NextGen Training PM Manual
Patient Services Coastal Health & Wellness
For Coastal Health & Wellness use only. Rights Reserved.
TABLE OF CONTENTS
1. GETTING STARTED WITH PM
A. How to Access, Login and Exit the NextGen Application Pg
I. Accessing NextGen 1
II. Logging In 2
III. Logging Out/Closing the NextGen Application 3
B. Common NextGen PM Elements
I. Shortcuts 4
II. PM Buttons and Fields 5
III. PM Toolbar and Icons 6
IV. PM Desktop 8
V. Patient Information Toolbar 9
C. Changing Your Password in PM
I. Changing your Password 10
D. PM Advisor
I. Accessing the Advisor screen 11
II. Using the Advisor 12
2. APPOINTMENTS
A. Scheduling an Appointment
I. Resources 13
II. Events 14
III. Categories 15
IV. Locations (Sites) 15
V. Appointment Book Toolbar 16
VI. Icons 16
VII. Views 19
Daily 19
Weekly List 20
Weekly Schedule 20
Monthly 21
Multi-View 21
VIII. Scheduling an Appointment 22
Person Lookup 25
Person not listed 26
Appointment Reminder (EDI Patient Preference) 31
Scheduling Conflicts 33
Person is listed 34
TABLE OF CONTENTS
B. Confirming an Appointment
I. Appointment Lookup 36
II. Person not listed 37
III. Person is listed 37
IV. Appointment Reminders 38
C. Canceling an Appointment
I. Appointment Lookup 40
II. Person not listed 41
III. Person is listed 41
IV. Canceling an Appointment 43
3. PATIENT SERVICES
A. Determining Eligibility
I. Person Lookup 44
II. Person Not Listed 45
III. Person is listed 46
IV. Person with Healthcare Coverage 46
Employer tab 49
Contracts 50
V. Person without Healthcare Coverage 50
B. Tasking
I. Creating a Task 52
II. Retrieving a Task 54
Worklog Manager 54
Task Types
57
Worklog manager added fields 57
C. Creating And Managing Charts
I. Collecting Required Documentation 58
II. Searching Persons/Patients 58
III. Person is not Listed 59
o Patient Lookup
59
o Name 59
o Social Security Number (SSN) 60
o Birth Date (DOB) 60
o Birth Sex 60
Address
60
o Billing/Secondary Address 60
Demographics 60
o Marital Status 60
o Student Status 60
o Preferred Language 60
o Primary Care and Primary Dental Provider 61
TABLE OF CONTENTS
Contact Information 61
o Contact Method 61
o Preferred Contact 62
o Notifications 62
IV. UDS 62
o Homeless Status 62
o Migrant Status 62
o Language Barrier 63
o Race 63
o Ethnicity 63
o Veteran Status 63
o Primary Medical Coverage 63
o Consent to Treat 64
Self Pay Checkbox 64
Head of Household 64
V. Chart Details
64
TVFC Form Date 64
Marketing Plans 65
VI. Insurance 65
Adding an Insurance 66
Insurance Maintenance 67
o Detail Tab 67
O Detail – 2 Tab (Patient name clarification on insurance card)
o
68
o Ins Cards (Scanning insurance cards) 68
Adjusting the scanned card 71
o Benefit Info Tab 72
o Authorizations 73
VII. Creating a Chart 76
VIII. Privacy 79
IX. Employer 80
X Relations/Roles/Contact/Guarantor/Head of Household 82
Relationship
73
o Person not listed in Matching Records 84
o Person is listed in Matching Records
86
Support Role
87
Guarantor 88
o Self Guarantor 89
o Not Self Guarantor 89
Head of Household 91
o Self Head of Household 91
o NOT Self Head of Household 92
XI. Accounts 94
Family Information 95
Sliding Fee Schedule Verification 96
Expiring Family Information and Sliding Fee Schedule Verification 97
Sliding Fee Alert 98
TABLE OF CONTENTS
XII. Taking the Patient’s Picture 98
XIII. Clinical History/Notes 101
Accessing built-in forms 101
o What and when is the Patient Acknowledgment Form required
o
103
o What and when is the TVFC Eligibility Form required
o
104
Acquiring signatures 104
Sealing notes 105
Documenting verbal notes 106
XIV. Scanning Documents 106
Creating a batch 107
Verifying the Scanned Documents 109
Filing the scanned documents to a patient’s chart 109
D. Creating a Batch and Set as Active
I. Creating a batch 113
II. Batch description 114
III. Securing the Batch 114
IV. Set as active 115
E. Checking In Patients with AutoFlow
I. Accessing the Appointment 117
II. Check-In/Create Encounter 117
III. How to Change a Guarantor for Specific Encounters 120
Person as Guarantor 120
Employer as Guarantor 122
Self as Guarantor 122
IV. Appointment Link Selection 123
V. AutoFlow Begins 124
Confirming Demographics 124
Confirming UDS Required Fields 125
Chart Details 126
o TVFC Form Date (refer to TVFC Eligibility Form Memo) 126
o Marketing Plans 126
Attaching an Insurance to an Encounter 126
Charge Posting 127
Patient Balance 129
Payment Entry 130
VI. Printing the Receipt 131
VII. Autoflow Interruption 132
F. Patient Payments
I. Accessing the Active Batch 133
II. Accessing the Account/Encounter 134
Account Source 134
Encounter Source 134
Denture Contract Payments 134
TABLE OF CONTENTS
o Person is not listed 135
o Person is listed 135
V. Entering the Payment 137
Unapplied Payments 137
Payment Posting To Outstanding Line Items 138
VI. Printing the Receipt 138
G. Medical/Dental Record Payments
I. Scheduling The Patient On The Medical/Dental Records Schedule 140
II. Creating The Medical Records Encounter 140
III. Entering the MedRec Charge 141
IV. Payment Entry 142
V. Printing the Receipt 143
H. Posting the Batch and End of Day Balancing
I. Accessing the Active Batch 144
II. Accessing the Batch Listing Report 145
III. Balancing the Batch with the Cash Drawer 146
Ledger 146
o Modifying An Incorrect Transaction 146
Header 147
IV. Posting the Batch 148
I. Other
I. Denture Contract Process 150
II. ClaimRemedi 160
Getting Started With NEXTGEN
HOW TO ACCESS, LOGIN AND EXIT THE NEXTGEN APPLICATION
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I. ACCESSING NEXTGEN
1. Double left click on the NextGen 5 icon located on either the desktop or through RDS.
The NextGen Application Launcher will display.
2. Left click once on Practice management (PM) The NextGen login window will display. The
database name will display on the top banner based on which database the user is accessing.
Getting Started With NEXTGEN
HOW TO ACCESS, LOGIN AND EXIT THE NEXTGEN APPLICATION
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II. LOGGING IN
3. Left click once in the User field and enter your user name.
(First time logging in, user name will be provided by IT)
4. Left click once in the Password field and enter your password
(First time logging in, a password will be provided by IT)
5. Confirm the following fields display “Coastal Health & Wellness”
Enterprise
Practice
6. Left click once on Logon, the appropriate database desktop will display
PM
Getting Started With NEXTGEN
HOW TO ACCESS, LOGIN AND EXIT THE NEXTGEN APPLICATION
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III. LOGGING OUT/CLOSING THE NEXTGEN APPLICATION
7. Left click once on File, then Logout or Exit or the Down arrow in EDR, then Log Off or Exit
PM
A NextGen alert will display,
Are you sure you want to
logout of NextGen? All open
screens will be closed. Left click once on Yes
Common NextGen PM Elements SHORTCUT MENUS, BUTTONS AND FIELDS, TOOLBAR AND ICONS, DESKTOP
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The Practice Management (PM) database is used to conduct all business aspects of CHW. Users
will be able to perform/access the following:
Maintain and schedule appointments
Maintain patient demographic charts
Create and maintain billing encounters
Bill for services provided
Generate paper and electronic claims
Generate standard and customized reports
Generate customized letters to send to patients
I. SHORT CUT MENUS
Mouse and Keyboard
Throughout the Nextgen application there are short-cut menus. Users can access short-
cut menus by right-clicking in the appropriate area.
Users can usually complete a task by clicking on an icon from the toolbar menu located
across each desktop or by right clicking on an item and selecting the option from the
shortcut menu.
Mouse Usage:
Use the left mouse button to select and click items.
Use the right mouse button to display a shortcut menu of options.
Minimize:
Click on the Minimize button on the title bar of the active window. The program
window will minimize to the Windows taskbar.
Maximize/Restore:
On the Windows taskbar, click the Icon of the database to restore.
NextGen Application Launcher
PM
On the PM title bar, select the Maximize button to change the sizing of the user
screen or restore to normal size
Common NextGen PM Elements SHORTCUT MENUS, BUTTONS AND FIELDS, TOOLBAR AND ICONS, DESKTOP
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II. PM BUTTONS AND FIELDS
Common NextGen PM Elements SHORTCUT MENUS, BUTTONS AND FIELDS, TOOLBAR AND ICONS, DESKTOP
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III. PM TOOLBAR AND ICONS
Common NextGen PM Elements SHORTCUT MENUS, BUTTONS AND FIELDS, TOOLBAR AND ICONS, DESKTOP
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PM TOOLBAR AND ICONS (CONTINUED)
Click the EHR button to launch
the EHR application.
Click the Doc Mgmt button to launch
the Document Management application.
Common NextGen PM Elements SHORTCUT MENUS, BUTTONS AND FIELDS, TOOLBAR AND ICONS, DESKTOP
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IV. PM DESKTOP
When a user logs into the PM application, the PM’s main desktop window will display.
