Configuring Virtual Visit Billing Rules

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Medical Necessity Verification for Orders

You can enable an automated process for verifying medical necessity for a practice. To use the system Medical Necessity verification function, you must select Enable Medical Necessity in the Orders/Plans section of the Practice Configuration practice template, and then enter a state or region from the State/Region field. To run the Medical Necessity check for a patient, you must document the insurance details and region in the patient’s demographics information. For more information about the Medical Necessity practice configuration, go to NextGen Healthcare Success Community, and download the Practice Configuration Template User Guide for NextGen® Adaptive Content Engine. orders plans If you select Enable Medical Necessity on the Practice Configuration practice template, the Medical Necessity text field and ABN button appear on the My Plan, My Custom Plan, Labs, Diagnostic Studies, Office Procedures, and Associate Multiple Diagnoses to Orders templates. Based on this medical necessity

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Add Virtual Visit Billing Rules

You can add a billing rule for virtual visits. Open NextGen® Enterprise EHR. Open the Virtual Visit Payer Configuration template. In Visit type category, select the visit type category, and select OK. Note: You can configure the list of available visit type categories. In Payer name, select and select the payer name from the list, and select OK. Note: If you do not configure a payer name, the billing rule is applied to all payers for the selected visit type. In Place of service,select the place of service from the list, and select OK. Note: If you do not configure a place of service, the billing rule is applied to Office for the selected visit type. If you set up the SIM codes for places of service in File Maintenance and you want to use the codes for virtual visit billing, you must add them to the relevant Service Categories list. In Modifier, select the modifier from the list, and select OK. Note: If you set up the SIM codes for modifiers in File Maintenance and you want to use the c

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Update Virtual Visit Billing Rules

You can update a billing rule for virtual visits. Open NextGen® Enterprise EHR. Open the Virtual Visit Payer Configuration template. Select the billing rule from the grid. To update the visit type, select the visit type category, and select OK. To update the payer name, select the payer name, and select OK. To clear the payer name, select . Note: If you do not configure a payer name, the billing rule is applied to all payers for the selected visit type. To update the place of service, select a place of service, and select OK. To update the modifier, select a modifier, and select OK. Note: If you set up the SIM codes for modifiers in File Maintenance and want to use the codes for virtual visit billing, you must add them in the relevant Service Categories in File Maintenance. Select Update. The billing rule is updated in the grid. Parent topic: Configuring Virtual Visit Billing Rules See also Open the Virtual Visit Payer Configuration Template

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Open the Virtual Visit Payer Configuration Template

You can configure the billing rules for virtual visits using the Virtual Visit Payer Configuration template. Open NextGen® Enterprise EHR. Select File > System \ Practice Template.The Select Template window opens. Select the Practice tab. Under Show, select All.A list of practice templates appears. Select Virtual Visit Payer Configuration and select OK. The Virtual Visit Payer Configuration template opens. Virtual Visit Payer Configuration Template Parent topic: Configuring Virtual Visit Billing Rules

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Delete Virtual Visit Billing Rules

You can delete a billing rule for virtual visit. Open NextGen® Enterprise EHR. Open the Virtual Visit Payer Configuration template. Select the billing rule from the grid, and select Remove. The selected billing rule is removed from the grid. Parent topic: Configuring Virtual Visit Billing Rules See also Open the Virtual Visit Payer Configuration Template

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Configure Categories for Virtual Visit Types

You can configure category lists for virtual visit billing. You can add service categories and codes to this category list. Before you begin In Service Categories in File Maintenance, you must add the necessary service category. Service Categories List Note: For more information on how to add or modify the service categories, go to NextGen Healthcare Success Community, and download the File Maintenance Master Files Guide for NextGen® Enterprise. Open NextGen® Enterprise EHR. Select File > System \ Practice Template.The Select Template window opens. Under Show, select All. A list of system templates appears. To open the Custom DBPicklists system template, double-click Custom DB Picklists.The Custom DBPicklists system template opens. In Dbpicklist Name, select Virtual Visit categories. Custom DBpicklist From Step 2 Add/Edit List Items, select Configure.The Custom DBPicklist Setup template opens. Custom DBpicklist setup Select the service category as the Virtual Visit categories, and save

Configuring Virtual Visit Billing Rules

Recommendations

Medical Necessity Verification for Orders

Add Virtual Visit Billing Rules

Update Virtual Visit Billing Rules

Open the Virtual Visit Payer Configuration Template

Delete Virtual Visit Billing Rules

Configure Categories for Virtual Visit Types

Configuring Virtual Visit Billing Rules

Medical Necessity Verification for Orders

Add Virtual Visit Billing Rules

Update Virtual Visit Billing Rules

Open the Virtual Visit Payer Configuration Template

Delete Virtual Visit Billing Rules

Configure Categories for Virtual Visit Types