Program Configuration for UB Billing

NextGen Behavioral Health Suite Help 5.5

Configure UB Billing Options at Program Selection

When you configure a program for UB billing, the following scenarios happen during program enrollment for a patient: The data entered in the Admit Date/Time and Discharge Date/Time are saved on the Encounter Maintenance window and appear on future claim forms. The data entered in the Admission Source and Admission Type fields appear on the Program Hx window. The captured data are saved on the Encounter Maintenance window on the UB tab and appear on future claim forms. Open the BH Foundation Configuration template, and expand the BH Content panel. In the DBPicklist Name grid, select Programs.The list of programs appears in the List Item grid. BH Content panel Select a program in the List Item grid.The program details appear in the respective fields. In Qualifier 1, enter UB. Qualifier 1 field Select Update. Expand the Miscellaneous Configuration panel. Select the Enable Encounter Admit/Discharge Date and Time Update on Program Selection checkbox. Enable Encounter Admit/Discharge Date an

NextGen Behavioral Health Suite Help 5.5

Miscellaneous Configurations for BH Encounters

Configuration Name Configuration Details Enable Payer Location Updates When selected, the Encounter Location and Encounter Payers are updated when you select a program from the Program picklist on a BH Suite template. The system updates the location and payers to match those setup in the patient's Program Enrollment section on the Demographic (BH) template. Enable Encounter Admit/Discharge Date and Time Update on Program Selection When selected, the Admit/Discharge Date and Time information appears on the tis_programs_hx window. Encounter Maintenance window When you enroll a client in a program configured for UB billing, the Open Date entered on the tis_programs_hx window appears in the Admit Date and Admit Time fields on the Encounter Maintenance window. When you close a program, the Discharge Date and Discharge Time fields automatically appear on the Encounter Maintenance window. Payer(s) required on chart Program creation (reorder program enc payer stack) When selected, the payer de

Help Guide for NextGen® Enterprise PM 8

Set Up an Encounter for Regular UB Users

Access the Encounter Maintenance window for the patient and encounter the UB claim is being created for if you want occurrence and value codes to display on the UB claim. In NextGen® Enterprise PM, select the Chart icon on the main toolbar. The Patient Lookup window appears. Enter the search criteria and then select Find. To open the chart, right-click the chart and then select Open. On the Encounters tab, right-click the encounter and then select open menu icon . The Encounter Maintenance window appears. Select the UB tab, then the Occurrence Codes sub-tab. Enter the occurrence codes and dates in the field locator fields, if applicable. To enter the value codes and associated dollar value or unit value, select the Value Codes tab and enter the data in the Field Locator fields. Select OK. To enter the charges for the patient and the encounter, open the Charge Posting window. Bill the encounter and create the UB claim. Parent topic: Set Up UB Claims for Regular UB Users

Help Guide for NextGen® Enterprise PM 8

Setting Up Encounters for UB Claims

The following list outlines the areas of the Encounter Maintenance window that are important to the setup of UB claims: On the General tab, complete the Service Location field. On the UB tab, access the following sub-tabs: Condition Codes, Occurrence Codes, and Value Codes. Encounter Maintenance Note: For Enhanced UB users, the automated UB claims process only applies to payers who are considered primary. The automating of the Type of Bill field, the Occurrence codes, and the Value codes, which are explained in the following sections, only occurs for primary payers who have the required criteria. UB/General Tab UB/Condition Codes Tab UB/Occurrence Codes Tab UB/Value Codes Tab Setting Up Practice Preferences for UB Claims Parent topic: UB Claims

Help Guide for NextGen® Enterprise PM 8

Set Up and Bill a Single Encounter

When creating an encounter for recurring billing, you must set up the encounter to activate the automated billing for the single encounter. Access the applicable encounter. The Encounter Maintenance window opens. Enter the date the illness/injury began in the Onset Date field. This is a required field for the initial encounter for recurring billing. Enter the date the patient is discharged from therapy in the Discharge Date field on the General tab. This field is required for a single encounter in a series. Enable the Initial Enc in Series check box. Note: This field displays only when the Type of Facility and Bill Classification fields are set up in Practice Preferences. Select OK. Add the appropriate charges. Note: The revenue codes, which are attached to service items, must be set up before posting charges on the Charge Posting window in order for recurring UB billing to be recognized. Bill the encounter. After the billing process is complete, a single claim in a series is generated

Help Guide for NextGen® Enterprise PM 8

Set Up Encounters for Enhanced UB Claims (Before Billing)

Access the Create Encounter or Encounter Maintenance window for the patient and encounter the UB claim is being created for. In NextGen® Enterprise PM, select the Chart button on the main toolbar. The Patient Lookup window opens. Enter Search Criteria to locate the desired patient and then select Find. From the Matching Records section, double-click to open the desired patient. The Patient Chart window opens. Select the Encounters tab. Right-click the encounter, and then select Open. The Encounter Maintenance window opens. Encounter Maintenance Enter the date the patient first began experiencing symptoms, in the Onset Date field. Select a service location in the Service Location field. The service location must be the same as the service location that was selected on the UB tab of the Modify Payer Information window. Select OK. Parent topic: Setting Up UB Claims for Enhanced UB Users

Program Configuration for UB Billing

Recommendations

Configure UB Billing Options at Program Selection

Miscellaneous Configurations for BH Encounters

Set Up an Encounter for Regular UB Users

Setting Up Encounters for UB Claims

Set Up and Bill a Single Encounter

Set Up Encounters for Enhanced UB Claims (Before Billing)

Configure UB Billing Options at Program Selection

Miscellaneous Configurations for BH Encounters

Set Up an Encounter for Regular UB Users

Setting Up Encounters for UB Claims

Set Up and Bill a Single Encounter

Set Up Encounters for Enhanced UB Claims (Before Billing)