All PM functions are performed within this window.
Toolbar: Contains a row of icons
that give access to functions and
modules.
Menu Bar: Contains several shortcut menus. When clicking on an item in the menu bar, the short cut menu displays
Title Bar: Displays the “NextGen” the name of the practice: Coastal Health & Wellness
Current User Status Bar: Displays the current
status of PM. (i.e.) When generating
a report, the status bar displays
“Generating Report”… Current Version, Date, and Time
Current DB
Common NextGen PM Elements SHORTCUT MENUS, BUTTONS AND FIELDS, TOOLBAR AND ICONS, DESKTOP
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V. PATIENT INFORMATION TOOLBAR
Users can easily identify patient information when switching between the patient chart, charges
and payment entry
A. Patient Demographic Row – Contains the patient’s name, sex, DOB, person number,
medical record number and other ID
B. Patient Picture
C. Alerts Button – allows users to access patient chart alerts
D. Contact information & Contact Preference – displays perfered contact number. Hovering
over “contact” displays all contact numbers
E. Patient Status - displays patients if in collection or budget statuses
F. Preferred Language - helps identify the language patients prefer to speak
G. Patient Portal - indicates if patient is registered with the patient portal – if patient is
registered with the patient portal, the patient portal icon is blue . if patient is not
registered with the patient portal, the patient portal icon is greyed-out
H. Email address – displays current email address.
This field is required.
I. Encounter Information – displays when the encounter tab is active and an encounter is
selected. Displays encounter primary insurance, if patient is self pay, self pay will display.
Rendering and Guarantor infomation of the current encounter displays
J. Patient Information Badges – provides quick access to patient appointments, insurance,
patient balance, & recall plans
K. Hyperlinks – Appointment search ahead & UDS
A
B
C
D
E
F
G
H I
J
K
K
Getting Started With PM
CHANGING YOUR PASSWORD IN PM
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I. CHANGING YOUR PASSWORD 1. Complete “Getting Started with NextGen - How to Access, Login and Exit the
NextGen Application” process
2. Left click once on Tasks from the menu bar
3. Left click once on Change Password, the Change Password screen displays
4. Left click once on the Old Password field and enter your current password
5. Left click once on the New Password field and enter your new password
6. Left click once on the Confirm New Password field and re-enter your new password
7. Left click once on OK
Getting Started with PM ADVISOR
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Definition:
The Advisor is a dashboard built in utility containing data sections that supply users with a
quick, at-a-glance summary information about the status about Coastal Health and Wellness
as a practice or per location.
1. Complete “Getting Started with NextGen - How to Access, Login and Exit the NextGen
Application” process
I. ACCESSING THE ADVISOR SCREEN
Users can access the Advisor by accessing Tasks from the menu bar and selecting Advisor
A message can
display from the CHW
here
A tally of
appointments is
tracked here
A tally of encounters
is tracked here
A tally of all accounts
receivable
A tally of all
statements/invoices
A tally of claims is
tracked here
All tasks are
accessible here
Letters available to
send out if applicable
Getting Started with PM ADVISOR
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Most users will only access Messages, Appointments, and Tasks
II. USING THE ADVISOR
2. Left click once on the down arrow next to Location to view one location at a time
3. Left click one on the down arrow next to Rendering to view one provider at a time,
specific to appointments
4. Left click once on the print icon, to print a face sheet of the advisor
5. Left click once on the refresh icon, to manually refresh the advisor screen
6. Left click once on the close icon, to close the advisor
7. Left click once on Tasks on the menu bar, then Advisor to re-access the Advisor at anytime
NEXTGEN PM
SCHEDULING AN APPOINTMENT
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Purpose:
To allocate a specific time for a patient to receive services from a resource for a
specific event (type of appointment)
Definition:
The act of creating a new or follow up appointment for a patient
1. Complete “Getting Started with NextGen - How to Access, Login and Exit the NextGen
Application” process
2. Understand “Getting Started with PM - Common NextGen PM Elements”
I. RESOURCES Resources can be a person, such as, a provider (Physicians, Physician Assistants, Family Nurse
Practitioners, Counselors, Dentist, Dental Hygienist, Nurse). A resource can also be a place or
thing such as, scheduling a patient to go to the Lab/X-Ray
Medical Provider Specialty Duration of Appt
(Minutes)
Doctor of Medicine
MD
Family Practice 20
Doctor of Osteopathic Medicine
DO
Family Practice 20
Physician Assistant
PA-C
Family Practice 20
Family Nurse Practitioner
FNP-BC
Family Practice 20
Counselor Specialty Duration of Appt
(Minutes)
Licensed Clinical Social Worker
LCSW
Mental Health 20/60
Licensed Professional Counselor
LPC
Mental Health 20/60
Dental Providers Specialty Duration of Appt
(Minutes)
Dentist
DDS
General Dentistry 30
Dental Hygienist Specialty Duration of Appt
(Minutes)
Hygienist
RDH
Dental Hygienist 30
Other Resources Specialty Duration of Appt
(Minutes)
Dental Walk-In Dental 20
Medical Walk-In Medical 20
Medical / Dental Records Medical 20
Lab/X-Ray Only Medical 20
Nurse Only Medical 20
OB/GYN Medical 15
NEXTGEN PM
SCHEDULING AN APPOINTMENT
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II. EVENTS
Events are types of appointments. When patients schedule an appointment with a
resource an event informs the resource what type of an appointment the patient is seeking
services for.
Event Abbreviation Department Duration of Appt
(Minutes)
Medical Annual Exam ANU Medical 20
Medical Family Planning FP Medical 20
Medical Hospital Follow Up HFU Medical 20
Medical New Patient MNP Medical 20
Medical New Prenatal Visit NOB Medical 15
Medical Newborn Visit NB Medical 20
Medical Prenatal Visit OB Medical 15
Medical Procedure PRO Medical 20
Medical Visit MV Medical 20
Medical Well Child Visit WCC Medical 20
Medical Well Woman Exam WWE Medical 20
Medicare Annual Preventive MAP Medical 20
Medicare Initial Preventive MIP Medical 20
Initial Counseling Visit ICV Medical 60
CHSBE CHS Medical 20
Counselor Visit CV Counselors 20
Couple/Family Counseling CFC Counselors 40
Dental Follow Up DFU Dental 30
Dental Hygienist Visit DH Dental 30
Dental New Patient DNP Dental 30
Dental Pedi DP Dental 30
Denture Contract DC Dental 30
Lab Only LAB Medical 20
Nurse Only NUR Medical 20
X-Ray Only XR Medical 20
Medical / Dental Records MDR Medical / Dental 20
NEXTGEN PM
SCHEDULING AN APPOINTMENT
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III. CATEGORIES
Categories are types of events that are specific to the location (site) and events (type of
appointments) to be restricted to a time period and a resource.
Category Color Type of Appt
Duration
of
Category
(Minutes)
Admin Time Blocked Time for Medical and Dental Providers 20
Dental Walk-In Dental Walk-In Providers Only 20
Denture Contract Denture Contract 30
G-Counselor Galv Counselor Only 20
G-Dental Galv Dental Only 30
G-Medical Galv Medical Only 20
Lab/X-Ray Only Lab Only 20
Medical Walk-In Medical Walk-In Providers Only 20
Mobile Clinic Mobile Clinic 20
OB/GN Prenatal 15/30
Same Day Same Day Appointment 20
Nurse Only Nurse Only 20
Out of Office Blocked Time for Out of Office for Providers 20 / 30
Medical / Dental Records Only Medical / Dental Records 20
TC-Counselor TC Counselor Only 20
TC-Dental TC Dental Only 30
TC-Dental Pedi TC Dental Pedi Only 30
TC-Medical TC Medical Only 20
IV. LOCATIONS (SITES)
Locations are where patients are scheduled to be seen by a resource with a specific event
Site Color
Galv Coastal Health &
Wellness
GALVESTON
TC Coastal Health & Wellness MID COUNTY ANNEX
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SCHEDULING AN APPOINTMENT
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V. APPOINTMENT BOOK TOOLBAR
VI. ICONS
(a). Change Dates:
Left click once to view the monthly calendar
Left click once on the date to view the schedule for that day, this option can be used in all
views
(b). Go To Today:
When searching in-between resources and dates, left click once to return to today’s date,
this option can be used in all views
(c). Previous Day:
When searching in-between resources and dates, left click once to return to the previous
day or year, this option can be used in all views
(d). Next Day
When searching in-between resources and dates, left click once to view the schedule for
the next day, this option can be used in all views
(e). Change Resources (Daily View Only)
When searching in-between resources and dates, left click once to change one resource at
a time, this option can only be used in Daily View
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(f). Change Resources (Multi-View)
When searching in-between resources and dates, left click once to change multiple
resources at a time, this option can only be used in Multi-View
(g). Change Location (Multi-View)
When searching in-between resources and dates, left click once to change locations, if
user prefers to view all providers in the Gal Coastal Health & Wellness clinic at once,
this option can only be used in the Multi-View
(h). Add Appointment
Left click once in any view to add an appointment to the appointment book
(i). Edit Appointment
When an appointment is selected in the appointment book, left click once to edit
the selected appointment
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SCHEDULING AN APPOINTMENT
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(j). Make Recurring
Appointments can be made recurring at anytime, such as, a patient who is on a
pain contract who will see one specific provider every month on the same day of
the week, left click once to make appointment recurring
Edit the end after or edit the end on
Edit the Occurs
Edit the Daily
Left click once on OK
(k). Refresh
Left click once to manually refresh the appointment book
(l). Reset Desktop
Left click once to reset users’ desktop back to defaulted settings
(m). Hide Patient Names
Left click once to hide the patient’s name on the appointment book screen and
only show the event (type of appointment), can be used for HIPAA
(n). Appointment Search
Left click once to search for any appointments by event, service location,
resources, date, time, day of the week, and patient.
