Medicare Certification Period

NextGen® Therapy Suite Help 30.3.13.0

KX Modifier

KX Modifier tracking occurs automatically when you submit charges on encounters. The system looks to the Procedure Module or the Charges table in NextGen® Enterprise PM for any billable codes for the current encounter, and then, based on configuration set up, checks the payer’s contract in File Maintenance or in the Reimbursement Rate grid on the Billing Configuration system template for any codes with the GP, GO or GN modifier to calculate reimbursement for the current calendar year. In the Medicare Certification box on the NTS Homepage, the Used this year field displays the system-calculated value. In the corresponding Amt used field, you can manually enter any amount used externally in the same calendar year. KX Modifier amount fields After patient treatment charges pass the first-tier cap (as designated in the Billing Configuration system template), the system applies the KX modifier to all charges for the remainder of the calendar year. Parent topic: Medicare Certification Box

NextGen® Therapy Suite Help 30.3.13.0

Medicare Certification Box

The fields in the Medicare box track certification period and therapy cap totals. Medicare Certification Period KX Modifier Manage ABN Link Parent topic: Homepage Template

NextGen® Therapy Suite Help 30.3.13.0

Track MCR Certification

Determine if the financial class should be tracking the Medicare Certification Period that is on Homepage. If you have Medicare payers in different financial classes, set up each of the financial classes to add dates to the Medicare Certification period on Homepage. Add the Financial Class. In the MCR Cert column select either Primary or Any option. Select the Add/Update button. This then tracks the Medicare Certification Period based on your longest goal or 90 days, whichever is shorter. For non-Medicare financial classes in this grid, enter No for the MCR Cert column. Any means if Medicare is primary, secondary or tertiary ins. Primary – primary only Parent topic: Finclass Settings

NextGen® Therapy Suite Help 30.3.13.0

Alert for Script/POC/Medcert

Use this setting to configure the timeframe in which you are alerted that the Script/POC/Medcert period is about to expire. This alert appears on Homepage. Parent topic: Scripts

NextGen® Therapy Suite Help 30.3.13.0

Script Fields

Use the Script fields to record and track the date of scripts that the patient has referring them to the client for therapy or chiropractic care. If this is a Medicare patient, you also track the Plan of Care (POC) from the script fields. Script fields Enter an External Script Enter a New Internal Script Parent topic: Homepage Template

NextGen® Therapy Suite Help 30.3.13.0

Change Certification Timeframe

You can change the timeframe on the certification period if your contract states that it is different than 90 days. To do this, fill in the Cert Days field to designate when your certification should expire. If not filled out, the system defaults to 90 days. Parent topic: Finclass Settings

Medicare Certification Period

Recommendations

KX Modifier

Medicare Certification Box

Track MCR Certification

Alert for Script/POC/Medcert

Script Fields

Change Certification Timeframe

KX Modifier

Medicare Certification Box

Track MCR Certification

Alert for Script/POC/Medcert

Script Fields

Change Certification Timeframe