Set Up Practice Preferences for Dental Billing

Help Guide for NextGen® Enterprise PM 8

View Code Tables for Dental Billing

The Tooth, Surface, and Quadrant code tables in File Maintenance are preloaded with standardized codes and descriptions that are used to identify teeth, surfaces, and quadrants for dental services entered on the Charge Posting window in NextGen® Enterprise PM. Access File Maintenance. Select Code Tables. The Code Tables List window opens. In the Code Table field, select a code table. Items within the selected code table are displayed. The following list describes the code tables used for dental billing. Quadrants: Corresponds to the quadrant or area of the mouth for specific dental procedures on the Charge Posting window. The quadrant prints in box 25 on both the ADA 2019 form and the ADA 2024 form. Surface: Corresponds to the surface on the tooth for specific dental procedures on the Charge Posting window. You can select one or more codes if the Allow multiple tooth surfaces check box is selected in Practice Preferences > Charge Entry. The surface prints in box 28 on both the ADA 2019

Help Guide for NextGen® Enterprise PM 8

Enter Dental Charges

Open NextGen® Enterprise PM, and then select Charges. The Charge Posting window opens. Select the desired patient and encounter. Do one of the following: To add a charge, select New. To modify a charge, select the charge and then select Open. In the Svc Dates fields, enter the service date range for the charge. These fields default to the Billable Date, when you select it on the Encounter Maintenance window. Select Svc Item, and then enter the applicable dental service item. The Unit and Override fields default to the price from the SIM Library. The Extended field is calculated as (Quantity x Override = Extended) and displays the total price for the charge. Select Modifier, and then enter up to four modifiers for the charge. Select Quantity, and then enter the desired quantity. The Quantity field defaults to 1. The Unit and Override fields default to the price from the SIM Library. The Extended field displays the total price for the charge. (Quantity x Override = Extended) Select Tooth

Help Guide for NextGen® Enterprise PM 8

Set Up Practice Preferences for Dental Billing

Dental billing in NextGen® Enterprise PM requires specific settings in Practice Preferences. Two Charge Entry options must be enabled to display dental fields on the Charge Posting window, and one Claims option must be enabled to enable the three Qualifying Encounter check boxes on the General tab of the Service Items library. Access Practice Preferences. From the Preferences List, select Charge Entry. To display Tooth, Surface and Quadrant fields on the Charge Posting window, select the Display tooth, surface, quadrant check box. To allow multiple selections in the Surface field on the Charge Posting window, select the Allow multiple tooth surfaces check box. Practice Preferences From the Preferences List on the left, select Claims. To enable the three Qualifying Encounter check boxes on the General tab of the Service Items library, select the Enable Qualifying Encounter Billing check box. Practice Preferences To save changes and close the window, select OK. The dental fields display

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. To save changes and close the window, select OK. Parent topic: Practice Preferences for 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

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

Set Up Practice Preferences for Dental Billing

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View Code Tables for Dental Billing

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Set Up Practice Preferences for Dental Billing

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Enable Charge Discounts in Practice Preferences