Left click once on Find, the system will search for any available appointment with
specific search criteria
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(o). Exit Desktop
Left click once to exit the appointment book
VII. VIEWS
Daily View
Left click once on the Daily Tab at the bottom left of the appointment book screen
o The daily view allows users to view one resource one day at a time. Users
can also view the To Do List and the Nextgen Inbox Mail from the Daily
View.
Location - TC Category – TC-
Medical
Category – TC-
Medical
Category – Lunch
One resource, one day
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Weekly List:
Left click once on the Weekly List Tab at the bottom left of the appointment book
screen
o The Weekly List view allows users to view one resource’s weekly list of
appointments.
Weekly Schedule:
Left click once on the Weekly Schedule Tab at the bottom of the appointment book
screen
o The Weekly Schedule view allows users to view one resource’s weekly
schedule of appointments.
Location - Galv
Category – G
Medical Location - TC
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Monthly:
Left click once on the Monthly Tab at the bottom of the appointment book screen
o The Monthly view allows users to view one resource’s monthly total of
appointments.
Multi-View:
Left click once on the Multi-View Tab at the bottom of the appointment book screen
o The Multi-View allows users to view all resources at once including both
locations. Using the Change Multi-View Location can also limit the
resources by viewing by location, left click once on change
locations icon, the end user can now view all resources per location.
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VIII. SCHEDULING AN APPOINTMENT
1. Left click once on the appointment book icon
The appointment book may be defaulted specifically to job functions. Contact
Center staff will be able to view both medical and dental resources, while Dental
Staff will only be able to view dental resources.
2. Right click once on a cell within a Resource’s schedule, the time slot must be
available based on the current “Scheduling Appointment Guidelines”
Example:
a. Right click once on the 9:20 A time slot, on the resource selected template. to
view the shortcut menu
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3. Left click once on New, the Add Appointment screen displays
4. Confirm the Date and Time selected to confirm it is correct, located of the upper left
hand side of the Add Appointment screen
5. Left click once on the down arrow next to the Event/Event Chain field to choose an
event.
When adding appointments by individual resources on both the daily
and multi-view tabs, users should only be able to view the following:
o Medical providers, should only be able to view medical
events
o Dental providers, should only be able to view dental events
o Counselors, should only be able to view counseling visit
o Lab Only, should only be able to view lab only
o Etc…
NEXTGEN PM
SCHEDULING AN APPOINTMENT
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6. Left click once on the event (type of appointment)
7. Confirm Service Location
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PERSON LOOKUP
8. Left click once on the Norton icon, next to the First (Name) field on the
upper right side of the Add Appointment screen, to display the shortcut menu and
search for the person who is requesting an appointment
9. Left click once on Lookup..,the People Lookup screen displays
10. Left click once in the Last (name) field and enter the person’s last name
11. Left click once in the Birth Date field and enter the person’s date of birth
12. Left click once on the Find button to display a search result of Matching Records of
all persons with the same last name and date of birth
NOTE: The less search criteria the user enters, the more person search result will
display. If person is not listed based on search ALWAYS perform a double
search by removing data from a field. Ex: Only enter a last name without a DOB
or enter a DOB without a last name.
Review each result in the matching records list and determine if the person is
listed
PM distinguishes between a person and patients. A Person does not have
a chart and a Patient has a chart;.
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Person (displayed with a globe next to the name): A person is an
individual who has or will not receive medical/dental services. Users may
enter them in the system as the parent of a child or as the insurance
guarantor. A person may also be an individual who has made an
appointment to be seen for the first time and has not yet been seen.
Patient (displayed with a chart next to the name): A patient with a
chart receives medical/dental services. A patient is considered a “person”
before the chart is created.
PERSON NOT LISTED IN MATCHING RECORDS
If users determine a person is not listed in the Matching Records list, which
means the person does not exist in the database, an appointment can still be
made. Users can add the person by entering required data and ONLY based on
the current “Scheduling Appointment Guidelines”.
13. Left click once on the New button, the Add Person Information screen displays, the
Demographics tab will be defaulted open. Required information will display in bold
red but, the following information must always be completed
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14. Left click once in the Last (Name) field and enter the person’s full last name (DO
NOT ENTER SPECIAL CHARACTERS)
15. Left click once in the First (Name) field and enter the person’s full first name (DO
NOT ENTER SPECIAL CHARACTERS)
16. Left click once in the Birth Date field and enter the person’s date of birth, in the
following format MM/DD/YYYY
The age is populated by the system automatically
17. Left click once in the Birth Sex field and select the person’s sex
18. Left click once in the Street 1 field of the Address Billing section and enter the
person's billing address.
This address is where a billing statement can be mailed to the person, if this is
the person’s physical address complete Billing address fields only. If the
person’s billing address is not the physical address, such as, a PO BOX,
complete the Address Secondary section.
Enter the person’s address in the following format: 1234 My Lane Ave Apt 1
in the Street 1 field
DO NOT enter special characters in a person’s address fields, such as,
periods, or # signs.
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19. Left click once in the Zip field and enter the person’s zip code in the following
format:
77591
Using the Tab key on the keyboard, tab through the Zip, so the system will
populate the City, State, County, and Country automatically
20. Left click once on the down arrow next to the Preferred Contact field and select the
correct contact preference for the person, by asking
o What is the best way to contact you?
21. Left click once on the down arrow of the Notifications field and select the preferred
notification method the patient would like to be contracted.
22. Left click once in the any of the following and enter the person’s Contact Methods,
by asking
o What is the best way to contact you?
o Required: Home Phone
Cell Phone
NOTE: A N/A option checkbox is available if a required field cannot not be collected,
due to the person not having what is required.
o Optional:
Day Phone
Alternate Phone
Secondary Phone
For each contact method, the area code is populated by the system automatically
Users can also re-sequence the telephone numbers and email in any order the patient
prefers to be contacted first.
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Left click once on title of the Number/Address field of the Contact Method
needed to be re-sequence and left click once on the up or down blue arrows to
re-sequence as preferred
23. Left click once on the UDS red required category, located on the left hand side of the
Add Person Information screen, users must complete all required fields
Left click once on the down arrow of the Homeless Status field and select
once of the following:
Left click once on the down arrow of the Migrant Worker Status field and
select one of the following:
Left click once on the down arrow of the Language Barrier field and select
one of the following:
Left click once on the down arrow of the Veteran Status field and select one
of the following:
NEXTGEN PM
SCHEDULING AN APPOINTMENT
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24. Left click once on OK, on the Add Person Information screen
The person information will now display on the add appointment screen.
In the Description field, the person’s last name and first name displays,
this description displays on the resource’s schedule in the specific time
slot selected in the daily and multi-view option
NEXTGEN PM
SCHEDULING AN APPOINTMENT
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25. Left click once in the Details field to add any other important information for call
center, nursing and or providers such as the following:
Patient needs transportation
o Send task to call center to add patient to transportation list
Patient on pain contract
26. Left click once in the Translator Needed field and enter a language of the person
who needs the translator
Enter exact language as listed below or the word No, if the person does not
need a translator: Sign Language
Spanish
Vietnamese
Any other language
27. Left click once in the Insurance (Yes/No) field and enter in the following:
Yes
Patient’s appointment is covered by insurance
No
Patient’s appointment will not be covered or does not have insurance
28. Confirm a resource displays in the Rendering Physician field. This could be a
generic resource like “Medical Walk-in”
APPOINTMENT REMINDER (EDI PATIENT PREFERENCE)
29. After creating the appointment, but before selecting OK, left click once on the
“Add-Ons” option on the menu bar and select EDI Patient Preference. The
NextGen EDI Patient Preference pop-up will display
NEXTGEN PM
SCHEDULING AN APPOINTMENT
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30. Left click once in the checkbox to select a preference in the Contact Option/Order
section
Phone Call Reminder (unless patient opts-out, all reminders are defaulted to phone
call)
o Select this option if patient prefers a phone call voice reminder
o Select the down arrow to select a phone number patient would like to
receive the reminder
Text Message Reminder
o Select this option if patient prefers to receive a text
o Select the down arrow to select a phone number patient would like to
receive the reminder
Email Reminder
o Select this option if patient prefers to receive an email
o Select the down arrow to select a phone number patient would like to
receive the reminder
Opt-out
o Select this option if patient prefers to not receive a reminder
31. Left click once on Save to save the selection
Changes will not save unless the Save button is selected
Other options:
Reload – returns options to previously selected prior to saving
Reset – returns options to practice default – phone call voice
reminder
Cancel – cancels current window and closes
32. Left click once on OK to complete scheduling the appointment, scheduling conflicts
may appear, if scheduling conflicts display, continue to Scheduling Conflicts section.
