Example
The following image shows settings where the default (*) is not to require the Skill and To Gain fields be filled out, unless the payer is in the Medicare financial class, in which case, the fields are required.
Recommendations
NextGen® Therapy Suite Help 30.3.13.0
You can configure settings for financial categories and payers who do or do not require entries in the Skill and To Gain fields. Select the field under the Fin Category. Treatment Skill/Gain (Intent) settings on the PT/OT Treatment Template Panel The Fin Category window opens. Select a financial category or select the asterisk * to apply the setting to all financial categories. To apply the setting to only a certain payer in the financial category, select the field under Payer Name, and then select the payer. Otherwise, the field shows an asterisk, and the setting applies to all payers in that Financial category. Select the option for the setting that you want to apply. Select Add/Update. Example Parent topic: Treatment Skill/Gain (Intent)Configure Skill and To Gain Fields
NextGen® Therapy Suite Help 30.3.13.0
Use the Treatment Skill/Gain (Intent) grid to configure the use of the Skill and To Gain fields on the Treatment template. These fields can be configured in any of the following states based on the requirements of the financial class or payer: Not Required - Hide – The fields do not appear on the template. Use this when no payers need the fields filled in. Not Required - Show – The fields appear on the template, but insurers do not require them, and users may leave them blank and still submit charges on the encounter. Required – If the user documents treatment in any grid on the template that has Skill and To Gain fields, then the user must also enter values in the Skill and To Gain fields for that grid in order to submit charges on that encounter. Configure Skill and To Gain Fields Parent topic: PT/OT Treatment Template Panel: Treatment Grid OrderTreatment Skill/Gain (Intent)
NextGen® Therapy Suite Help 30.3.13.0
Below each grid on the NTS Treatment template you may see the Skill and To Gain fields. These may be configured to be hidden, optional, or required, based on the patient’s insurance (financial class/payer). Note: For information on configuring sub-navigation links, go to NextGen Healthcare Success Community, and download the latest Configuration Guide for NextGen® Therapy Suite. Use the Skill fields to enter the skills that the therapist used to assist the patient in the therapy on this encounter, and the To Gain fields to enter justifications (intent) for each therapy that was completed with the patient on this encounter. For either of these types of fields, you can select multiple picklist entries and enter text. The entries in the fields are incorporated into statements on the Office Note. Add Entries to a Skill or To Gain Field Parent topic: Treatment SectionSkill and To Gain
NextGen® Therapy Suite Help 30.3.13.0
Determine if the financial category selected will be able to require/view/hide the Medicare Clinical Impression that is shown on Single Visit as Medical Necessity. This field is required on Medicare patients with an Eval or Progress Visit. Required and on an eval visit type or checked the re-eval charge checkbox, the med necessity field is red. The label will be red on visits that this is required on, and it is a hard stop on Fee Sheet. If the financial class is set to Required, the therapist will not be able to submit charges on an eval or progress visit type without completing documentation in the Medical Necessity field. Not Required – Show makes the field visible on Single Visit on an Eval or Progress visit type, but it will not be a hard stop on Fee Sheet if they choose to not fill it out. Not Required – Hide hides the field so it is not viewable to users. No POC on Re-eval: If you have any payers that do not require a POC to be sent with a Re-eval, you can use this setting to turMCR Clinical Impression
Help Guide for NextGen® Enterprise PM 8
Select one of the Medicare claim types from the drop-down list in the Process as Claim Type field. Enter the values in the required fields and select OK. Parent topic: Set Up Medicare and Medicaid Claim TypesSet Up Medicare Claims
File Maintenance Help for NextGen® Enterprise 8
Select one of the Medicare claim types from the drop-down list in the Process as Claim Type field. Enter the values in the required fields and select OK. Parent topic: Set Up Medicare and Medicaid Claim Types