Set up Payers for Charge Discounts

Help Guide for NextGen® Enterprise PM 8

Set up Transaction Codes for Charge Discounts

When Charge Discounts are enabled in Practice Preferences, Discount Criteria section becomes available in the setup of Transaction Codes. You can set up specific adjustment transaction codes that are used for calculating charge discounts. You can create separate transaction codes to differentiate discount adjustments entered from the Charge Posting window and from other types of adjustments entered from the Payment Entry window. To set up adjustment Transaction Codes for charge discounts, do the following: Open File Maintenance. Select System Master Files, and then PM. Select Transaction Codes. The Transaction Codes List window opens. Do one of the following: To add a new transaction code, select the Open Menu icon and select New. To modify an existing transaction code, select the transaction code from the list, select Open Menu and select Open. The Add Transaction Code Information window opens. Enter a descriptive name for the code in the Transaction Description field. This is a requi

Help Guide for NextGen® Enterprise PM 8

Enable Charge Discounts in Practice Preferences

Open NextGen® Enterprise PM. From the Admin menu, select Preferences, and then Practice. The Practice Preferences window opens. Note: This setting affects the patient discount calculation while using an adjustment transaction code when source is a patient. Insurance discount using an adjustment transaction code when source is the third party is calculated based on the total charge amount, regardless of this setting. In the Preference List, select Charge Entry, and then select the Charges tab. Select Enable discounts in charge entry to enable charge discounts in the Charge Posting window. Note: The Discounts icon becomes available on the Charge Posting toolbar, and the Discounts Criteria section in the Transaction Codes window. Select Apply patient discount to patient balance only to calculate patient discounts using the Patient Amount on each charge and not the Original Charge Amount. Do not select Apply patient discount to patient balance only to calculate patient discounts using the

Help Guide for NextGen® Enterprise PM 8

Set up Payers for Charge Discounts

Payers can use the charge discounts. The discounted amount is calculated based on the total charge amount, and not the insurance balance amount. Discounts are calculated differently for contracted payers and non-contracted payers. Note: The Contracted payer selection is only for the charge discounts. It is not related to contracts that are set up for payers in the Contracts Library. You can view the Contracted payer indicator on the NextGen® Enterprise EHR templates. To flag a payer as a Contracted payer for charge discounts, do the following: Open File Maintenance. Select System Master Files, and then select PM. Select Payers. The Payers List window opens. Double-click the desired payer. The Modify Payer Information window opens. Select the Defaults-2 tab. Select the Contracted payer check box. Note: If you do not select the Contract payer check box, then the payer is considered as a Non-contracted payer for charge discounts. Select OK. Parent topic: Setting Up Charge Discounts

Help Guide for NextGen® Enterprise PM 8

Setting Up Charge Discounts

The Charge Discounts functionality in NextGen® Enterprise PM involves the following setup: Enable discounts for a practice in the Practice Preferences window. flag payers as either contracted or non-contracted for discounts in the Payers window. Create adjustment transaction codes for discounts in the Transaction Codes window. Enable tracking of discounts within a practice in the Significant Events window. Set up user security access rights for discounts in System Administration. Enable Charge Discounts in Practice Preferences You can enable charge discounts on the Charges tab in the Practice Preferences window. Set up Payers for Charge Discounts You can set up payers for charge discounts on the Modify Payer Information window. Set up Transaction Codes for Charge Discounts You can set up transaction codes on the Transaction Code List window for charge discounts. Significant Events for Charge Discounts You can enable significant events to track user activity related to charge discounts

Help Guide for NextGen® Enterprise PM 8

Setting Up Charge Discounts

The Charge Discounts functionality in NextGen® Enterprise PM involves the following setup: Enable discounts for a practice in the Practice Preferences window. flag payers as either contracted or non-contracted for discounts in the Payers window. Create adjustment transaction codes for discounts in the Transaction Codes window. Enable tracking of discounts within a practice in the Significant Events window. Set up user security access rights for discounts in System Administration. Enable Charge Discounts in Practice Preferences You can enable charge discounts on the Charges tab in the Practice Preferences window. Set up Payers for Charge Discounts You can set up payers for charge discounts on the Modify Payer Information window. Set up Transaction Codes for Charge Discounts You can set up transaction codes on the Transaction Code List window for charge discounts. Significant Events for Charge Discounts You can enable significant events to track user activity related to charge discounts

Help Guide for NextGen® Enterprise PM 8

Apply Line Item Level Discounts

To apply charge discounts at the line-item level ensure the Discounts icon is available on the Charge Posting window by selecting Enable discounts in charge entry on the Charge Entry tab in the Practice Preferences window. Open NextGen® Enterprise PM. Select Charges. The Charge Posting window opens. Select the desired patient and encounter, and then enter and save charges. Select Discounts on the charge posting toolbar to apply charge discount. The Discounts window opens. Select the adjustment transaction code in the Discount Adjustment Code field. The transaction codes available for selection are determined by the following: If the primary payer on the encounter is flagged as a Contracted Payer, the transaction codes are selected as Contracted Payers or <None> for Discount Application, when Discount is enabled in the Discount Criteria section. If the primary payer on the encounter is flagged as a Non-Contracted Payer, then the transaction codes selected as Discount with a Discount App

Set up Payers for Charge Discounts

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