NOTE: A reminder tab within the Add or Edit Appointment window is available
to review all patient reminders after the latest 5.9 version upgrade
NEXTGEN PM
SCHEDULING AN APPOINTMENT
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SCHEDULING CONFLICTS
Confirm no warnings display after the appointment is scheduled
A warning is displayed when an appointment conflict is made, such as,
when a dental event is being scheduled with a medical provider or when
an appointment is scheduled on a day the provider is out of the office
33. Left click once on Cancel on the Scheduling Conflicts screen to be able to make
changes as needed
34. Left click OK on the Scheduling Conflicts screen to proceed, the Appointment
Confirmation will display
NEXTGEN PM
SCHEDULING AN APPOINTMENT
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35. Confirm the appointment with the person
Patient Information: Name, Address, Phone Numbers,
Appointment Information: Date, Time, Event, Location, and Resource
PERSON IS LISTED IN MATCHING RECORDS
If user determines the person is listed in Matching Records list, meaning the
person exists in the database
36. Confirm the person listed is the correct person by verifying the last name, first name,
and date of birth
37. Left click once on the person’s last name to highlight and make active within the
Matching Records result list
38. Left click once on Open, the Update Person Information screen displays
Alerts may display, read carefully and take any action as applicable
NEXTGEN PM
SCHEDULING AN APPOINTMENT
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39. Confirm or update the following sections of the person’s chart:
o Billing Address
o Contact Information
Users can also re-sequence the telephone numbers and email in any order
the patient prefers to be contacted first.
40. Follow all steps in the “Person NOT LISTED in Matching Records” section of this
document to complete scheduling an appointment.
41. The appointment will display with person/patient’s Last Name, First Name, Event (type of
appointment) on Daily and Last Name, First Name, Event in abbreviations in the Multi-View
NEXTGEN PM
CONFIRMING AN APPOINTMENT
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Purpose:
To inform the patient when, where, and what type of an appointment they have
scheduled
1. Complete “Getting Started with NextGen - How to Access, Login and Exit the NextGen
Application” process
2. Understand “Getting Started with PM - Common NextGen PM Elements”
3. Complete “Scheduling an Appointment” process
I. APPOINTMENT LOOKUP
4. Left click once on the Appointment Lookup icon, the Appointment Lookup
screen displays
5. Left click once in the Last (name) field and enter the person’s last name
6. Left click once in the Birth Date field and enter the person’s date of birth
7. Left click once on the Find button to display a search result of Matching Records of all
persons with the same last name and date of birth
NOTE: The less search criteria the user enters, the more person search result will display.
If person is not listed based on search ALWAYS perform a double search by removing
NEXTGEN PM
CONFIRMING AN APPOINTMENT
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data from a field. Ex: Only enter a last name without a DOB or enter a DOB without a last
name.
Review each result in the matching records list and determine if the person is
listed
PM distinguishes between a person and patients. A Person does not have
a chart and a Patient has a chart;.
Person (displayed with a globe next to the name): A person is an
individual who has or will not receive medical/dental services. Users may
enter them in the system as the parent of a child or as the insurance
guarantor. A person may also be an individual who has made an
appointment to be seen for the first time and has not yet been seen.
Patient (displayed with a chart next to the name): A patient with a
chart receives medical/dental services. A patient is considered a “person”
before the chart is created.
II. PERSON NOT LISTED IN APPOINTMENT LIST FIELD
If users determine the person is not listed in Appointment List field, this means -
there are no past or future appointments for this patient. Inform patient there is no
appointment, but an appointment can be made today by following the “Scheduling
An Appointment” process
III. PERSON IS LISTED IN APPOINTMENT LIST FIELD
If user determines the person is listed in the Appointment List field
8. Confirm the searched person is the correct person, by verifying the last name, first name, and
date of birth
NEXTGEN PM
CONFIRMING AN APPOINTMENT
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9. Confirm the Date/Time
4. Confirm Patient
5. Confirm Event
6. Confirm Resource
7. Confirm Location
APPOINTMENT REMINDERS o CHW has systems in place to send appointment reminders 48 hours prior to an
appointment based on the patient’s preference. (keep in mind, an appointment
must be pre-scheduled 48 hours prior to the reminder sent)
o NOTE: A reminder tab within the Add or Edit Appointment window is available
to review all patient reminders after the latest 5.9 version upgrade
8. Left click once on Open to access the Edit Appointment window
9. Left click once on the Reminder tab located on the bottom right of the Edit Appointment
window
NEXTGEN PM
CONFIRMING AN APPOINTMENT
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NEXTGEN PM
CANCELING AN APPOINTMENT
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Purpose:
To accurately cancel an appointment that was previously scheduled for a person
1. Complete “Getting Started with NextGen - How to Access, Login and Exit the NextGen
Application” process
2. Understand “Getting Started with PM - Common NextGen PM Elements”
3. Complete “Confirming an Appointment” process
I. APPOINTMENT LOOKUP
4. Left click once on the Appointment Lookup icon, the Appointment Lookup
screen displays
5. Left click once in the Last (name) field and enter the person’s last name
6. Left click once in the Birth Date field and enter the person’s date of birth
7. Left click once on the Find button to display a search result of Matching Records of all
persons with the same last name and date of birth
NOTE: The less search criteria the user enters, the more person search result will
display. If person is not listed based on search ALWAYS perform a double search by
removing data from a field. Ex: Only enter a last name without a DOB or enter a
DOB without a last name.
Review each result in the matching records list and determine if the person is
listed
NEXTGEN PM
CANCELING AN APPOINTMENT
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PM distinguishes between a person and patients. A Person does not have
a chart and a Patient has a chart;.
Person (displayed with a globe next to the name): A person is an
individual who has or will not receive medical/dental services. Users may
enter them in the system as the parent of a child or as the insurance
guarantor. A person may also be an individual who has made an
appointment to be seen for the first time and has not yet been seen.
Patient (displayed with a chart next to the name): A patient with a
chart receives medical/dental services. A patient is considered a “person”
before the chart is created.
II. PERSON NOT LISTED IN APPOINTMENT LIST FIELD
If user determines the person is not listed in Appointment List field, this means -
there are no past or future appointments for this patient. Inform patient that there
is no appointment, but an appointment can be made today by following the
“Scheduling An Appointment” process
III. PERSON IS LISTED IN APPOINTMENT LIST FIELD
If user determines the person is listed in the Appointment List field
8. Confirm the searched person is the correct person by verifying the last name, first name,
and date of birth
NEXTGEN PM
CANCELING AN APPOINTMENT
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9. Confirm the Date/Time
10. Confirm Patient
11. Confirm Event
12. Confirm Resource
13. Confirm Location
14. Confirm Status
Expected
Kept – NEVER cancel
No Show – NEVER cancel
15. Left click once on the appointment to highlight which appointment the patient is referring
to
10. Left click once on Open, the Edit Appointment screen displays
NEXTGEN PM
CANCELING AN APPOINTMENT
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11. Confirm all appointment information with patient
If appointment needs to be canceled per patient request, provider request and/or
scheduling error confirm and/or inform patient of reason for canceling
IV. CANCELING AN APPOINTMENT
All CHW appointments are cancelled and NOT re-scheduled.
12. Left click once in the Canceled checkbox to cancel the appointment
13. Left click once on the down arrow of the Reason field and select a reason for cancelation
14. Follow the “Scheduling An Appointment” process to schedule a new appointment to
replace the cancelled appointment
15. Continue to next patient
NEXTGEN PM Patient Services
DETERMINING ELIGIBILITY
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Purpose:
Users will determine eligibility prior to checking – in a patient. This step secures
access for services rendered by a patient.
Definition:
A prerequisite met by the patient to access services provided by Coastal Health &
Wellness
1. Complete “Getting Started with NextGen - How to Access, Login and Exit the NextGen
Application” process
2. Understand “Getting Started with PM - Common NextGen PM Elements”
I. PERSON LOOKUP
3. Left click once on , to search for a person in the system, the People Lookup screen
displays
4. Left click once in the Last (name) field and enter the person’s last name
5. Left click once in the Birth Date field and enter the person’s date of birth
6. Left click once on the Find button to display a search result of Matching Records of all
persons with the same last name and date of birth
NOTE: The less search criteria the user enters, the more person search result will
display. If person is not listed based on search ALWAYS perform a double search
by removing data from a field. Ex: Only enter a last name without a DOB or enter
a DOB without a last name.
Review each result in the matching records list and determine if the person is
listed
PM distinguishes between a person and patients. A Person does not have
a chart and a Patient has a chart;.
Person (displayed with a globe next to the name): A person is an
individual who has or will not receive medical/dental services. Users may
enter them in the system as the parent of a child or as the insurance
guarantor. A person may also be an individual who has made an
appointment to be seen for the first time and has not yet been seen.
NEXTGEN PM Patient Services
DETERMINING ELIGIBILITY
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Patient (displayed with a chart next to the name): A patient with a
chart receives medical/dental services. A patient is considered a “person”
before the chart is created.
II. PERSON NOT LISTED IN MATCHING RECORDS
If the user determines the person is not listed in matching records list, this means
– the person does not exist in the database. The person has the following options:
YES
become a patient today
NO
Prefer to return another day
DOES THE PATIENT HAVE HEALTHCARE COVERAGE?
INSURANCE, CONTRACT, MEDICAID, OR MEDICARE
Yes, I have coverage No, I do not have coverage Yes, I have coverage No, I do not have
coverage
Does the person have
their insurance card or a
contract eligibility form?
Add required patient
information to create a
patient chart, “Creating
and Managing Charts”
process, Financial
Screening section
If during walk-in hours -
Verify coverage through
ClaimRemedi (see
document
“ClaimRemedi”)
o Add to walk-in schedule
Check-in process
If not walk-in hours –
Hand the person the Checklist for
Financial Screening and Application for
Discounted Services to be filled out
Discuss the required documents with
the person
o If person does not have required
documents today follow Prefer to
return another day columns
o OR Offer to “Waive” financial
screening and collect required fee
Communicate to the person to complete
the Application for Discounted Services
Ask the person to sit in the Financial
Screening waiting area and a Patient
Services Specialist will do a face to face
interview to determine financial
screening.
