Display Medicare Rule

NextGen® Medication Inventory Control Help 10.6.3.0

Configure Payer Exceptions to Allow Combined Medications

Select the financial class in the Financial Classes that DO NOT Allow Combining Meds grid. Select any payer that is an exception to the rule of not allowing medications to be combined, from the left-hand grid. Select the right-pointing arrow between the grids to move that payer to the Payers in Financial Class that Allow Combining Meds grid. Parent topic: Payer Exceptions Configuration to Allow Combined Medications

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Payer Panel

The Payer panel on the PT Finalize template displays demographic payer information for the patient. If appropriate, select the Apply Medicare checkbox to apply Medicare rules for calculating billing units. Payer For more information about Medicare's use of the 8 Minute Rule, click the information icon . Parent topic: Finalize Template

NextGen® Medication Inventory Control Help 10.6.3.0

Information Link

Above the Billing Rules grid is a blue information button that opens a page with instructions for adding, updating, and deleting medication billing rules. Parent topic: Medication Billing Rules Panel

NextGen® Medication Inventory Control Help 10.6.3.0

Payer Exceptions Configuration to Allow Combined Medications

All payers in a financial class which does not allow medications to be combined will be in one of the two grids below the Financial Classes that DO NOT Allow Combining Meds grid, depending on whether they follow the rule and do not allow combining (left-hand grid) or are an exception, and do allow medications to be combined (right-hand grid). Note: When you first add a financial class that does not allow combining medications, all payers are in the left-hand grid by default. You can move payers between the two grids at any time, using the arrows between the grids. Configure Payer Exceptions to Allow Combined Medications Parent topic: Configure Financial Classes That Do Not Allow Combining Medications

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

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

Display Medicare Rule

Recommendations

Configure Payer Exceptions to Allow Combined Medications

Payer Panel

Information Link

Payer Exceptions Configuration to Allow Combined Medications

Configuring Billing Rules

Medication Billing Rules Panel

Display Medicare Rule

Configure Payer Exceptions to Allow Combined Medications

Payer Panel

Information Link

Payer Exceptions Configuration to Allow Combined Medications

Configuring Billing Rules

Medication Billing Rules Panel