Payer Picklist and Payer Defaults

NextGen® Therapy Suite Help 30.3.13.0

Worklog Grid

Use the Worklog grid to set up which upcoming VISIT TYPE types trigger a patient’s name to appear in the Upcoming Appointments grid on the Precert Worklog template. Worklog grid Add an Appointment Type to the Worklog Grid Delete an Appointment Type from the Worklog Grid Parent topic: Pre-Certification Configuration

NextGen® Therapy Suite Help 30.3.13.0

Pre-cert Companies

Use the Pre-cert Companies grid to add third-party companies that you work with to obtain pre-certifications/authorizations. Companies listed in the Pre-cert Companies grid appear in the Pre-Cert Company field picklist for the Precertification/Authorization panel grid on the Pre-Cert template, so that you can associate a company with an authorization. Pre-cert Companies grid Picklist for the Pre-Cert Company field Add a Pre-Cert Company Update or Delete a Pre-Cert Company Parent topic: Pre-Certification Configuration

NextGen® Therapy Suite Help 30.3.13.0

Add a Payer to the Payer Picklist

Add a payer to the Payer Picklist grid, if: You want that payer to have different pre-certification reminder timelines than the Default entry, especially if the payer requires greater or lesser advanced notice to issue a new precertification than is set for the default. You want to add the payer to the Payer Default list. You want a different alert to fire for the payer (they will also need to be added to the Payer Default grid). Select the Payer Name field. The AINF Pre Cert System Payers picklist opens. This list pulls payers from your Payer Master file. Select the payer, and then select OK. To add a specific alert to appear for that payer, enter the text in the Payer Specific Alert field. Note: If you would like an alert to show for that payer on the Pre-cert template when the Precert Not Required button is selected, enter it in the Payer Specific Alert field. This alert will only fire if the payer is also in the Payer Defaults grid. Enter the number of days from the pre-certificati

NextGen® Therapy Suite Help 30.3.13.0

Edit a Payer Picklist Entry

You can edit any entry in the Payer Picklist grid, including the Default. In the Payer Picklist grid, select the line you want to update. The default settings appear in the fields above the grid. To change the alert, edit the text in the Payer Specific Alert field. To change the number of days from the precertification expiration date at which time the patient’s name appears in the Pre-Cert Worklog, change the entry in the Send to Worklog…days field. To change the number of visits remaining of the pre-cert visit allotment at which time the patient’s name appears in the Pre-Cert Worklog, change the entry in the Send to Worklog…visits field. Select Add/Update. Parent topic: Payer Picklist and Payer Defaults

NextGen® Therapy Suite Help 30.3.13.0

Add Pre-Cert Payers to Payer Defaults

Add payers to this grid if they often require authorization for treatment. The system will alert users when patients with this payer have upcoming evaluation or 'new patient' appointments. Select the Payer field, and then select a payer from the picklist. The picklist only has the payers that you entered into the Payer Picklist on the left. Ainf Pre Cert Payers picklist list matches Payer Name column in grid Note: You can enter a Group #, but it is not required. NextGen Healthcare does not recommend it due to frequent insurance company policy changes. Mark the appropriate checkbox(es) if the: Evaluation is included in the approved number of visits – this automatically checks the Eval Included checkbox on the PreCert template when this payer is selected. Payer requires pre-cert when they are the secondary payer – this automatically adds the payer to the Precert Worklog Appointments Requiring Precerts grid when they are listed as the secondary payer. Select the Add/Update button. This ad

NextGen® Therapy Suite Help 30.3.13.0

Update or Remove Payers in the Payer Default Grid

If anything changes in the future with payer requirements or contracts, you can update or remove payers in the Payer Defaults grid. To update a payer, select the payer from the Payer Defaults grid, edit the payer’s information, and then select Add/Update. To delete payers from the grid, select a payer, and then select Delete. Parent topic: Payer Picklist and Payer Defaults

Payer Picklist and Payer Defaults

Recommendations

Worklog Grid

Pre-cert Companies

Add a Payer to the Payer Picklist

Edit a Payer Picklist Entry

Add Pre-Cert Payers to Payer Defaults

Update or Remove Payers in the Payer Default Grid

Worklog Grid

Pre-cert Companies

Add a Payer to the Payer Picklist

Edit a Payer Picklist Entry

Add Pre-Cert Payers to Payer Defaults

Update or Remove Payers in the Payer Default Grid