Send a task to the financial screeners,
Refer persons with
coverage to call the
Contact Center to
schedule an
appointment or to return
during walk-in hours
Ask the person to bring
in a copy of their
insurance/coverage card
Close out all screens
Continue with next
person
Hand the person the
Checklist for
Financial Screening
and Application for
Discounted Services
to be filled out and
they can return with
all supporting
documents at their
convenience
Close out all screens
Continue with next
person
Frito, Chips 123 my avenue 6/11/1971 Frito, Corn 123 my avenue 6/11/1971 Frito, Lays 123 my avenue 6/11/1971
NEXTGEN PM Patient Services
DETERMINING ELIGIBILITY
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Refer to Contact Center
to schedule an
appointment
see “Tasking” process
Close out all screens
Continue with next person
III. PERSON IS LISTED IN MATCHING RECORDS
If user determines the person is listed in Matching Records list
Confirm the searched person, is the correct person, by verifying the last
name, first name, and date of birth
7.Left click once on the person’s last name to highlight the person selected in the Matching
Records result list
8. Left click once on Open, the Update Patient Information screen displays
IV. PERSON WITH HEALTHCARE COVERAGE
NEXTGEN PM Patient Services
DETERMINING ELIGIBILITY
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9. Ask the person if they are covered by any Insurance, Medicare, Medicaid, or Contract
COMMERCIAL INSURANCE,
MEDICARE, MEDICAID,
CONTRACTS
CONTRACTS (CONTINUED STEP)
NO COVERAGE
Continue to step #9,
accessing all insurances/contracts
Continue to step #11,
accessing the Employer
tab, to access all
contracts
Continue to step #13 ,
accessing the UDS tab to
access the Sliding Fee
Schedule Verification and
Family Information
10. Verify Available Insurances, located at the bottom of the Update Patient Information
screen.
Use the scroll button of the Available Insurance screen, to view all
insurance/contracts listed
NEXTGEN PM Patient Services
DETERMINING ELIGIBILITY
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PATIENT HAS HEALTHCARE COVERAGE
COMMERCIAL INSURANCE, MEDICARE, MEDICAID, & CONTRACTS
Person’s with coverage CAN ALSO be financially screened
Financial Screening should occur prior to a patient’s appointment
If insurance is NOT LISTED OR
Insurance is EXPIRED
If Person is eligible to be financially screened
Verify coverage through ClaimRemedi (see
document “ClaimRemedi”)
Follow steps in “Creating and Managing Charts”
process, Insurance section, on how to add/update
an insurance to a person’s chart, of the Insurance
Maintenance screen
Continue to step #13, UDS tab, to access and
verify the Sliding Fee Schedule Verification and
Family Information data (SFSV & FI)
Verify if person has a current SFSV & FI, does
not have a SFVI & FI or SFVI & FI is expired
Offer person to be financially screened
o If yes – see step “if person is eligible to
be financially screened”
o If no – follow “Check-in with
AutoFlow” process
Collect appropriate co-pays
Verify any current listed SFSV & FI Expiration
Date
Add/update the SFSV & FI by following starting
with the “Creating and Managing Charts” process,
Financial Screening section, Family Information
section
If insurance is LISTED AND
Insurance is NOT EXPIRED
If Person is eligible to be financially screened
Verify information in “Creating and Managing
Charts” process, Benefit Info “Eligibility and
Benefit Information History” and Note section of
the Detail Tab of the Insurance Maintenance
screen to determine verification of insurance and
the ability to check-in patient
Continue to step #13, UDS tab, to access and
verify the Sliding Fee Schedule Verification and
Family Information data (SFSV & FI)
Verify if person has a current SFSV & FI, does
not have a SFVI & FI or SFVI & FI is expired
Offer person to be financially screened
o If yes – see step “if person is eligible to
be financially screened”
o If no – follow “Check-in with
AutoFlow” process
Collect appropriate co-pays
Verify any current listed SFSV & FI Expiration
Date
Add/update the SFSV & FI by following starting
with the “Creating and Managing Charts” process,
Financial Screening section, Family Information
section
**MEDICAID clients must have CHW as PCP**
**CONTRACT clients must also have an employer entered, follow “Financial Screening” process, Employer
section** And a required mini registration form must be collected from these agencies
11. Close any Insurance Maintenance screens to return to the Update Patient Information screen
NEXTGEN PM Patient Services
DETERMINING ELIGIBILITY
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EMPLOYER TAB
12. Left click once on the Employer section of the Update Patient Information screen, to access
the list of Contracts
13. Request the mini-registration form from the agency, from the patient
NEXTGEN PM Patient Services
DETERMINING ELIGIBILITY
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CONTRACTS
Person’s with coverage CAN ALSO be financially screened
Financial Screening should occur prior to a patient’s appointment
If person has mini-registration form If Person is eligible to be financially screened
Scan the mini-registration form, follow
“Creating and Managing Charts” process,
Scanning Documents section
Follow steps in “Financial Screening”
process, Insurance section, on how to
add/update an insurance to a person’s chart,
of the Insurance Maintenance screen
Continue to step #13, UDS tab, to access and
verify the Sliding Fee Schedule Verification
and Family Information data (SFSV & FI)
Verify if person has a current SFSV & FI,
does not have a SFVI & FI or SFVI & FI is
expired
Offer person to be financially screened
o If yes – see step “if person is eligible
to be financially screened”
o If no – follow “Check-in with
AutoFlow” process
Collect appropriate co-pays
Verify any current listed SFSV & FI
Expiration Date
Add/update the SFSV & FI by following
starting with the “Creating and Managing Charts”
process, Financial Screening section, Family
Information section
If person DOES NOT have mini-registration form
Obtain the mini-registration from the agency by calling for a faxed copy
Patient must wait for collection of mini-registration form
Follow – the same steps as indicated in section “If person has mini-registration form”
V. PERSON WITHOUT HEALTHCARE COVERAGE
14. Left click once on the UDS section, to access Sliding Fee Schedule Verification and Family
Information (SFSV & FI)
NEXTGEN PM Patient Services
DETERMINING ELIGIBILITY
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15. Confirm the Sliding Fee Schedule Verification and Family Information is not expired by
verifying the Expiration Date
EXPIRED NOT EXPIRED
Communicate to the person that if they would like to receive
services today, they must update their eligibility and go
through financial screening
If person agrees and has all required documents
Hand person the Checklist for Financial Screening and
Application for Discounted Services
Communicate to the person to complete the Application
for Discounted Services
Ask the person to sit in the Financial Screening waiting
area and a Patient Services Specialist will call the person
and do a face to face interview to determine financial
screening.
Send a task to the financial screeners, see “Tasking”
process
If person does not agree or does not have required documents
Hand the person the Checklist and Application for
Discounted Services and they can return with all
supporting documents at their convenience
Continue to check-in patient using the
“Check-in with AutoFlow” Process
16. Close all screens and continue to the next person
NEXTGEN PM Patient Services
TASKING
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Purpose:
A means of communication from the front desk users to the financial screeners.
Required when a person requests to be financial screened
Definition:
The act of assigning a user a task assignment to perform electronically
1. Complete “Getting Started with NextGen - How to Access, Login and Exit the NextGen
Application” process
2. Understand “Getting Started with PM - Common NextGen PM Elements”
I. CREATING A TASK
3. Left click once on Tasks from the menu bar, the shortcut menu will display
4. Left click once on Create Task, the Add Task screen displays
NEXTGEN PM Patient Services
TASKING
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5. Creating tasks will be specific to each department, see task list at the end of this document
6. Left click once on the down arrow of the Task Type field, a drop down menu will display
with tasks that can be assigned, select the appropriate task
7. Press the Tab key once on the key board, the Status, Priority and the Assigned To field
will auto populate according to the Task selected
NEXTGEN PM Patient Services
TASKING
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8. Left click once in the Subject field and document appointment or walk-in time, provider,
patient last name and any other language than English
a. Example:
Appointments should be entered - 1:00 Tigrett, Appointment time and provider
Walk-in patients should be entered - 10:08 Wilson, Walk-in time and patient last
name
Add “SP” after a provider name or patient name to indicate Spanish speaker
o Vietnamese and Sign Language is also a majority of other translations needed
9. Left click once in the Details field and always document the following:
a. Type in the patient’s full name
b. Type in the patient’s DOB
c. Type in the appointment information:
o Resource Name
o Time
10. Left click once on the “Ctrl-Shift-D adds current date/time and signature” hyperlink
a. This documents the date and time users are documenting the task
11. Left click once in the Start Date field and enter the date the task is being created
12. Left click once in the Follow Up Dt field and enter the date the task is being created
13. Left click once in the Due Date field and enter the date the task is being created
14. Leave the Expiration Dt blank
15. Left click once on OK, the task is sent to all that is assigned to
II. RETRIEVING TASKS
WORKLOG MANAGER
16. Left click once on Worklog icon on the PM toolbar
NEXTGEN PM Patient Services
TASKING
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17. Left click once on the down arrow of the Task Type field and select the tasks types to view
a. If scheduled to be in Galveston as the financial screener select both
Galveston Appointment
Galveston Walk-In
If scheduled to be in Texas City as the financial screener select both
Texas City Appointment
Texas City Walk-In
18. Left click once on the down arrow of the Status field and select Not started
19. Left click on Find, a list of tasks will display in the Task List field, based on the above
filters
NEXTGEN PM Patient Services
TASKING
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Sort the tasks by priority and subject, first come first served, bases
Appointments must be financially screened prior to walk-ins
20. Double left click on the task to complete, the Edit Task screen will display
21. Left click once on the down arrow of the Status field and select In Progress
This status notifies other users the patient has been selected to be called
Physically call the patient to the financially screen area
NEXTGEN PM Patient Services
TASKING
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22. Left click once on the down arrow of the Status field and select Completed, once the patient
arrives at the financial screening area
This status notifies other users the patient is being financially screened and no longer
waiting
23. Left click once in the Completion Reason field and select one of the following
a. Completed – patient was successfully financially screened
b. Patient Left W/O Financial Screening – patient left without being financially
screened
24. Left click once on OK and the task is complete and should not be listed within the worklog
as “not stated” status
TASK TYPES
TASK REASON
Galveston Appointment For Patients with appointments in need of
financial screening in Galveston
Galveston Walk-In For Patients without appointments in need of
financial screening in Galveston
Texas City Appointment For Patients with appointments in need of
financial screening in Texas City
Texas City Walk-In For Patients without appointments in need of
financial screening in Texas City
WORKLOG MANAGER ADDED FIELDS
o Filters can be utilized to search for previously completed tasks
o Utilize the Task Type, Status, and the Create Dates fields to filter searches
NEXTGEN PM Patient Services
CREATING AND MANAGING CHARTS
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Definition:
Financial screening is conducted to evaluate if a person is eligible for discounted rate
for services provided by CHW. Users must complete all required demographics,
insurance, family size, income and UDS fields.
