Managed Care Operation

Subgroup	Used in	Description
Eligibility Referral Inquiry	NextGen® Enterprise PM	Enables users to run the Eligibility and Referral Inquiries process to obtain results.
Elig Manager	NextGen® Enterprise PM	Enables users to track NextGen® Eligibility Verification eligibility transactions by day and status using a user-friendly visual graph and detailed grid; allowing users to: view eligibility responses, submit or resubmit eligibility inquiries, access the Eligibility Referral Report, create tasks, manage transactions, and print.
Submit Eligibility Request	NextGen® Enterprise PM	Enables users to submit eligibility requests.
Submit Historical Authorization Request	NextGen® Enterprise PM	Currently not available.
Submit Historical Referral Request	NextGen® Enterprise PM	Enables users to submit Historical Referral Requests in NextGen® Enterprise PM using RTS (Real-Time Transaction Server.)
Submit New Authorization Request	NextGen® Enterprise PM	Currently not available.
Submit New Referral Request	NextGen® Enterprise PM	Enables users to submit Referral Requests in NextGen® Enterprise PM using RTS (Real-Time Transaction Server.)
View Eligibility/Referral Response	NextGen® Enterprise PM	Enables users to view lists of submissions.
Provider Referral Request	NextGen® Enterprise PM	Enables users to submit provider referral history inquiries.
Referral Request	NextGen® Enterprise PM	Enables users to submit referral requests.

System Administrator Help

Tasks Operation

Subgroup Used in Description Allow NextGen® Enterprise EHR Task Generation from NextGen® Enterprise PM NextGen® Enterprise PM & NextGen® Enterprise EHR Enables NextGen® Enterprise PMt users to create NextGen® Enterprise EHR tasks within certain areas of NextGen® Enterprise PMand send the tasks to a user or workgroup in NextGen® Enterprise EHR. The tasks can be created from the Tasks menu.: right-clicking on an encounter from the patient chart. right-clicking on an encounter from the Encounter Lookup. right-clicking on the tasks section of the Clinical History/Notes tab in the patient chart. Allow Encounter Void Task Deletion NextGen® Enterprise PM & NextGen® Enterprise EHR Ability to delete tasks from the workflow Module when an encounter has been marked as void in NextGen® Enterprise PM. Allow Transaction Approval Task Deletion NextGen® Enterprise PM Ability to delete a task once a transaction has been completed and approved. Allow User Task Approval for Other Users NextGen® Enterpris

System Administrator Help

Administration Operations

Subgroup Used in Description Advanced Audit Setup NextGen® Enterprise PM & NextGen® Enterprise EHR Enables users to access Advanced Audit Setup from the NextGen® Enterprise and NextGen® Enterprise PM applications. Association Maintenance NextGen® Enterprise PM & NextGen® Enterprise EHR Enables users to create and modify associations in the System Administrator application. Change Password NextGen® Enterprise PM Enables users to change their passwords. Copy User Preferences NextGen® Enterprise PM Enables users to copy user preferences, work flow module preferences and PAQ custom rules from one user to another user or user group profile. Edit NextGen® Enterprise EHR Component Profiles NextGen® Enterprise EHR Enables users to edit the Graphical Exam Tool (GET) profile. If access rights are set to Yes, the Settings option on the GET tool is enabled; if access rights are set to No, the option is disabled. External Application Setup NextGen® Enterprise EHR Enables administrators to grant use

System Administrator User Guide

Managed Care Operation

The Managed Care Operations subgroup in the System Administrator enables you to set rights for NextGen® Eligibility Verification. Subgroup Used in Description Eligibility Referral Inquiry NextGen® Enterprise PM Enables users to run the Eligibility and Referral Inquiries process to obtain results. Elig Manager NextGen® Enterprise PM Enables users to track NextGen® Eligibility Verification eligibility transactions by day and status using a user-friendly visual graph and detailed grid; allowing users to: view eligibility responses, submit or resubmit eligibility inquiries, access the Eligibility Referral Report, create tasks, manage transactions, and print. Submit Eligibility Request NextGen® Enterprise PM Enables users to submit eligibility requests. Submit Historical Authorization Request NextGen® Enterprise PM Currently not available. Submit Historical Referral Request NextGen® Enterprise PM Enables users to submit Historical Referral Requests in NextGen® Enterprise PM using RTS (Real-

Help Guide for NextGen® Enterprise PM 8

Eligibility Referral Report

The Eligibility Referral report is available if your system is licensed for NextGen Eligibility Verification. You can use the report to track referral requests submitted to payers from NextGen® Enterprise PM. For more information, go to the NextGen Healthcare Success Community and download the User Guide for NextGen® Eligibility Verification Report configuration and filter options include Create Date, Status, Inquiry Type, Response Status, Payer Subgrouping, Primary Payer, Provider Subgrouping, and Rendering Provider. To access the report in NextGen® Enterprise PM, select Reports > General and then select Eligibility Referral. Eligibility Referral Report Columns Parent topic: General Reports

Help Guide for NextGen® Enterprise PM 8

Eligibility Referral Report

The Eligibility Referral report is available if your system is licensed for NextGen Eligibility Verification. You can use the report to track referral requests submitted to payers from NextGen® Enterprise PM. For more information, go to the NextGen Healthcare Success Community and download the User Guide for NextGen® Eligibility Verification Report configuration and filter options include Create Date, Status, Inquiry Type, Response Status, Payer Subgrouping, Primary Payer, Provider Subgrouping, and Rendering Provider. To access the report in NextGen® Enterprise PM, select Reports > General and then select Eligibility Referral. Eligibility Referral Report Columns Parent topic: General Reports

System Administrator User Guide

Tasks Operation

Subgroup Used in Description Allow NextGen® Enterprise EHR Task Generation from NextGen® Enterprise PM NextGen® Enterprise PM & NextGen® Enterprise EHR Enables NextGen® Enterprise PMt users to create NextGen® Enterprise EHR tasks within certain areas of NextGen® Enterprise PMand send the tasks to a user or workgroup in NextGen® Enterprise EHR. The tasks can be created from the Tasks menu.: right-clicking on an encounter from the patient chart. right-clicking on an encounter from the Encounter Lookup. right-clicking on the tasks section of the Clinical History/Notes tab in the patient chart. Allow Encounter Void Task Deletion NextGen® Enterprise PM & NextGen® Enterprise EHR Ability to delete tasks from the workflow Module when an encounter has been marked as void in NextGen® Enterprise PM. Allow Transaction Approval Task Deletion NextGen® Enterprise PM Ability to delete a task once a transaction has been completed and approved. Allow User Task Approval for Other Users NextGen® Enterpris

Managed Care Operation

Recommendations

Tasks Operation

Administration Operations

Managed Care Operation

Eligibility Referral Report

Eligibility Referral Report

Tasks Operation

Managed Care Operation

Tasks Operation

Administration Operations

Managed Care Operation

Eligibility Referral Report

Eligibility Referral Report

Tasks Operation