CPT Code/Payer-Specific Alerts

NextGen® Therapy Suite Help 30.3.13.0

Time and Done Alerts

If any exercise has been marked as D (done) but no time is entered for that code, an alert appears when you select Save & Close on the template or try to navigate to a different treatment template. The alert indicates which sections lack necessary data. Similar alert appears when you enter time for a given CPT code but do not mark any exercise within the associated grid as D. You can select Yes to navigate away from the template without time documented, but you will need to enter time associated with the exercise before you can submit charges. If any exercise was marked as Done by accident, go back to that exercise and clear the D checkbox. Parent topic: Treatment Section

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

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

Treatment Section

The treatment grid shows therapies and education that you have documented for the patient. You can document therapies completed with the patient using any of the treatment templates in the left-hand list. The therapies documented on the templates are billable, with the exception of the Education template, which always shows a billable Total Time entry of zero. Treatment grid Treatment Template Editing Modes Treatment Template Enter Treatments/Activities for a Body Area Apply Option Settings to Multiple Grid Entries Update a Single Grid Entry Sort Order for Patient's Exercises You can sort the order of a patient's exercises during documentation on the NTS Treatment template. Delete Individual Treatments or Activities Clear the Entire Grid Allow Body Area Override Skill and To Gain Entering Time for Treatments You can enter the time for treatments below the respective grids. The application calculates the total time from the time entered in each grid of the template. Time and Done Alerts

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 (*

Help Guide for NextGen® Enterprise PM 8

Set Up a Fee Schedule for Contract Payers

If the co-pay for a CPT4 code might be different from the default co-pay. The options in the Fee Schedule tab override the options in the General tab. The information entered applies when the payer attached to the contract is the primary payer for an encounter. Contractual requirements alerts can be set up to display during appointment scheduling, patient registration, and billing processes. Automatic contractual adjustments and the distribution of insurance reimbursement can be set up to be applied to patient balances. In File Maintenance, select Libraries, and then select Contract. The Contracts List window opens. Double-click the library, and then select Fee Schedule. Enter a CPT4 Code. The CPT4 codes and their descriptions that are specific to each contract display in the CPT4/Desc list box. To search for a specific code, enter the CPT4 code in the field above the CPT4/Desc column and the code is highlighted. Note: To clear the list to find another code, select the Reload CPT4s but

CPT Code/Payer-Specific Alerts

Recommendations

Time and Done Alerts

Prevent Billing Grid

Specify a Prevent Billing Event with Alert

Treatment Section

Add an Alert

Set Up a Fee Schedule for Contract Payers

CPT Code/Payer-Specific Alerts

Time and Done Alerts

Prevent Billing Grid

Specify a Prevent Billing Event with Alert

Treatment Section

Add an Alert

Set Up a Fee Schedule for Contract Payers