1. Complete “Getting Started with NextGen - How to Access, Login and Exit the NextGen
Application” process
2. Understand “Getting Started with PM - Common NextGen PM Elements”
I. COLLECTING REQUIRED DOCUMENTATION
3. Collect the following information to complete financial screening
Application for Discounted Services, if applicable
Proof of Identification
Proof of Income
Proof of Address
II. SEARCHING PERSONS/PATIENTS
4. Left click once on , to search for a person in the system, the Patient Lookup screen
displays
5. Left click once in the Last name field and enter the person’s last name
6. Left click once in the Birth Date field and enter the person’s date of birth
7. Left click once on the Find button to display a search result of Matching Records of all persons
with the same last name and date of birth
NOTE: The less search criteria the user enters, the more person search result will
display. If person is not listed based on search ALWAYS perform a double search by
removing data from a field. Ex: Only enter a last name without a DOB or enter a DOB
without a last name.
Review each result in the matching records list and determine if the person is listed
PM distinguishes between a person and patients. A Person does not have a chart
and a Patient has a chart;.
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Person (displayed with a globe next to the name): A person is an
individual who has or will not receive medical/dental services. Users may enter
them in the system as the parent of a child or as the insurance guarantor. A
person may also be an individual who has made an appointment to be seen for
the first time and has not yet been seen.
Patient (displayed with a chart next to the name): A patient with a chart
receives medical/dental services. A patient is considered a “person” before the
chart is created.
III. PERSON NOT LISTED IN MATCHING RECORDS
o If the user determines the person is not listed in matching records list, this means – the
person does not exist in the database.
8. Left click on New button located on the Patient Lookup screen, to add a new person, the Add
Patient Information screen displays with the Demographics category defaulted open.
Some fields will be required “IN RED” but most of the person’s information will
always need to completed or confirmed
9. Left click once in the Last (Name) field and enter the person’s full last name (DO NOT ENTER
SPECIAL CHARACTERS)
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10. Left click once in the First (Name) field and enter the person’s full first name (DO NOT
ENTER SPECIAL CHARACTERS)
11. Left click once in the SSN (Social Security Number) field and enter the person’s SSN.
12. Left click once in the Birth Date field and enter the person’s date of birth, in the following
format MM/DD/YYYY
The age is populated by the system automatically
13. Left click once in the Birth Sex field and select the person’s sex
ADDRESS
14. Left click once in the Street 1 field of the Address Billing section and enter the person's billing
address.
This address is where a billing statement can be mailed to the person, if this is the
person’s physical address complete Billing address fields only. If the person’s billing
address is not the physical address, such as, a PO BOX, complete the Address
Secondary section as well.
Enter the person’s address in the following format: 1234 My Lane Ave Apt 1 in the
Street 1 field
DO NOT enter special characters in a person’s address fields, such as, periods, or
# signs.
15. Left click once in the Zip field and enter the person’s zip code in the following format:
77591
Using the Tab key on the keyboard, tab through the Zip, so the system will populate
the City, State, County, and Country automatically
DEMOGRAPHICS
16. Left click once on the down arrow of the Marital Status field and select one of the following
17. Left click once on the down arrow of the Student Status and select one of the following
18. Left click once on the down arrow of the Pref Language and select a preferred language the
person prefers to speak
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19. Left click once on the down arrow of the Primary Care Provider and select a primary
“medical” provider the patient will become a patient with, if the patient does not know at the
time of financial screening select the “…………………….” dummy.
20. Left click once on the down arrow of the Primary Dental Provider and select a primary
“dental” provider the person will become a patient with, if the patient does not know at the time
of financial screening select the “…………………….” dummy.
CONTACT INFORMATION
21. Left click once in any of the Number/Address fields for each Contact Method, by asking
o What is the best way to contact you?
o Required: Home Phone
Cell Phone
NOTE: A N/A option checkbox is available if a required field cannot not be collected, due to
the person not having what is required. This checkbox will grey-out the required fields.
o Optional:
Day Phone
Alternate Phone
Secondary Phone
For each contact method, the area code is self-populated by the system automatically
Users can also re-sequence the telephone numbers and email in any order the patient prefers to
be contacted first.
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Left click once on title of the Number/Address field of the Contact Method needed to
be re-sequence and left click once on the up or down blue arrows to re-sequence as
preferred
22. Left click once on the down arrow next to the Preferred Contact field and select the correct
contact preference for the person
23. Left click once on the down arrow of the Notifications field and select the preferred notification
method the patient would like to be contracted.
IV. UDS
24. Left click once the UDS red required category located on the left hand side of the Add Patient
Information screen, users must complete all required fields, but not limited to the following
25. Left click once on the down arrow of the Homeless Status field and select once of the
following:
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26. Left click once on the down arrow of the Migrant Worker Status field and select one of the
following:
27. Left click once on the down arrow of the Language Barrier field and select one of the
following:
28. Left click once on the down arrow next to the Race field and select one of the following:
NOTE: If a patient has documented/stated more than one race select the “More than one
Race” option NOT multiple races
29. Left click once on the down arrow next to the Ethnicity field and select one of the following:
30. Left click once on the down arrow of the Veteran Status field and select one of the following:
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31. Left click once in the Primary Medical Coverage field and type in the first letter of the
primary medical insurance name. An Insurance List will display with insurance names that
start with the first letter in the Primary Medical Coverage field, using the scroll button, search
and select the medical insurance
32. Left click once in the Consent to Treat checkbox to indicate a signature was obtained on the
“Patient Acknowledgment Form” section Consent to Treatment
33. Left click once in the Consent to Treat Date field and enter the date the person signed the
“Patient Acknowledgment Form” section Consent to Treatment
SELF PAY
34. Left click once in the self-pay check box if:
Patient is underinsured and is eligible for a discounted rate, regardless if patient has
coverage
Patient is uninsured and is eligible for a discounted rate and has NO coverage
HEAD OF HOUSEHOLD
Perform this task for ONLY patients determined eligible for a discounted rate. See also
section Relations/Role category, Head of Household
35. Left click once on the manila folder of the Head of Household section
SEE SECTION RELATIONS/ROLES/CONTACT/GUARANTOR/HEAD OF
HOUSEHOLD OF THIS DOCUMENT TO COMPLETE
V. CHART DETAILS
36. Left click once on Chart Details red required category located on the left hand side of the Add
Patient Information screen, users must complete all required fields, but not limited to the
following
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TVFC FORM DATE (TVFC Eligibility Form Memo – must be completed)
37. Left click once in the TVFC Form Date field and enter the date the patient became eligible
Enter just a date: mm/dd/yy - for all patients WHO ARE eligible for Texas
Vaccines – based on the information collected on the TVFC form
Leave blank – if a patient is determined NOT eligible for TVFC immunizations
MARKETING PLANS
38. Left click once in the down arrow of the Marketing Plan field, a list of options will display.
39. Left click once on the best option. If the option is not available, select option “other” and enter
the response in the Marketing Comments field. For clarification or detail of any option listed
above, use the Marketing Comments for this response.
For example:
o If the Advertising option is selected and the patient stated they saw a
billboard, enter the word billboard in the Marketing Comments field.
o If the Contracted Facility option is selected and the patient states they were
referred by a contracted site, such as, Bay Area Recovery, enter Bay Area
Recovery in the Marketing Comments field.
o Etc…
VI. INSURANCE
ONLY for person's with Commercial Insurance, Medicare, Medicaid and Contracts
Follow ClaimRemedi process
If no insurance, continue to Sliding Fee Schedule Verification, to document financial
screening
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ADDING AN INSURANCE
40. Left click once on Norton, of the Available Insurance grid located at the bottom of
the Add Patient Information screen, to access the shortcut menu
41. Left click once on New Insurance, the Payer Lookup screen displays
42. . Left click once in the Payer Name field, type in the first letter of the insurance or the whole
name of the insurance and click once on Find
A Payer List will display with insurance names that start with the first letter that
was typed in the Payer Name field
If the insurance presented by the patient is not available, send email with all
pertinent information by email to the insurance verification department.
