Add a Billing Limitation

NextGen® Therapy Suite Help 30.3.13.0

Billing Limitations Grid

Use the Billing Limitations grid if you need to set up a Financial Category to handle different rules by State and to set billing caps for them. Billing Limitations grid Add a Billing Limitation Parent topic: Financial Class Setup

NextGen® Therapy Suite Help 30.3.13.0

Configure Payer-Specific Adjustments

Set up a payer that allows less than 8 minutes in order to bill a unit. Note: You must apply adjustments to each code for which they apply. Select a code in the CPT Codes grid (in the CPT Codes panel), that you want to apply the override to. This pulls that code into the fields above the grids in the Payer Specific Billing panel. Select the Finclass Name field under the Payer Specific Adjustments grid. This opens a picklist of all financial classes that have been configured for your organization. Select the financial class, and then select OK. Select the Payer Name field and select a payer name from the list. Enter in the Time Rule amount. Enter the new minimum time that the payer allows. If the payer has a maximum number of allowable units that differs from the standard, enter that in the Max Units field. Payer Specific Adjustments grid If Medicare is the secondary insurance, select the MC Rule checkbox. The system uses the payer-specific adjustments (minimum minutes) and then applies

NextGen® Therapy Suite Help 30.3.13.0

Configure a Financial Category Replacement Code

Select the code in the CPT Codes grid (in the CPT Codes panel) that you want to apply a replacement code for. Select the Financial Category field under the Financial Category Replacement Code grid. CPT Codes panel and Payer Specific Billing panel A picklist opens, of all financial categories that have been configured for your organization. Select the financial category, and then select OK. If this replacement only applies to a specific payer within a financial category, select the Payer Name field and select a payer from the list. Otherwise leave this field blank, and the replacement code will apply to all payers within that financial class. If this replacement applies only to a specific visit set, select the Visit Set field, and then select the visit set. Otherwise leave this field blank. Enter the replacement code into the Replacement Cpt Code field. Select Add/Update. The new entry appears in the grid. Parent topic: The Financial Category Replacement Code

NextGen® Therapy Suite Help 30.3.13.0

Add a Modifier

You can add a modifier to any code in the Codes grid. Select the code that you want to add a modifier to. Select the field below the Mod column of the Modifiers grid, and then enter the modifier to be applied. Select the option for Cpt Code. Select the field below the Cpt Code Ind column. A picklist of codes opens. If a modifier is needed, do the following: Due to billing two therapies together, choose the code for the additional therapy – the one NOT selected from the CPT Code grid, and then select OK. On the code you selected from the CPT Code grid (for example, for a chiropractor who needs to apply an AT modifier to CMT codes and the payer is Medicare), select that same code from the list, and then select OK. Select the field below Financial Category column. A picklist of financial categories opens. Select a financial category from the picklist, and then select OK. Select the field below the Payer Name column and select a financial category from the picklist. Select Add to add the m

NextGen® Therapy Suite Help 30.3.13.0

Assign Reimbursement Rates

In the NTS Billing Config system template, expand the Payer Reimbursement & Medicare Therapy Cap panel. Payer Reimbursement & Medicare Therapy Cap panel Select the field above the Payer Reimbursement grid. A picklist of payers opens. Note: To see a list of Financial Classes in the Payer Reimbursement grid, you must clear the Use Contract Rates checkbox on the NTS Practice Config template in the Fee Sheet section. Select the payer from the list, and then select OK. Codes for the selected payer fill the Payer Reimbursement grid. Select a code in the grid. The code for that service enters the field above the center grid. In the boxes below the center grid, add the Rate, the Effective date (MM/DD/YYYY) and the Expiration date (MM/DD/YYYY). Select the Add button. The rate is added to the Payer Reimbursement grid. If the effective date is a date in the future and there is no current rate exists, the Rate column will show an asterisk for the code. If a rate already exists, your new rate will

NextGen® Orthopedic Suite Help 80.2.14.0

Add an Alert

You can add alerts for preregistration templates based on the chief complaints and financial class of the encounter-level insurance. The alerts added on the Billing Configuration practice template appear on the following preregistration templates, based on the configuration. Pre Reg Clinical Approval Billing Approval Clinical 1 Clinical 2 On the Billing Configuration practice template, expand the Alerts panel. Alerts panel on the Billing Configuration template Note: The Workflow/Template field displays Pre-Reg, by default. Click the blank field below the Complaint column, and select a complaint from the list. Note: If an alert is applicable for all payers in the financial class and all complaints, select the asterisk (*) from the list. After you select the complaint, the windows for selecting the financial class name and payer open. Select the financial class name and payer. Note: If an alert is applicable for all payers in the financial class and all complaints, select the asterisk (*

Add a Billing Limitation

Recommendations

Billing Limitations Grid

Configure Payer-Specific Adjustments

Configure a Financial Category Replacement Code

Add a Modifier

Assign Reimbursement Rates

Add an Alert

Billing Limitations Grid

Configure Payer-Specific Adjustments

Configure a Financial Category Replacement Code

Add a Modifier

Assign Reimbursement Rates

Add an Alert