View Usage and Fix/Apply Precert

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

Enter a New Authorization by Units

Select the payer from the Insurance Information grid. Select the Units option below the Precertification/Authorization grid. Use the fields below the Precertification/Authorization grid to enter the authorization information. You can use the Get button to populate the fields with authorization information that has already been attached to the Insurance in NextGen® Enterprise PM. Select Get and then select the appropriate authorization from the pop up to pull into the Precert template fields. Note: Pre-Cert Company, Associated Diagnosis, and Expiration Date are optional. The Associated Diagnosis grid will only display Dx codes after the therapist has established the treating diagnosis. Using the grid that displays CPT codes, select the CPT codes that pertain to the authorization. All selected CPT codes display a checkmark next to them at the top of the grid. Note: You can use the From and To fields to help filter and search for CPT codes. If you are filtering the grid, and all CPT codes

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

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

Expiring or Expired Pre-certs by Visits & Never Pre-certed

The grid in the Expiring/Expired Precerts by Visits & Never Pre-certed panel displays patients who have never had pre-cert or those who have an authorization by visits that is about to expire or has expired. This grid also displays any patient who was previously in the Appointments Requiring Precerts grid for whom an authorization is yet to be entered. Expiring/Expired Precerts by Visits & Never Pre-certed panel Expiring thresholds per payer are set up on the Precert Config system template. To open the patient chart to update any patient-specific pre-certification information, you can select the patient row, and then select the Launch Chart button. Parent topic: Precert Worklog

Help Guide for NextGen® Enterprise PM 8

Authorizations Report Columns

The following columns are available on the Authorizations report: Column Name Description Data Populates From Auth Cd Authorization Code Authorization Code Tracking Desc Full description of the authorization coverage Authorization Code Tracking Line Item Auth Line Item Authorization Authorization Code Tracking Provider Payer ID Provider payer ID Insurance sub tab of the Encounter tab in Patient Chart Payer Name The name of the payer Insurance sub tab of the Encounter tab in Patient Chart Contracted Ind Contracted Payer Indicator Payers Master File Provider NPI Provider NPI Insurance sub tab of the Encounter tab in Patient Chart Pat Name Patient name Patient Information Per Nbr Person Number Patient Information Ins Name Name of insurance company Insurance sub tab of the Encounter tab in Patient Chart Prov Name Provider name Authorization Code Tracking St Dt The start date of the authorization Authorization Code Tracking End Dt The date that the authorization is no longer in effect. Auth

View Usage and Fix/Apply Precert

Recommendations

Enter a New Authorization by Visits

Enter a New Authorization by Units

Re-certify an Existing Authorization

Precertification/Authorization Panel

Expiring or Expired Pre-certs by Visits & Never Pre-certed

Authorizations Report Columns

Enter a New Authorization by Visits

Enter a New Authorization by Units

Re-certify an Existing Authorization

Precertification/Authorization Panel

Expiring or Expired Pre-certs by Visits & Never Pre-certed

Authorizations Report Columns