NextGen Knowledge Center

Managed Care Operation

The Managed Care Operations subgroup in the System Administrator enables you to set rights for NextGen® Eligibility Verification.

SubgroupUsed inDescription
Eligibility Referral InquiryNextGen® Enterprise PMEnables users to run the Eligibility and Referral Inquiries process to obtain results.
Elig ManagerNextGen® Enterprise PMEnables 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 RequestNextGen® Enterprise PMEnables users to submit eligibility requests.
Submit Historical Authorization RequestNextGen® Enterprise PMCurrently not available.
Submit Historical Referral RequestNextGen® Enterprise PMEnables users to submit Historical Referral Requests in NextGen® Enterprise PM using RTS (Real-Time Transaction Server.)
Submit New Authorization RequestNextGen® Enterprise PMCurrently not available.
Submit New Referral RequestNextGen® Enterprise PMEnables users to submit Referral Requests in NextGen® Enterprise PM using RTS (Real-Time Transaction Server.)
View Eligibility/Referral ResponseNextGen® Enterprise PMEnables users to view lists of submissions.
Provider Referral RequestNextGen® Enterprise PMEnables users to submit provider referral history inquiries.
Referral RequestNextGen® Enterprise PMEnables users to submit referral requests.