Billing in a Behavioral Health Encounter

NextGen® Adaptive Content Engine Help Enterprise 8

Behavioral Health Configuration Options

Several configuration steps must be reviewed and possibly implemented to complete the Behavioral Health workflows as outlined in this user guide: On the Practice Configuration system template: Assessment/Diagnosis panel configuration enables seamless billing between the NextGen® Enterprise and NextGen® Enterprise PM applications Learn how to use the DSM IV and Behavioral Health-based Add or Update Assessment templates as part of your practice's workflow DSM IV or DSM-5 configuration for which code set standards appear on the documents A Signature panel option ensures that the configured procedures for billing a Behavioral Health encounter are enforced, including an alert option In File Maintenance, add Severity descriptions to meet DSM-5 documentation standards Billing configurations: Service Code Mapping system template File Maintenance provider level configuration The Home Page - Behavioral Health template: Some practices may find setting this home page as the default template for ev

NextGen Behavioral Health Suite Help 5.5

Billing in a Behavioral Health Encounter

The NextGen® Behavioral Health Suite template set includes two areas that enable a provider to submit services codes to the Superbill. Which area you bill from is determined by the template used in your workflow. The two areas for NextGen® Behavioral Health Suite billing are: The Charges panel, available 3.5 (or later) version templates The Finalize template Once the charges are calculated and submitted to the Superbill, the NextGen® Enterprise PM receives the charges for the services with a Start and End Time, a CPT® or HCPCS service code, a diagnosis code, as well as the date of service and the name of the provider of service. NextGen® Enterprise PM requires this data to be able to evaluate whether the total of the duration times may be "rolled up." Users can view the submitted items and make any necessary updates. Charges The Charges panel enables you to bill for services rendered during the encounter. Behavioral Health E&M Coding Guidelines E&M Coding guidelines and the impact to c

NextGen® Adaptive Content Engine Help Enterprise 8

Behavioral Health Billing Section

The Behavioral health billing section enables a provider to document time-based charges in the NextGen® Enterprise application. Once configured, when the user selects the Service performed by check box in the Behavioral health billing section, a stored procedure fills the mapped Behavioral Health service in the Service code and Service description fields. Service codes are configured on the Service Code Mapping system template. Practices can review and copy the code mappings packaged in this release. The system template looks at elements such as payer, visit type, licensure of the provider and others to generate a short list of billing codes or a single code to be used. The advantage of having the billing section work in conjunction with the Service Code Mapping system template is that it negates the clinical user from having to go to the Finalize template to manually enter the service code. Refer to the Billing Configuration Options section of this guide for more information. Template

NextGen® Adaptive Content Engine Help Enterprise 8

Behavioral Health Billing on the Finalize Template

The Finalize template calculates the Evaluation and Management (E&M) code and submits the code to the NextGen® Enterprise PM application. The Evaluation and Management Coding panel on the Finalize template calculates the E&M code based on the elements documented or the amount of time documented when more than 50% of the visit is spent counseling and/or coordinating care. The system fills the Visit Code field with the suggested Current Procedural Terminology (CPT) codes. You should review the suggested CPT code prior to submitting the code for billing. When the practice selects the 97 Coding Guidelines option on the Practice Configuration practice template and the specialty is set to Behavioral Health, the system defaults to the '97 Single System Psychiatric exam guidelines for the following visit types: Family Consultation General Medical Exam Hospital Consult Medication Management without Psychotherapy Onsite Consult Psychotherapy - Individual with E&M Medication Management with Psych

NextGen® Adaptive Content Engine Help Enterprise 8

Finalize Behavioral Health Billing

To finalize billing, navigate to the Behavioral health billing section. For the End time field, do one of the following: Click the clock button to enter the current time. Click the field to type the time that marked the end of the exam. Note: The read-only Duration field fills after the entry of the End time. If appropriate, select the option for Service performed by. Note: A stored procedure that works with the Service Code Mapping system template calculates a service code based on selected practice, payer, visit type, licensure, and the time-based calculation. The stored procedure launches an alert if E&M coding or other additional coding is required. The system fills the fields with the name of the current user and fills the Service Description and Service Code fields if a mapped service code is found. To select a different service description/code or if no matching service code is found click the Service description field to select a code in the Service Item Mstr picklist. To addre

NextGen® Adaptive Content Engine Help Enterprise 8

Finalize Behavioral Health Billing

The Start time and End time fields are available in the Behavioral health billing section and in the Program Name panel. The values documented in either place are immediately reflected in the same fields in the other section. To finalize billing, navigate to the Behavioral health billing section. For the End time field, do one of the following: Click the clock clock icon for start and end button to enter the current time. Click the field to type the time that marked the end of the exam. Note: The read-only Duration field fills after the entry of the End time. If appropriate, select the option for Service performed by. Note: A stored procedure that works with the Service Code Mapping system template calculates a service code based on selected practice, payer, visit type, licensure, and the time-based calculation. The stored procedure launches an alert if E&M coding or other additional coding is required. The system fills the fields with the name of the current user and fills the Service

Billing in a Behavioral Health Encounter

Recommendations

Behavioral Health Configuration Options

Billing in a Behavioral Health Encounter

Behavioral Health Billing Section

Behavioral Health Billing on the Finalize Template

Finalize Behavioral Health Billing

Finalize Behavioral Health Billing

Behavioral Health Configuration Options

Billing in a Behavioral Health Encounter

Behavioral Health Billing Section

Behavioral Health Billing on the Finalize Template

Finalize Behavioral Health Billing

Finalize Behavioral Health Billing