Configure Financial Classes That Do Not Allow Combining Medications

NextGen® Medication Inventory Control Help 10.6.3.0

Configure Payers That Do Not Bill for Medication Marked Billable

For any billable medication selected in the Medication Information Configuration grid, you can set up financial class and payer exceptions who do not bill for that medication. In the Medication Information Configuration grid, select the billable medication for which you want to add the rule. The drug name, J-Code and NDC number for the selected medication are displayed in blue text on the Medication Billing Rules panel header. Select the field below the Financial Class column of the Payers that DO NOT bill for Medication marked Billable grid. The MLTS Medcfg Finclass Payer PL picklist window for financial classes opens. Select a financial class and select OK. The MLTS Medcfg Finclass Payer PL picklist window for payers opens. Select a payer and select OK. Note: For all payers, select the asterisk (*). Select Add. The Financial class/Payer entry is added to the grid. Parent topic: Medication Billing Rules Panel

NextGen® Medication Inventory Control Help 10.6.3.0

Payer Exceptions Configuration to Allow Combined Medications

All payers in a financial class which does not allow medications to be combined will be in one of the two grids below the Financial Classes that DO NOT Allow Combining Meds grid, depending on whether they follow the rule and do not allow combining (left-hand grid) or are an exception, and do allow medications to be combined (right-hand grid). Note: When you first add a financial class that does not allow combining medications, all payers are in the left-hand grid by default. You can move payers between the two grids at any time, using the arrows between the grids. Configure Payer Exceptions to Allow Combined Medications Parent topic: Configure Financial Classes That Do Not Allow Combining Medications

NextGen® Medication Inventory Control Help 10.6.3.0

Medication Billing Rules Panel

The Medication Billing Rules panel enables you to configure billing rules for medications. Use the Medication Billing Rules panel to set up: Standard or special billing rules, including financial class-specific or payer-specific billing rules Payers that do not bill for a medication Financial classes and/or specific payers that do not allow combining medications for billing purposes. For all of these actions, rules that have been set up for one medication, financial class, or payer can be copied to another, to save setup time. Note: The Billing Rules grid only applies to medication administered from the MICS Dispensing and MICS Injections/Aspirations templates. Information Link Configuring Billing Rules Configure Payers That Do Not Bill for Medication Marked Billable Configure Financial Classes That Do Not Allow Combining Medications Copying Billing Configurations Parent topic: Configuring Medication Information and Billing Rules

NextGen® Medication Inventory Control Help 10.6.3.0

Configure Payer Exceptions to Allow Combined Medications

Select the financial class in the Financial Classes that DO NOT Allow Combining Meds grid. Select any payer that is an exception to the rule of not allowing medications to be combined, from the left-hand grid. Select the right-pointing arrow between the grids to move that payer to the Payers in Financial Class that Allow Combining Meds grid. Parent topic: Payer Exceptions Configuration to Allow Combined Medications

NextGen® Medication Inventory Control Help 10.6.3.0

Add a Special Billing Rule

In the Medication Information Configuration grid, select the billable medication for which you want to add the rule. A check mark appears next to the selected medication in the grid, and the drug name, J-Code and NDC number are displayed in blue text on the Medication Billing Rules panel header. In the Medication Billing Rules panel, make sure that the option for Special Rules is selected. Select the field below the Financial Class column of the Billing Rules grid. A picklist of financial classes opens. Select the financial class for the rule, or select the asterisk to set the rule for all financial classes, and select OK. A picklist of payers for the selected financial class opens. Select a payer, if you are setting the billing rule for only certain payers, or select the asterisk (*) if you are setting the rule for all payers in the financial class, and select OK. Select the field below the Quantity column and enter a quantity. Select the field below the # of Billing Units column and

NextGen® Medication Inventory Control Help 10.6.3.0

Add a Standard Billing Rule

In the Medication Information Configuration grid, select the billable medication for which you want to add a rule. A check mark appears next to the selected medication in the grid, and the drug name, J-Code and NDC number are displayed in blue text on the Medication Billing Rules panel header. Make sure that the option for Standard Rules is selected above the Billing Rules grid. Select the field below the Financial Class column. A picklist of financial classes opens. Select the financial class for the rule, or select the asterisk to set the rule for all financial classes, and select OK. A picklist of payers for the selected financial class opens. Select a payer, if you are setting the billing rule for only a certain payer, or select the asterisk (*) if you are setting the rule for all payers in the financial class, and select OK. Select the field below the Quantity column and enter a quantity. Select the field below the # of Billing Units column and enter a quantity. Select Add to add

Configure Financial Classes That Do Not Allow Combining Medications

Recommendations

Configure Payers That Do Not Bill for Medication Marked Billable

Payer Exceptions Configuration to Allow Combined Medications

Medication Billing Rules Panel

Configure Payer Exceptions to Allow Combined Medications

Add a Special Billing Rule

Add a Standard Billing Rule

Configure Payers That Do Not Bill for Medication Marked Billable

Payer Exceptions Configuration to Allow Combined Medications

Medication Billing Rules Panel

Configure Payer Exceptions to Allow Combined Medications

Add a Special Billing Rule

Add a Standard Billing Rule