43. Double left click on the name of the insurance to select the insurance, the Insurance
Maintenance screen displays
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INSURANCE MAINTENANCE
o DETAIL TAB
44. Confirm the Insurance selected is correct in the Plan Name field
45. Left click once in the HIC/Policy Nbr field and enter a policy number
If the policy number is a social security number user can use the, Ctrl S command
and it will copy the person's social security number from the PM chart
46. Left click once in the Group Number field to enter a group number, if applicable
47. Left click once in the checkbox next to Active to activate the insurance, it will indicate active
with a check mark
48. Left click once in the Effective Date field and enter the date the insurance will be effective
49. Left click once in the Expiration Date field and enter the date the insurance verification will
expire
50. Left click once in the Note and enter pertinent information related to the verification of the
insurance
51. Left click once on the Amount radio button next to indicate the Co-Payment
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52. Left click once in the Co-Payment field to enter a co-pay amount that is indicated on the
person's insurance card
53. Left click once in the Deductible field, during the ClaimRemedi process, a deductible amount
should display in the report, enter this amount here
O DETAIL – 2 (Patient name clarification on insurance card)
54. Left click once on the Detail - 2 Tab next to the Detail Tab
This tab is designed to enter a different name, DOB or sex listed on the patient
insurance card.
Left click once in any of the fields and document any different information listed on
the patients’ insurance card.
Example:
Frito-Pie Chips is what is displayed on the Medicare card, but the clinic is
financially screening Frito Chips because that is what is on the ID
O INS CARDS TAB (scanning insurance cards)
55. Left click once on the Ins Cards Tab next to the Detail-2 Tab, in this tab the insurance card
will be scanned
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56. Left click once on Norton, to access the shortcut menu \
57. Left click once on New Insurance Card..., the scanning device input screen will display
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57. Confirm the Description field displays the correct name of the insurance and the date the
insurance card is being scanned
58. Left click once on Norton to the left of the Front field, to access the shortcut menu
Insert card into scanner appropriately according to the scanner settings, to scan the front
of the insurance card
Confirm the correct scanner is selected with a check mark indicator
59. Left click once on Acquire
The scanner will scan the card
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ADJUSTING THE SCANNED CARD
60. Left click once on Crop
A small cross will appear +
61. Left click once at the top left side of the insurance card, hold while dragging the curser to the
bottom right and release
The photo of the card will now only display what the user cropped
62. Left click once on the rotate left icon, the card will display right side up
Repeat steps for section Ins Card tab, to scan the Back side of the insurance card
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o BENEFITS INFO TAB
63. Left click once on the Norton button and select New to enter Eligibility and Benefits
information
It is expected that staff enter all pertinent insurance information in the following fields
o Spoke with:
Enter a specific person’s name as the person who you received the information
from
o Eligible for DOS
Select Yes or No
If “No” is selected enter a note in the “Reason NOT Eligible on DOS”
field. Example – adult who has Medicaid but today’s visit is for dental
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services and this patient’s coverage does not cover dental services. Also
select Type of Benefit as Medical Only
NOTE: Insurance should not be attached to the encounter if the insurance
does not cover the type of service.
o PCP Name
Enter the patient’s “PCP” Primary Care Provider’s name if not CHW
o Type of Benefit
Dental Only
Medical & Dental
Medical Only
o Specific Note Regarding COPAY and Deductible Information
Enter specific information regarding co-pay and/or deductible for the patient’s
coverage. Example – patient has met all co-pays for this calendar year or no need
to collect co-pay for today’s type of service.
o Pre-Authorization Required
Select Yes or No
If “Yes” is selected – save the Eligibility and Benefit Information
window and access the Authorizations tab
o AUTHORIZATIONS
64. Left click once on the Norton button and select New Authorization
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65. Left click once in the Authorization Code field and enter authorization number
66. Left click once in the Effective and Expiration Date fields and enter the appropriate dates
67. Left click once in the Nbr Encounters field and enter a total encounter numbers covered by the
authorization code
68. Left click once on OK on any open tab to return to the Insurance Maintenance screen.
69. Left click once on OK on the Insurance Maintenance screen to return to the Modify Patient
Information screen to view the newly entered insurance.
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Once an insurance has been added to a person’s chart , the insurance will become
available to attach to an encounter at Encounter Creation and a green check mark
will display to indicate that it is available
An insurance can be deactivated in this screen as well, by left clicking once on the
green arrow, the green arrow will disappear and the insurance is no longer available
when linking patients through relations, all insurance information is listed for all
patients linked.
For example, Patient58 (Child) (Patient) is covered by Aetna and Patient0516
(Parent) (Father) is not covered by Aetna, users will see Patient58 (Child)
(Patient) insurance(s) display in Patient0516 (Parent) (Father) insurance listings
when linked through relations
Users will need to remove the green check mark under the "Available" column from
the non-covered patient/parent/child insurance listing. This will unlink the insurance
and not be available for selection. Only patients covered by the insurance should
have the green check mark attached.
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An expired insurance will display with a red X on the file folder
VII. CREATING A CHART
For ALL new persons entered into NextGen, users must create a chart to continue
data entry. Data will not be saved for all other categories if a chart is not created
first. A warning will display stating data will not be saved without creating a chart.
70. Left click once on the button located on the bottom left of the Add Patient
Information screen, NextGen alert will displaying, “Are you sure you would like to create a
chart?”
71. Left click once on OK, a chart is now created, alerts may display and the system requires an
encounter to be created – this is hardcoded
Close out alerts
Cancel from encounter creation
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Return to completing the rest of the chart
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72. Left click once on the Patient Information tab
73. Left click once on the manilla file folder located to the left of the patient’s name and below the
Patient Informaiton tab, the Modify Patient Information screen displays
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VIII. PRIVACY
74. Left click once on the Privacy category located on the left hand side of the Modify Patient
Information screen
75. Left click once in the Privacy Notice Issued to Patient and enter a date in which the patient
was issued the Privacy Noticed as indicated in the Patient Acknowledgment Form
If patient is not present to sign – leave blank, the privacy alert will display when the patient
returns
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76. Left click once in the Privacy Notice Received from Patient field and enter a date in which the
patient signed the Patient Notice section of the Patient Acknowledgment form
If patient is not present to sign – leave blank, the privacy alert will display when the patient
returns
77. Left click once on the down arrow of the Privacy Notice Reason and select from the following:
78. Left click once in the Privacy Notice Notes field and enter any pertinent notes pertaining to
privacy notice information
IX. EMPLOYER (CONTRACTS COVERAGE ONLY)
79. Left click once on the Employer category, the category is ONLY for patients who are
covered by a contract.
See current list of contracts
Ask the person for a copy of the mini registration form on the contracted agency's
letter head, exception - Title V
If the person does not have the form contact the agency for a fax copy
This form will be scanned into the person's PM chart
If no contract needs to be added, continue to
Relations/Roles/Contact/Guarantor/Head of Household section
80. Left click once on Norton, to access the shortcut menu
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81. Left click once on New, the Employer Lookup screen displays
82. Left click once on Find, a list of current available contracts will display in the Matching
Records
83. Double left click on the contract the person is covered under, this action is only to add the
contract to the PM chart. At Encounter Creation, this contract will also need to be added as as
a Guarantor to invoice the contracted agency
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84. Confirm that at least an address is listed and left click once on OK, the contract will display in
the PM chart for selection at Encounter Creation
X. RELATIONS/ROLES/CONTACT/GUARANTOR/HEAD OF HOUSEHOLD
85. Left click once on Relations/Role category, this category is used to:
Link other family members in the same household
Document emergency contacts
Guarantors – who is responsible for balances accrued for services rendered
Head of Household – who finances are used to determine eligibility for a
discounted rate
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RELATIONSHIP
86. Left click once on Norton, to access the shortcut menu, in the Relationship grid
87. Left click once on New, the Relationship Lookup screen box will display, to search for the
head of household or a person that the head of household is financially responsible for
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88. Left click once in the Last (name) field and enter the person’s last name
89. Left click once in the Birth Date field and enter the person’s date of birth
90. Left click once on the Find button to display a search result of Matching Records of all
persons with the same last name and date of birth
NOTE: The less search criteria the user enters, the more person search result will display.
If person is not listed based on search ALWAYS perform a double search by removing
data from a field. Ex: Only enter a last name without a DOB or enter a DOB without a last
name.
Review each result in the matching records list and determine if the person is listed
PM distinguishes between a person and patients. A Person does not have a chart
and a Patient has a chart;.
Person (displayed with a globe next to the name): A person is an
individual who has or will not receive medical/dental services. Users may enter
them in the system as the parent of a child or as the insurance guarantor. A
person may also be an individual who has made an appointment to be seen for
the first time and has not yet been seen.
Patient (displayed with a chart next to the name): A patient with a chart
receives medical/dental services. A patient is considered a “person” before the
chart is created.
o Person not listed in Matching Records
If the user determines the person is not listed in matching records list, this means
– the person does not exist in the database.
91. Left click once on New to add a new person, the Add Relationship Information screen
displays with the Demographics tab defaulted open
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Some fields will be required “IN RED” but the following information will
always need to be completed or confirmed with any relations
Demographics category
Full Name (Last and First)
Relationship
Birth Date
Birth Sex
Address (Billing)
Race
Contact Information
92. Left click OK and the person will display in the Relationship grid
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o Person is listed in Matching Records
If user determines that the person is listed in Matching Records list
Confirm the searched person, is the correct person, by verifying the last name,
first name, and date of birth
93. Left click once on the person’s last name to highlight the person selected in the Matching
Records result list
94. Left click once on Open, the Modify Relationship Information screen displays
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95. Confirm the following and add a relationship if one does not exist.
