Configure Payers That Do Not Bill for Medication Marked Billable

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

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

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® Orthopedic Suite Help 80.2.14.0

Manage Payers for Non-Billable Procedures

You can add or remove payers in the exclusion list for a financial class. For a financial class associated with a non-billable procedure, you can manage the exclusion list for payers that require specific International Classification of Diseases (ICD) codes to be sent for the procedure. On the Billing Configuration practice template, expand the Non-billable panel. Non-billable panel on the Billing Configuration template Select a procedure from the Procedures grid. The procedure description, Current Procedural Terminology (CPT) code, and ICD code are automatically filled in their corresponding fields, and the configured financial classes are displayed in the Financial Classes grid. Select a financial class from the Financial Classes grid. The payers associated with the financial class are displayed in their corresponding grids. To remove a payer from the exclusion list, do the following: Select a payer from the Payers in the exclusion list grid. Click the Right arrow icon icon. The sele

NextGen® Orthopedic Suite Help 80.2.14.0

Configuring Preferences for Non-Billable Procedures

You can update the procedure information and configure financial classes and payers for various non-billable procedures. You can use the Non-billable panel on the Billing Configuration practice template to do the following for a non-billable procedure. Select a Current Procedural Terminology (CPT) code Select an International Classification of Diseases (ICD) code Manage financial classes that require specific ICD codes Manage payers in the exclusion list for a financial class Non-billable panel on the Billing Configuration template Selecting a procedure from the Procedures grid displays the description, CPT code, and ICD code in their corresponding fields, and you can update them as needed. You can also add or remove financial classes in the Financial Classes grid for the selected procedure. If you select an existing financial class from the Financial Classes grid, the applicable payers are displayed in their corresponding grids that help you manage the payers in the exclusion list for

Configure Payers That Do Not Bill for Medication Marked Billable

Recommendations

Configure Financial Classes That Do Not Allow Combining Medications

Medication Billing Rules Panel

Add a Standard Billing Rule

Add a Special Billing Rule

Manage Payers for Non-Billable Procedures

Configuring Preferences for Non-Billable Procedures

Configure Payers That Do Not Bill for Medication Marked Billable

Configure Financial Classes That Do Not Allow Combining Medications

Medication Billing Rules Panel

Add a Standard Billing Rule

Add a Special Billing Rule

Manage Payers for Non-Billable Procedures

Configuring Preferences for Non-Billable Procedures