Mark an Authorization as Done
Select the payer from the
Insurance Information
grid.
Select the Authorization from the
Precertification/Authorization
.
Select the
Done
button.
Select the effective date when authorization was done, from the
Calendar
that opens.
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NextGen® Therapy Suite Help 30.3.13.0
Editing an Existing Authorization
Select the payer from the Insurance Information grid. Select the Authorization from the Precertification/Authorization. Select the Edit button. The authorization information is shown in the fields below the grid. Using the fields, edit any of the applicable information. Select Update. Parent topic: Precertification/Authorization Panel
NextGen® Therapy Suite Help 30.3.13.0
No Authorization Required
You cannot mark a payer as Not Req if that payer has an existing authorization that has not been marked as Done. If an existing authorization exists, you must mark it as Done prior to being able to select the Not Req button. If no authorization is required for a payer: Select the payer from the Insurance Information grid. Select the Not Req button. Not Req button under the Insurance Information grid The Req column next to the payer in the Insurance Information grid then has NR (not required) and the Action field in the Precertification/Authorization grid displays "Pre-cert not required". Req column on the Insurance Information grid and Action column in the Precertification/Authorization grid This Insurance grid on Homepage displays the payer Pre-cert requirement as Not Required. Parent topic: Precertification/Authorization Panel
NextGen® Therapy Suite Help 30.3.13.0
Enter a New Authorization by Visits
Select the payer from the Insurance Information grid. Select the Visits option below the Precertification/Authorization grid. Use the fields below the Precertification/Authorization grid to enter the authorization information: NBR, Authorization #, Effective Date, Expiration Date and Visits. Note: You can use the Get button to populate the fields with authorization information that has already been attached to the Insurance in the NextGen® Enterprise PM. Select Get and then select the appropriate authorization from the picklist to pull into the Pre-Cert template fields. You must assign the NBR manually. Entries for Pre-Cert Company, Expiration Date, and Associated Diagnosis are optional. The Associated Diagnosis grid only displays Dx codes after you have established the treating diagnosis. Select Add to save the authorization. The authorization appears in the Precertification/Authorization grid. Parent topic: Precertification/Authorization Panel
NextGen® Therapy Suite Help 30.3.13.0
View Usage and Fix/Apply Precert
You can see how an authorization is using Visits or Units from a given encounter, Select the desired authorization from Precertification/Authorization grid. Select the View Usage button. View Usage button If a Visit authorization is selected, the Pre-Cert Usage History window opens where you can view authorization details and which encounters were used towards the selected authorization. Pre-Cert Usage History window If a Unit authorization is selected, the Pre-Cert Unit Usage History window opens where you can view from the top grid all encounters within the case and how many units/visits were used from an encounter towards the selected authorization. Select an encounter from the top grid. In the Enc Precert Usage grid, view all Billed Units from that encounter, along with Units Used for the associated Authorization Numbers. If an authorization that was entered needs to be retroactive to include units used from a historical encounter, select the historical encounter from the top grid
NextGen® Therapy Suite Help 30.3.13.0
Re-certify an Existing Authorization
Select the payer from the Insurance Information grid. Select the Visits option below the Precertification/Authorization grid. Using the fields below the Precertification/Authorization grid, enter the authorization information that includes: NBR, Authorization #, Effective Date, Expiration Date, and # Visits. Note: If re-certifying an existing authorization for a payer, be sure to select the same NBR as the previous authorization. The Pre-Cert Company, Associated Diagnosis and Expiration Date fields are optional. The Associated Diagnosis grid only displays Dx codes after the therapist has established the treating diagnosis. Select the Add button to save the authorization. Parent topic: Precertification/Authorization Panel
NextGen® Therapy Suite Help 30.3.13.0
Establish a Patient as Self Pay
If a patient has a yearly limit that is being tracked or an existing authorization that expires and the insurance will no longer authorize payment until the insurance policy renews, a user can mark that patient as Self Pay for a selected period of time. The self-pay functionality acts as an interim “authorization” until a new authorization can be entered. Select the payer in the Insurance Information grid. Select the NBR field to select the Precert number that now needs to be self-pay. From the calendar popups, select the Effective and Expiration dates for the self-pay period. The new self-pay interim authorization appears in the Precertification/Authorization grid. Self Pay in the Precertification/Authorization grid Parent topic: Precertification/Authorization Panel
