Expiring or Expired Precerts by Units

NextGen® Therapy Suite Help 30.3.13.0

Expiring or Expired Pre-certs by Visits & Never Pre-certed

The grid in the Expiring/Expired Precerts by Visits & Never Pre-certed panel displays patients who have never had pre-cert or those who have an authorization by visits that is about to expire or has expired. This grid also displays any patient who was previously in the Appointments Requiring Precerts grid for whom an authorization is yet to be entered. Expiring/Expired Precerts by Visits & Never Pre-certed panel Expiring thresholds per payer are set up on the Precert Config system template. To open the patient chart to update any patient-specific pre-certification information, you can select the patient row, and then select the Launch Chart button. Parent topic: Precert Worklog

NextGen® Therapy Suite Help 30.3.13.0

Appointments Requiring Precerts

The Appointments Requiring Precerts grid displays patients that have upcoming appointments scheduled for payers that require a pre-cert. Payers can be configured to require a pre-cert in the Payers Defaults grid, on the Precert Config system template. Note: Only the payers that are configured in the Payer Defaults grid will have appointments that appear in the Appointments Requiring Precerts grid on the Pre-Cert Worklog. Appointments Requiring Precerts grid Patients remain listed in the Appointments Requiring Precerts grid until one of the following happens. A clinical encounter is created in NextGen® Enterprise EHR, attached to the case and documented on. The patient is checked in for an evaluation and the NTS Homepage or Single Visit template has been opened. This does not necessarily mean that a pre-cert was entered or documented. Opening a non-billable encounter and documenting anything from Homepage or Single Visit causes the patient’s name to move from the Appointments Requiring

NextGen® Therapy Suite Help 30.3.13.0

Precert Worklog

The Precert Worklog is a practice-level template that you can use to manage patient appointments that require pre-certification or that have a pre-cert that is about to expire. The Precert Worklog has the following panels. Appointments Requiring Precerts Expiring/Expired Precerts by Visits & Never Precerted Expiring/Expired Precerts by Units You can use the Launch Chart button to open a patient’s chart and update any patient-specific pre-certification information. NTS Pre Cert Worklog template Appointments Requiring Precerts The Appointments Requiring Precerts grid displays patients that have upcoming appointments scheduled for payers that require a pre-cert. Expiring or Expired Pre-certs by Visits & Never Pre-certed The grid in the Expiring/Expired Precerts by Visits & Never Pre-certed panel displays patients who have never had pre-cert or those who have an authorization by visits that is about to expire or has expired. Expiring or Expired Precerts by Units The grid in the Expiring/Ex

NextGen® Therapy Suite Help 30.3.13.0

Precert Grids

The Precert grids on the NTS Homepage template are view-only. They show any authorizations or yearly limits entered for the patient. All information in these grids is added from the NTS Pre-cert template. Refer to Pre-cert Template section for more information. Note: Authorizations do not pull automatically to the NTS Homepage and NTS Pre-cert templates if added to the patient in NextGen® Enterprise PM. Precert grids Precerts only appear in these grids if the encounter date falls within the effective date range for the authorizations entered. Precerts can be tracked by total Encounters/Visits (top grid) or by Units (bottom grid). If tracking by units, the units can be broken down by individual codes or a group of codes. The templates automatically begin deducting on each billable encounter from the total number of visits or units authorized. When the authorization/yearly limit reaches the threshold that is configured on the Precert Configuration system template an alert on the NTS Home

NextGen® Therapy Suite Help 30.3.13.0

Precertification/Authorization Panel

The grid in the Precertification/Authorization panel initially displays all authorizations entered for that case. When you select a payer in the Insurance Information grid, you then see authorizations for that payer. You can enter new information, update it, or remove authorizations. Precertification/Authorization panel No Authorization Required Enter a New Authorization by Visits Re-certify an Existing Authorization Enter a New Authorization by Units Mark an Authorization as Done Editing an Existing Authorization Establish a Patient as Self Pay View Usage and Fix/Apply Precert Parent topic: Pre-cert Template

NextGen® Therapy Suite Help 30.3.13.0

Enter a New Authorization by Units

Select the payer from the Insurance Information grid. Select the Units option below the Precertification/Authorization grid. Use the fields below the Precertification/Authorization grid to enter the authorization information. You can use the Get button to populate the fields with authorization information that has already been attached to the Insurance in NextGen® Enterprise PM. Select Get and then select the appropriate authorization from the pop up to pull into the Precert template fields. Note: Pre-Cert Company, Associated Diagnosis, and Expiration Date are optional. The Associated Diagnosis grid will only display Dx codes after the therapist has established the treating diagnosis. Using the grid that displays CPT codes, select the CPT codes that pertain to the authorization. All selected CPT codes display a checkmark next to them at the top of the grid. Note: You can use the From and To fields to help filter and search for CPT codes. If you are filtering the grid, and all CPT codes

Expiring or Expired Precerts by Units

Recommendations

Expiring or Expired Pre-certs by Visits & Never Pre-certed

Appointments Requiring Precerts

Precert Worklog

Precert Grids

Precertification/Authorization Panel

Enter a New Authorization by Units