Medication Billing Rules Panel

NextGen® Medication Inventory Control Help 10.6.3.0

Manage Billing for Specialties

You can add, update, and delete billing configurations for various specialties. Open the MICS Medication & Billing system template. To add a billing configuration for a specialty, do the following in the section above the Medication Information Configuration panel. Select the field appearing below the Specialty column, select the specialty to be configured, and then select OK. Select the location where the submitted charges need to be sent. Select Add. The billing configuration is added to the specialty grid. To update a billing configuration for a specialty, do the following in the section above the Medication Information Configuration panel. Select the specialty that needs to be edited from the grid. Make the desired changes. Select Update. The changes are updated to the specialty grid. To delete a billing configuration for a specialty, do the following in the section above the Medication Information Configuration panel. Select the specialty that needs to be deleted from the grid. Se

NextGen® Medication Inventory Control Help 10.6.3.0

Configuring Radiology Billing Rules

You can add, update, and deactivate billing rules for radiology tests. On the MICS Medication & Billing template, in the Radiology Billing Rules panel, you can configure billing rules for radiology tests. The following table describes the sections in the Radiology Billing Rules panel. You can add, update, and deactivate billing rules in the sections. Section Description Excluded from Billing To configure Current Procedural Terminology (CPT) codes that are excluded from billing. Placement Confirmation Code Conversions To configure billing conversions for placement confirmation codes. Manage Placement Confirmation Codes for Billing You can add, update, and deactivate Current Procedural Terminology (CPT) codes that are excluded from billing. Manage Placement Confirmation Code Conversions You can add, update, and deactivate placement confirmation codes that needs to be converted for billing. Parent topic: Configuring Medication Information and Billing Rules

NextGen® Medication Inventory Control Help 10.6.3.0

Medication Information Configuration

Use the Medication Information Configuration panel to view and add all billable and non-billable medications that are used throughout the NextGen® Medication Inventory Control. Medications added here are the only ones you can add to inventory or configure settings for. Note: The grid in the Medication Information Configuration panel is for non-immunization medications. Use the Immunization Configuration template for vaccines/immunizations. Filter Medication Information Add a Billable Medication You can add billable medications to the inventory. Add a Non-Billable Medication You can add non-billable medications to the inventory. Updating Medication Information Inactivate a Medication Add SIM Codes to the SIM Library You can add Service Item Master (SIM) codes to the SIM library in File Maintenance from NextGen® Medication Inventory Control. Associate a National Drug Code (NDC) with a SIM Code You can associate a National Drug Code (NDC) to a Service Item Master (SIM) code from NextGen®

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

Configuring Billing Rules

When a medication is added to the Medication Information Configuration grid, the Billing Rules grid displays a default standard rule and a default special rule that apply to all financial classes (as designated by an asterisk) and all payers,of 1:1 Quantity-to-Billing Unit. Standard Rules are ratios of billing units per quantity of medication given. There may be a single standard rule, or different rules defined for different financial classes or payers. Special Rules are ratios used for billing when the J-Code changes depending on the medication quantity given (For example, as for Depo-Medrol). You cannot remove either default all-payer rule, but you can: Edit the Quantity-to-Billing Unit ratio for a default all-payer rule Add either standard or special rules for individual financial classes and payers Update added rules Delete added rules Note: You cannot set up special rules for a medication for which you have already set up a standard rule, nor set up standard rules for a medicatio

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

Medication Billing Rules Panel

Recommendations

Manage Billing for Specialties

Configuring Radiology Billing Rules

Medication Information Configuration

Configure Financial Classes That Do Not Allow Combining Medications

Configuring Billing Rules

Configure Payers That Do Not Bill for Medication Marked Billable

Medication Billing Rules Panel

Manage Billing for Specialties

Configuring Radiology Billing Rules

Medication Information Configuration

Configure Financial Classes That Do Not Allow Combining Medications

Configuring Billing Rules

Configure Payers That Do Not Bill for Medication Marked Billable