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NextGen® Therapy Suite Help 30.3.13.0
Security Group Category/Payer Overrides
Use Security Group Category/Payer Overrides grid to create alerts that users, based on their security group and the patient’s payer on the case, will see on the NTS Homepage template. The Allow and Prevent options work in conjunction with the Action column to override the setting of Bill & Sign permissions (see Security Group Category Bill & Sign Visit Type Permissions) when a payer is an exception to the general setting. Category/Payer Overrides grid in the Security Groups and Sign Off section of the System Config template Add a Security Group Category Payer Alert Parent topic: Security Groups and Sign Off Panel
NextGen® Therapy Suite Help 30.3.13.0
Set an Alert Override
Select the alert in the Alerts panel grid. Select the Create Override button. Alert Overrides panel with alert information The alert appears the Alert Overrides panel grid. As desired or necessary, do any of the following: If the field under the Message column is not gray, change the text of the message, and then select Update Message. Select a financial class from the list under the Financial Class column. Select a payer from the list under the Payer column. Change or add additional selections for 'When' –templates on which the alert will appear. Select another Visit Set. Select Days or Visits for a frequency. Parent topic: Alert Overrides Panel
NextGen® Therapy Suite Help 30.3.13.0
Specify a Prevent Billing Event with Alert
Select the code that has a prevent billing scenario, from the CPT Codes grid in the CPT Codes panel. Select the Prevent option. Select the Cpt Code Ind, Financial Category and Payer Name fields under the grid, and then select entries from the picklists that open. Select the field under the Alert column and type in the text for the alert. Select the field under the Description column and type in a description. Select Add/Update. Parent topic: Prevent Billing Grid
NextGen® Therapy Suite Help 30.3.13.0
Prevent Billing Grid
Use this grid to: Specify any payers, financial categories, or other codes that would make the selected code unbillable. Set alerts that warn users of payer-specific coding restrictions. These alerts appear on treatment or modalities templates when the 'prevent conditions' are met. Prevent Billing grid highlighted on the Codes panel Alert warning of payer-specific coding restrictions Prevent – This selection prevents billing of a code that is not reimbursed by a payer or financial category, or it can be used for when a payer does not allow the specified code to be billed in conjunction with another code on the same encounter. Allow – This selection indicates an exception for a payer that allows billing on a code for which other payers in that financial category do not. Use it only if there is a Prevent selection for the financial category to that this payer belongs to. Alert Only – Select this option to set an alert for a designated code that a user sees when documenting on the treatme
NextGen® Therapy Suite Help 30.3.13.0
Alert Overrides Panel
You can override certain alerts. Keep in mind that an override does not disable the alert in the top grid. Regardless of what you change in the override, the application will still run the alert. Alert Overrides panel An Alert Override offers the ability to tailor the alert for your organization/state/payers. You can: Set different rules for any payers that may need the alert to fire at different intervals (number of days or number of visits). Send different alert messages for different payers. Add additional workflow templates that the alert will fire on. Change the users that will see the alert (based on visit set). Set an Alert Override Parent topic: Alert Configuration
NextGen® Therapy Suite Help 30.3.13.0
Add a Message for a Payer
Select the Payer from the Insurance Information grid. Select the text field below the messages grid to enter the payer message. Note: If no payer is selected first, the text field will not be editable. Add button on the Messages panel Select Add to save the message. Parent topic: Messages
Add a Security Group Category Payer Alert
Below the
Category/Payer Overrides
grid, select the fields to select the
Category
and
Payer Name
.
Under the
Rule
column, select either
Allow
or
Prevent
.
Select the action that is allowed or prevented, and then enter the text that you want to appear in the alert.
Select
Add
to add the alert to the grid.
