Receive a Secondary Payer Payment Before the Primary Payer

Help Guide for NextGen® Enterprise PM 8

Post a Budget Payment

You can select different payment source types for posting budget payments in Budget Accounts under Practice Preferences. NextGen® Enterprise PM recommends Accounts and Encounter source types as options on the Payment Entry windows. This enables you to apply patient payments to a budget regardless of selected source/Accnt and avoid any budget payment errors. Open NextGen® Enterprise PM. On the main toolbar, select Posting . The Batch Posting window opens. Double-click the batch header record. The Payment Entry window opens. In Source/Accnt list, select Budget. A budget payment is posted incorrectly if you select the default value of Encounter for Source/Accnt. The Payment Entry window refreshes with new fields. Enter the account name in Account or select Find Account Search Account Button. Accounts that match the search criteria appear in the Account list. Select the desired account. The Payment Entry window displays accounts detail and summary information for the account. In Paycode, s

Help Guide for NextGen® Enterprise PM 8

Enter a Transaction for an Account

Open NextGen® Enterprise PM. On the main toolbar, select Posting . The Batch Posting window opens. Double-click the batch header record. The Payment Entry window opens. In Source/Acct, select Account. In Account, enter the first few letters of the account name or select Account Lookup . Account records matching the search criteria appear in the Account list. Note: A status indicator for the data retrieval appears for an account with more than 100 line items. Large Account mode activates when more than 1000 items are retrieved and displayed. For more information on the number of line items displayed in the Large Account mode or modifying the number of line-items, contact NextGen Healthcare Support. Double-click the desired account. In Pay Amt, enter the payment amount. NextGen Healthcare displays Account Payment as the pay code. If necessary, enter an adjustment amount in the Adj Amt field. NextGen Healthcare displays Account Adjustment for the adjustment code. Select Recalc, and then s

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 checks to see if in the Transactions list of the Practice Preferences window, the Use settled up status options selected. When the Use settled up status is selected, the remaining dollar are settled to the patient, and NextGen® Enterprise PM displays the following message after posting the payment to the secondary payer: Note: NextGen Healthcare recommends that you select the Use settled up status. 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, then 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: The primary insurance payment is entered after the secondary insurance payment has been received and posted. A message appear to inform you that a secondary payer payment has been

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

Set Up a Payment Spread for a patient

When a payment is received and a patient has several line items with amounts due, NextGen® Enterprise PM applies payments to line items using the selected spread options. Open NextGen® Enterprise PM. On the main toolbar, select Posting . The Batch Posting window opens. Double-click the batch header record. The Payment Entry window opens. Enter the encounter number in Enc/Clm#. The account guarantor, patient, medical record number, and the billed account displays in the Payment Entry window. Select Open. The Payment Entry window is available for modifications. In Pay Amt and Adj Amt, enter the payment and adjustment amount respectively. Select the line items to apply the spread amount.` Right-click, and select Spread, and then select one of the following options: FIFO FIFO - Pat Resp Date Weight Distribution Select Save. The selected payment spread is applied to the given line item. Parent topic: Payments Spread Overview

Help Guide for NextGen® Enterprise PM 8

Setting Up Practice Preferences for ERA

You can configure the following ERA settings in Practice Preferences. Go to Practice Preferences, then Libraries and select Remittance Profile Library to set the default library to be used for all ERA payers that do not have a specific library linked in the practice. Go to Practice Preferences, then Transactions and select Default Reason Code Library to set the default library to be used for all payers (ERA and non-ERA) in the practice, that do not have a specific library linked. Note: NextGen Healthcare recommends the use of the HIPAA X12 Standard Reason Codes library as the default for a practice for all payers. Use settled up status with ERA. You can select this check box to default the Settled moved to Primary transaction status onto ERA payment or adjustment transactions received from the secondary payer before the primary payer. When a secondary transaction is received before primary, a credit balance is normally created in the secondary payer (Ins2 Amt) bucket in Balance Control

Receive a Secondary Payer Payment Before the Primary Payer

Recommendations

Post a Budget Payment

Enter a Transaction for an Account

Receive a Secondary Payer Payment before the Primary Payer

Posting Transactions Overview

Set Up a Payment Spread for a patient

Setting Up Practice Preferences for ERA

Post a Budget Payment

Enter a Transaction for an Account

Receive a Secondary Payer Payment before the Primary Payer

Posting Transactions Overview

Set Up a Payment Spread for a patient

Setting Up Practice Preferences for ERA