setting Up Encounter Rate Billing

Encounter rate billing in NextGen® Enterprise PM involves the following setup in System Administrator and File Maintenance: Security Access Rights Enterprise Preferences Practice Preferences CPT4 Codes Revenue Codes Departments Service Items Library Claim Edits Library Transaction Codes Encounter Rate Billing Library Payers Set Up Security Access Rights for Encounter Rate Billing Set Up Enterprise Preferences for Encounter Rate Billing Practice Preferences for Encounter Rate Billing Add or Modify CPT4 Codes for Encounter Rate Billing Add or Modify Revenue Codes for Encounter Rate Billing Add or Modify Departments for Encounter Rate Billing Add or Modify SIM Codes for Encounter Rate Billing Set Up Claim Edits for Encounter Rate Billing Add or Modify Transaction Codes for Encounter Rate Billing Add or Modify an Encounter Rate Billing Library Set Up Payers for Encounter Rate Billing Parent topic: Encounter Rate Billing

Help Guide for NextGen® Enterprise PM 8

Set Up Enterprise Preferences for Encounter Rate Billing

You must enable encounter rate billing for the enterprise. When enabled, further setup can be completed for practices within the enterprise that use encounter rate billing functionality. This also enables an Encounter Rate Billing library to be attached to the appropriate payers later in the setup. Access NextGen® Enterprise PM. From the Admin menu, select Preferences, and then Enterprise. The Enterprise Preferences window appears. Select the General tab. Select the Encounter rate billing check box. Enterprise Preferences To save changes and close the window, select OK. Parent topic: Setting Up Encounter Rate Billing

Practice Preferences for Encounter Rate Billing

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Set Up Enterprise Preferences for Encounter Rate Billing