Configure Payer Exceptions to Allow Combined Medications

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

Configure Financial Classes That Do Not Allow Combining Medications

By default, the NextGen® Medication Inventory Control application combines quantities to calculate and send billing units for all medications that have the same NDC. You can configure financial classes and payers who do not allow combining medications, using the Financial Classes that DO NOT Allow Combining Meds grid and the two payers grids below it. 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 Classes that DO NOT Allow Combining Meds grid. The MLTS Medcfg Finclass Payer PL picklist window for financial classes opens. Select a financial class and select OK. Select Add. The financial class is added to the grid. Payer Exceptions Configuration to Allow Combined Medications Parent topic: Medication Billing Rules Panel

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 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® Therapy Suite Help 30.3.13.0

Add a Billing Limitation

Select the field below the grid Financial Category column. A picklist opens. Select one of the Financial Categories you created in the Financial Class Setup grid, and then select OK. Select the Payer Name field. A list of payers for the selected Financial Category opens. Select a payer, and then select OK. Select the State field and select the appropriate state or select the asterisk, for all states. If the payer follows the Medicare Combine (MC) rule, select the MC Rule checkbox and then choose an option for whether the rule is applied by Time or Rate. If there is a billing unit cap for the financial class or payer, enter it in the Billing Cap field. Select Add/Update to add the billing limitation to the grid. Parent topic: Billing Limitations Grid

NextGen® Medication Inventory Control Help 10.6.3.0

Copy Multiple Billing Rules and/or Billing Configurations

To copy more than one billing rule at a time, and/or copy other billing configurations that you have set up for a medication, to another medication, use the Copy Rules section in the Medication Billing Rules panel. In the Medication Information Configuration panel grid, select the billable medication that has the rules you want to copy. The billing rules for the medication are displayed in the Billing Rules grid. In the Copy Rules section of the Medication Billing Rules panel, mark the checkbox(es)as appropriate for the configurations you want to copy: Billing Rules (all billing rules) Payers that DO NOT Bill for Medication Marked Billable Financial Classes/Payers that Allow/Do Not Allow Combining Meds (includes all payer exceptions) Select the Copy all Rules to field. A picklist of all medications in your inventory opens. In the picklist, find and select the medication to which you want to copy the selected configurations, and select OK. Select Copy. All selected configurations are co

Configure Payer Exceptions to Allow Combined Medications

Recommendations

Payer Exceptions Configuration to Allow Combined Medications

Configure Financial Classes That Do Not Allow Combining Medications

Medication Billing Rules Panel

Configure Payers That Do Not Bill for Medication Marked Billable

Add a Billing Limitation

Copy Multiple Billing Rules and/or Billing Configurations

Payer Exceptions Configuration to Allow Combined Medications

Configure Financial Classes That Do Not Allow Combining Medications

Medication Billing Rules Panel

Configure Payers That Do Not Bill for Medication Marked Billable

Add a Billing Limitation

Copy Multiple Billing Rules and/or Billing Configurations