Request a Provider Referral Inquiry

NextGen® Enterprise EHR Help

Add a New Referral to a Person or Patient

This feature is only available for practices that use NextGen® Eligibility Verification license. After you add an insurer to a person/patient's profile, you can refer the person/patient to a different provider. In the Insurance Listing section of the Demographics tab, select the Open Menu , and then select New Referral. The New Referral Entry window appears. Complete the following required fields Requesting Physician Referred To Entity Type Place of Service Enter any additional information, and select OK. Parent topic: Managing Insurance Information for a Person or Patient Profile

NextGen® Enterprise EHR Help

Add an Eligibility Verification to a Person or Patient

This feature is only available for practices that has NextGen® Eligibility Verification license. After you add an insurer to a person or patient's profile, you can create and issue an Eligibility Inquiry. Some practices require a confirmation of eligibility from an insurer before performing a medical procedure. In the Insurance Listing section of the Demographics tab, select the Open Menu , and then select Eligibility Verification. The Eligibility Verification window appears. Select one or more entries in the following required fields. Requesting Physician Type of Service Enter any additional information. Select OK to save the changes. Parent topic: Managing Insurance Information for a Person or Patient Profile

Help Guide for NextGen® Enterprise PM 8

Request a Provider Referral Inquiry

After you add an insurer to a person/patient's profile, you can request a history file for all previous patient referrals from the insurer. In the Insurance Listing section of the Demographics tab, select the Open Menu , and then select Referral History. The Provider Referral Inquiry window appears. Enter the Requesting Physician. This field is required. Enter any additional information. Select OK to save the changes. Parent topic: Managing Insurance Information for a Person or Patient Profile

NextGen® Enterprise EHR Help

Managing Insurance Information for a Person or Patient Profile

You can associate insurance information on the following windows: Add Person Information and Modify Person Information windows for person records Add Patient Information and Modify Patient Information windows for patient records In the Available Insurance section of the Demographics tab, select the Open Menu to perform the following tasks: Add Insurance to a Person or Patient record Hidden Insurance Information Open Insurance Information for a Person or Patient record Hide Insurance Add an Authorization to a Person or Patient record Add an Eligibility Verification to a Person or Patient record Add a Referral to a Person or Patient record Request a Provider Referral Inquiry Promote or Demote Insurance For more information on adding or modifying insurance information, go to the NextGen Healthcare Success Community and download the latest Encounter Maintenance User Guide for NextGen® Enterprise PM. Add Insurance to a Person or Patient You can use the Insurance Maintenance window to add an

Help Guide for NextGen® Enterprise PM 8

Add a New Referral to a Person or Patient

This feature is only available for practices that use NextGen® Eligibility Verification license. After you add an insurer to a person/patient's profile, you can refer the person/patient to a different provider. In the Insurance Listing section of the Demographics tab, select the Open Menu , and then select New Referral. The New Referral Entry window appears. Complete the following required fields Requesting Physician Referred To Entity Type Place of Service Enter any additional information, and select OK. Parent topic: Managing Insurance Information for a Person or Patient Profile

Help Guide for NextGen® Enterprise PM 8

Referral History Inquiries

Do the following to submit a referral history inquiry: Right-click and select Referral History from one of the defined access paths. The Provider Referral Inquiry appears. Complete the following required fields: Patient Insurances Requesting Physician Complete the optional fields: Requesting Location (leave blank) Referred To Entity Type Code Qualifier (leave blank) ID Code (leave blank) Reference Code Qualifier (leave blank) Reference ID Code (leave blank) Notes (not sent to payer but displays on response - 255-character limit) Select OK. The inquiry is now being processed. The progress bar at the bottom of the dialog box displays under Ready to Submit. When the submission is complete, the system displays the response in the Referral Result window. View the Transaction Details, Service Provider Details, and Subscriber Details. Note: Scroll-down and view additional information; for example, Services Detail and procedure and diagnosis codes, and benefit dates. To print a copy of the eli

Request a Provider Referral Inquiry

Recommendations

Add a New Referral to a Person or Patient

Add an Eligibility Verification to a Person or Patient

Request a Provider Referral Inquiry

Managing Insurance Information for a Person or Patient Profile

Add a New Referral to a Person or Patient

Referral History Inquiries

Add a New Referral to a Person or Patient

Add an Eligibility Verification to a Person or Patient

Request a Provider Referral Inquiry

Managing Insurance Information for a Person or Patient Profile

Add a New Referral to a Person or Patient

Referral History Inquiries