Update a Reimbursement Rate

NextGen® Therapy Suite Help 30.3.13.0

Assign Reimbursement Rates

In the NTS Billing Config system template, expand the Payer Reimbursement & Medicare Therapy Cap panel. Payer Reimbursement & Medicare Therapy Cap panel Select the field above the Payer Reimbursement grid. A picklist of payers opens. Note: To see a list of Financial Classes in the Payer Reimbursement grid, you must clear the Use Contract Rates checkbox on the NTS Practice Config template in the Fee Sheet section. Select the payer from the list, and then select OK. Codes for the selected payer fill the Payer Reimbursement grid. Select a code in the grid. The code for that service enters the field above the center grid. In the boxes below the center grid, add the Rate, the Effective date (MM/DD/YYYY) and the Expiration date (MM/DD/YYYY). Select the Add button. The rate is added to the Payer Reimbursement grid. If the effective date is a date in the future and there is no current rate exists, the Rate column will show an asterisk for the code. If a rate already exists, your new rate will

NextGen® Therapy Suite Help 30.3.13.0

Add a Medicare KX Mod Cap

The Medicare KX Mod Cap grid shows the yearly caps for your Medicare total used amounts. Use the fields below the grid to enter or update a new yearly cap for Medicare KX Mod. Medicare KX Mod Cap grid Select the field below the Year column to enter the calendar year that the cap applies to. Select the fields below the PT SLP Cap 1 and PT SLP Cap 2columns to enter the 1st and 2nd tier caps for PT/SLP. Select the fields below the OT Cap 1 and OT Cap 2 columns to enter the 1st and 2nd tier caps for OT. Select Add/Update. Parent topic: Payer Reimbursement & Medicare Therapy Cap

NextGen® Therapy Suite Help 30.3.13.0

Payer Reimbursement & Medicare Therapy Cap

The payer reimbursement rate is used to calculate the Medicare Cap usage and to determine optimal billing when payers have a billing cap configured in the Financial Class Setup panel. For example, if a payer has a 4-unit cap, this may result in the need to throw out a code. So, the system looks at the configured reimbursement rates to determine optimal billing. If you are using contracts in File Maintenance and have them turned on on the NTS Practice Config practice template, the system looks to those for the reimbursement rates. If you are not using contracts in File Maintenance, you must assign payer reimbursement rates so that in the event of a tie, and to prevent under-billing, the system can determine which code to send. All reimbursement rates are assigned to Financial Classes. You must indicate the reimbursement rates for all Financial Classes within the Financial Categories that have been assigned specific billing limitation in the NTS Billing Config template. Assign Reimbursem

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® Medication Inventory Control Help 10.6.3.0

Update a Medication Quantity

You can change a quantity in the Medication Quantity Picklist. Select the field below the Medication column of the grid. The MLTS MedOnly PL picklist opens. Select the medication for which you want to change the picklist entry, and select OK. The medication and unit type enter the respective fields, and the grids shows all values currently in the picklist for that medication. Select the entry from the grid. The quantity enters the field below the Quantity column of the grid. Select the Quantity field. A Number Pad opens. Enter the new quantity and select OK. Select Update. The picklist entry is updated in the grid. The medication name and unit type remain in the fields below the grid. Parent topic: Medication Quantity Picklists

NextGen® Therapy Suite Help 30.3.13.0

Add a Billing Limitation

Select the field below the grid Financial Category column. A picklist opens. Select one of the Financial Categories you created in the Financial Class Setup grid, and then select OK. Select the Payer Name field. A list of payers for the selected Financial Category opens. Select a payer, and then select OK. Select the State field and select the appropriate state or select the asterisk, for all states. If the payer follows the Medicare Combine (MC) rule, select the MC Rule checkbox and then choose an option for whether the rule is applied by Time or Rate. If there is a billing unit cap for the financial class or payer, enter it in the Billing Cap field. Select Add/Update to add the billing limitation to the grid. Parent topic: Billing Limitations Grid

Update a Reimbursement Rate

Recommendations

Assign Reimbursement Rates

Add a Medicare KX Mod Cap

Payer Reimbursement & Medicare Therapy Cap

Edit a Payer Picklist Entry

Update a Medication Quantity

Add a Billing Limitation

Assign Reimbursement Rates

Add a Medicare KX Mod Cap

Payer Reimbursement & Medicare Therapy Cap

Edit a Payer Picklist Entry

Update a Medication Quantity

Add a Billing Limitation