Set Up the Process Date for Encounter Rate SIM and Adjustments

Help Guide for NextGen® Enterprise PM 8

Process Date for Encounter Rate SIM and Adjustments

Some payers, such as Medicare for a Federally Qualified Health Center (FQHC), require that an encounter rate SIM code, or payment code, be included on claims to describe the type of visit. For example, code G0466 on a Medicare claim indicates a new patient visit, and code G0467 indicates an established patient visit. The Encounter Rate Billing library in File Maintenance can be setup for a payer to automatically insert the ER SIM code, or payment code as an additional charge line on encounters during the billing process in NextGen® Enterprise PM. With this setup, there is the potential for an ER SIM charge inserted by the system to have a process date that is different from the process dates on the original charge lines. For example, the original charges on an encounter may have been entered and processed on 2/28/17, but the encounter was not billed until 3/2/17. In this scenario, the original charges have a process date in the February accounting period, and the ER SIM charge on the s

Help Guide for NextGen® Enterprise PM 8

Set Up the Process Date for Encounter Rate SIM and Adjustments

To define how the process dates are assigned to Encounter Rate SIM charges and auto-adjustments, do the following: Access NextGen® Enterprise PM. From the Admin menu, select Preferences, and then Practice. The Practice Preferences window opens. From the Preference List, select General. In the Set Process Date for Encounter Rate SIM and Encounter Rate Adjustments as field, select one of the following: Current Process Date (default): Select this option to use the current system date as the process date. This is legacy functionality in versions prior to version 5.9. First charge line Process Date or Minimum Process Date, whichever is later: Select this option to use the process date from the first charge on the encounter, or use the Minimum Override Process Date defined from the File > Processes > Override Process Date. Practice Preferences To save changes and close the window, select OK. Parent topic: Process Date for Encounter Rate SIM and Adjustments

Help Guide for NextGen® Enterprise PM 8

Process Date for Encounter Rate SIM and Adjustments

Some payers, such as Medicare for a Federally Qualified Health Center (FQHC), require that an encounter rate SIM code, or payment code, be included on claims to describe the type of visit. For example, code G0466 on a Medicare claim indicates a new patient visit, and code G0467 indicates an established patient visit. The Encounter Rate Billing library in File Maintenance can be setup for a payer to automatically insert the ER SIM code, or payment code as an additional charge line on encounters during the billing process in NextGen® Enterprise PM. With this setup, there is the potential for an ER SIM charge inserted by the system to have a process date that is different from the process dates on the original charge lines. For example, the original charges on an encounter may have been entered and processed on 2/28/17, but the encounter was not billed until 3/2/17. In this scenario, the original charges have a process date in the February accounting period, and the ER SIM charge on the s

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

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

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

Set Up the Process Date for Encounter Rate SIM and Adjustments

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Process Date for Encounter Rate SIM and Adjustments

Set Up the Process Date for Encounter Rate SIM and Adjustments

Process Date for Encounter Rate SIM and Adjustments

Setting Up Encounter Rate Billing

Setting Up Encounter Rate Billing

Practice Preferences for Encounter Rate Billing

Set Up the Process Date for Encounter Rate SIM and Adjustments

Process Date for Encounter Rate SIM and Adjustments

Set Up the Process Date for Encounter Rate SIM and Adjustments

Process Date for Encounter Rate SIM and Adjustments

Setting Up Encounter Rate Billing

Setting Up Encounter Rate Billing

Practice Preferences for Encounter Rate Billing