Pre-cert Template

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

Pre-Certification Configuration

There are several sections in the NTS Pre-Cert Config template that you must set up prior to tracking pre-certifications (pre-certs) in NextGen® Enterprise EHR. Use this template to manage pre-certification alerts for payers, Pre-cert Companies, Worklog setup, and Pre-cert Alerts. Pre-Certification Configuration template Payer Picklist and Payer Defaults Pre-cert Companies Worklog Grid Alerts Section Additional Options Parent topic: Configuring NextGen Therapy Suite

NextGen® Therapy Suite Help 30.3.13.0

Insurance Grid

The Insurance grid displays any insurance attached to the case. The Pre-Cert Req column of the grid shows whether a payer attached to the case requires precertification/authorization prior to treatment. Payers that require authorization are configured in the Precert Configuration system template. For more information and instructions on configuring precertification, go to NextGen Healthcare Success Community and download the latest Configuration Guide for NextGen® Therapy Suite. If a payer is marked as “Required”, the only type of visit you will be able to submit charges on without entering a precertification authorization number is an Evaluation. All other visit types require you to enter a valid authorization or mark that payer as “Not Required” prior to submitting charges (see the Pre-cert Template chapter). Parent topic: Insurance Section

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

Insurance Information

The Insurance Information grid displays all payers attached to the case. Insurance Information grid Parent topic: Pre-cert Template

NextGen® Therapy Suite Help 30.3.13.0

Messages

Use the Messages panel to enter payer-specific messages regarding the authorization needs for the patient. Add a Message for a Payer Edit a Payer Message Parent topic: Pre-cert Template

Pre-cert Template

Recommendations

Precertification/Authorization Panel

Pre-Certification Configuration

Insurance Grid

Precert Grids

Insurance Information

Messages

Precertification/Authorization Panel

Pre-Certification Configuration

Insurance Grid

Precert Grids

Insurance Information

Messages