Enter Insurance Payer Information

NextGen® Enterprise EHR Help

General Tab

The General tab of the Create New Lab Order, Create New Radiology Order, Update Lab Order, or Update Radiology window displays default values for the ordering provider, location, billing type, order priority, order status, copy to physicians (primary care provider and referring provider from encounter). You can add other information, if it is available and required. Table 1. The following table describes the fields in the General tab Field Action/Description Ordering Provider Used to select the physician who is ordering the test(s). Select the down-arrow and select to select the provider if you need to update it. This default value for the encounter is the rendering provider. The Provider Search button brings up the Provider Search window and allows you to search physicians not in the list for the current practice and location. Location Used to select a location from which the order is originating. Select the down-arrow and select to select the location if it needs to be changed. This

Help Guide for NextGen® Enterprise PM 8

Add Payers and Guarantors to a Case on the Financial Tab

To set up payers and guarantors for a case, access the Financial tab. Access the desired case. Select the Financial tab. Select the patient's Employer. Select whether condition for this Case is related to the patient's employment. Enter any Employer Notes. Select the Guarantor for the Case. If needed, perform a search for a person or an employer. Select the Payers for this Case. Select the open menu icon. The Case Insurance Selection window opens. Select the pertinent Payers. Select OK. CAUTION: All of the Encounters attached to the Case must contain the same Payer as the selected Case. Once you have set up Case Payer, you are able to select Available Encounters and set up Synchronizing Encounters to a Case. If necessary, set up the payer authorization information. If necessary, set up the primary payer authorization number. If necessary, set up the primary payer reference number. If necessary, enter the Primary Payer Property/Casualty Number. If necessary, enter worker's compensation,

Help Guide for NextGen® Enterprise PM 8

Add Insurance to Encounters

You can use the Encounter Insurance Selection window to add one or more insurances to an encounter for billing or to access the Insurance Maintenance window for an insurance. A pushpin appears in columns when data exists for the category. To quickly view existing data for a category, you can hover over the pushpin icon, or select the pushpin icon to access the specific tab on the Insurance Maintenance window. For example, hover over the pushpin icon in the Card column to view the Last Card Attached Date or select the pushpin icon to access the Insurance Maintenance > Ins Cards tab. Open NextGen® Enterprise PM. On the main toolbar, select Chart or Chart Lookup.. The Patient Lookup window opens. In the Search Criteria section, enter the patient's information, and select Find. Patient records that match the search criteria, appear in the Matching Records section. Select the patient, and then select Open. The Patient Chart window opens. Select Encounters, and then select on the Insurance t

NextGen® Enterprise EHR Help

Assign Insurance to an Encounter

You can assign insurance to an unlocked encounter. Open NextGen® Enterprise EHR, and select a patient from Patient Lookup window. On the Encounter History tab, select an encounter, select Encounter Options, and then select Encounter Level Insurance.The Encounter Insurance Selection window opens. The top pane lists the patient available and selected insurance. The bottom pane lists significant events by date and time and creator. If there are multiple significant events, you can select the Date/Time arrow to sort the events in ascending or descending chronological order. To assign insurance to the encounter, do the following: In the Available Insurance section, select the insurance to attach to the encounter. Select the right-arrow button to move insurance to the Selected Insurance section. If there is more than one payer, attach each payer to the encounter in the following order for billing: Primary Secondary Tertiary Note: If an insurance has expired, a warning message appears when yo

Help Guide for NextGen® Enterprise PM 8

Components of the Patient Insurance - Encounter window

Field Description Assignment of Benefits Select one of the following options: No Patient Refuses to assign Yes Release of Information Select one of the following options to identify the release of information status: Approp Rel on File at Svc Prov Inf Consent to Rel Med Info Limited Ability to Rel Data No, Provider Not Allowed On File at Payer or Plan Sponsor Yes, Signed Stmt Perm Rel Notified by Enter the name of the person who sent the notification. Notification date Enter or select the date of notification. Verified by Enter the name of the person who verified the insurance. Verification date Enter or select the date the insurance was verified. Claim Level Authorizations Do one of the following: In the Claim Level Authorization list (displays only active authorizations): Select the applicable claim-level authorization to link to the encounter. Clear the applicable claim-level authorization to remove from the encounter. Select open menu and select one of the following options: Open t

Help Guide for NextGen® Enterprise PM 8

Add Insurance Verification Information to an Encounter

You can enter additional information for an insurance linked to an encounter in the Patient Insurance - Encounter window. This applies to primary, secondary, and tertiary payers. Open NextGen® Enterprise PM. On the main toolbar, select Chart or Chart Lookup.. The Patient Lookup window opens. In the Search Criteria section, enter the patient's information, and select Find. Patient records that match the search criteria, appear in the Matching Records section. Select the patient, and then select Open. The Patient Chart window opens. Select the Encounters tab. From the Encounters list, select an encounter with a payer attached. Select the Insurance tab. In the Encounter Insurance section, select the payer. In the Verification section, select open record . The Patient Insurance - Encounter window opens. Patient Insurance Encounter Window Make the desired changes, and select OK. Parent topic: Viewing Insurance Information in Encounters

Enter Insurance Payer Information

Recommendations

General Tab

Add Payers and Guarantors to a Case on the Financial Tab

Add Insurance to Encounters

Assign Insurance to an Encounter

Components of the Patient Insurance - Encounter window

Add Insurance Verification Information to an Encounter

General Tab

Add Payers and Guarantors to a Case on the Financial Tab

Add Insurance to Encounters

Assign Insurance to an Encounter

Components of the Patient Insurance - Encounter window

Add Insurance Verification Information to an Encounter