Demographics category
Full Name (Last and First)
Relationship
Birth Date
Birth Sex
Address (Billing)
Race
Contact Information
96. Left click once on OK, to return to the Relations/Roles category and the person will display
in the grid
SUPPORT ROLE
97. Left click once on Norton, to access the shortcut menu, in the Support Role grid
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98. Left click once in the following fields and enter or select from list
Last
First
Relationship
Support Role
99. Left click once on OK, to return to the Relations/Roles category and the person will display
in the grid
GUARANTOR
100. Left click once on the Norton button below Guarantor section
101. Left click once on Person as Guarantor,
Never select Employer as a Guarantor in this section, Employers should ONLY be
attached as guarantors at encounter creation
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o SELF GUARANTOR
Any person age 18 years and older within their own chart, will be Self Guarantor. This
person is responsible for their own bill, a balance accrued for services rendered
102. Left click once on the Self button, the Self Guarantor will display in the Guarantor section
o NOT SELF GUARANTOR
Any person under 18 years of age must have an adult responsible for their bill, a balance
accrued for services rendered.
Once persons are attached through Relationship, these persons will display for selection
here
If user determines the person is not listed in the Matching Records list, add the person
through the Relationship section of this document
If user determines the person is listed in Matching Records list
Confirm the searched person, is the correct person, by verifying the last name,
first name, and date of birth
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103. Left click once on the person’s last name to highlight the person selected in the Matching
Records result list
104. Left click once on Open, the Modify Guarantor Information screen will display
There is no information to change on the Modify Guarantor Information screen,
these updates were performed through the Relationship section
***For those patients with a guarantor already attached, left clicking on the manila folder of the
guarantor field will auto populate the Modify Guarantor Information screen.
105. Left click once on Change
106. Left click once on Person and select from the Guarantor Lookup list
107. Left click once om OK to proceed
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HEAD OF HOUSEHOLD
108. Left click once on the manila file folder below Head of Household, the Head of Household
Lookup will display
o SELF HEAD OF HOUSEHOLD
Any person age 18 years and older who will be using their finances as determination for
eligibility for a discounted rate, will be Self Head of Household.
109. Left click once on the Self button, the Self Head of Household will display in the Head of
Household section
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o NOT SELF HEAD OF HOUSEHOLD
Any person who will utilize another adults finances to determine eligibility for a
discounted rate, will be Head of Household.
Once persons are attached through Relationship, these persons will display for selection
here
If user determines the person is not listed in the Matching Records list, add the person
through the Relationship section of this document
If user determines the person is listed in Matching Records list
Confirm the searched person, is the correct person, by verifying the last name,
first name, and date of birth
110. Left click once on the person’s last name to highlight the person selected in the Matching
Records result list
111. Left click once on Open, the Modify Head of Household Information will display
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There is no information to change on the Modify Head of Household Information
screen, these updates were performed through the Relationship section
***For those patients with a head of household already attached, left clicking on the manila
folder of the head of household field, will auto populate the Modify Head of Household
Information screen.
112. Left click once on Delete
113. Left click once on OK to confirm deletion of current Head of Household attached and
follow section Head of Household
114. Left click once on OK once the Head of Household is selected to proceed
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XI. ACCOUNTS
ONLY CREATE ACCOUNTS FOR HEAD OF HOUSEHOLDS
If person is not the head of household, return to the UDS section and attach head of
household information to complete
115. Left click once on the Account button to create the account for the head of household.
all other family members or anyone other than the head of household should NOT have
accounts. The head of household should be attached in the Relations/Role category also
attached in the UDS category \
116. Left click once on OK, on the Confirm create of account? screen.
An Account will only be created for the head of household
117. Left click once or confirm the Properties Tab is opened
Users can view the Account Demographics, Account Settings, and Family Information
Add the Family Information here
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FAMILY INFORMATION
118. Left click once on Norton, of the Family Information grid
119. Left click once on New, the Family Info screen displays
120. Left click on the up and down arrows under the Family Size field, to select the correct
family size
121. Left click once on in the Income field and enter the household income in whole dollar
amounts
122. Left click once on the down arrow of the Income Cycle field and select one of the
following:
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123. Left click once in the Verify Date field and enter today's date as the date the Family Size
and Income is verified
124. Left click once in the Effective Date field and enter today's date as the date the Family Size
and Income is effective
125. Left click once on the Expiration Date field and enter the expiration date, according to the
Sliding Fee Schedule Verification
SLIDING FEE SCHEDULE VERIFICATION
126. Left click once on Norton, under the Sliding Fee Schedule Verification, to access
the shortcut menu and left click once on New, the Sliding Fee Verification screen will
display
127. Left click once on the down arrow of the Sliding Fee Schedule field and select the correct
sliding fee verification schedule
CHW 1 Year Discount (year)
Complete financial screening
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CHW 6 Month Discount (year)
Unemployed, seeking employment
128. Left click once in the Effective Date field and enter today's date as the date the Sliding Fee
Schedule is effective
129. Left click once in the Expiration Date field and enter a date based on either the 1 year or 6
month date range of the Sliding Fee Schedule
130. Left click once on OK, on the Sliding Fee Verification screen, to return to the Family Info
screen
The Sliding Fee Schedule Verification will display
EXPIRING A FAMILY INFO AND SLIDING FEE SCHEDULE VERIFICATION
When updating non-expired Family Information and Sliding Fee Schedule Verification,
users must expire the Family Information by opening the current Family Information
and changing the expired date to yesterday’s date. This must be preformed prior to
adding a new Family Information and Sliding Fee Schedule Verification
131. Left click once on OK, on the Family Info screen to return to the Account, Family
Information will display
132. Left click once on the icon to exit the Account profile and return to the patient’s chart
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SLIDING FEE ALERT
o The Sliding Fee alert will not display as the user returns to the person’s chart. The chart
must be closed for the Sliding Fee alert to update.
o Sliding Fee alerts are real time, if the alert displays, the patient has a current Sliding Fee,
if the alert does not display, the Sliding Fee Schedule Verification and Family Income
has expired
o All sliding fee patient responsibility percentages will also display per encounter when an
encounter is created
XII. TAKING THE PATIENT’S PICTURE
133. Left click once on the Norton button of the Patient’s Picture field, located on the Patient
Information tab
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134. Left click once on New, the Scanning Device Input box displays
135. Left click once on Norton, under the Image box
136. Left click once on Acquire to take the patient’s picture
137. Adjust the camera to take the picture of the patient
Once the image is adjusted properly by viewing the image on the screen
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138. Left click once on Capture button, the patient’s picture will display
139. Left click once in the Selected Segment box
A small cross will appear +
140. Left click once in the Image box, starting with any part of the image that needs to be
cropped, hold while dragging the curser to the bottom right and release
The picture will now only display what was cropped in the Selected Segment box
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141. Left click once on OK on the Scanning Device Input and the person picture will display, in
the Patient Picture field
XIII. ACCESSING CHART NOTES
ACCESSING BUILT IN FORMS
142. Left click once on Clinical History/Notes Tab
143. Left click once on the Notes manila folder in the Chart Notes section
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144. Right click once in the white field of the Details field, to access the shortcut menu
145. Left click once on New, to access the Note...section
146. Left click once on Note, the Chart Notes screen displays with a prelisted documents
147. Left click once in the Subject field and type the current approved titles for each of the
prelisted documents
148. Confirm the Editor field displays Microsoft
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149. Left click once to highlight the form needed
150. Left click once on OK, the form will generate and open in a Microsoft Word format
o What and when is the Patient Acknowledgment Form required
Required for all patients seen through CHW
Financial Responsibility o Required at each visit, enter a date
o WAIVER – required for patients who decline financial
screening and do not have healthcare coverage.
Patient Rights, Responsibilities and Notice of Privacy Practices
o Required yearly or if changes to policy occur
Consent to Treatment
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o Required yearly or if changes to policy occur, enter a date
o Enter a description of legal representative if applicable
Financial Screening Outcome o Required ONLY for patients who are financially screened and
eligible for a discounted rate
o Enter a date
o Left click once in the Complete checkbox to indicate a completed
financial screening outcome
o Enter dates indicating length of time the financial screening is
effective to
o Enter a percentage of discount
o Enter a nominal fee or deposit amount
o What and when is the TVFC Eligibility Form required (refer to TVFC Eligibility
Form memo)
Required for all patients 18 and under
Enter a parent/guardian name on line 3
Enter dates and indicate by left clicking in any of the columns A-G check
boxes for table 5
Enter or Confirm Medicaid, CHIP, or Private Insurance is entered at the
bottom of the form
DO NOT SEAL THIS DOCUMENT (same document is used)
ACQUIRING SIGNATURES
151. Double left click in the electronic signature box on the form and the IntegiSign Desktop
screen displays
152. Left click once in the Signer Name field and type in the patient’s full name
153. Ask patient to sign on the electronic signature pad
o The electronic signature will appear in the electronic signature box on the form
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154. Left click once on OK on the IntegiSign Desktop screen and collect signatures for each
section of the documents as needed, including user signatures if required
155. Left click once on X of the Microsoft Word form to close, after all required signatures have
been captured, Microsoft Word will ask to save changes to form, left click Save, the
NextGen system will display
156. Left click once on Yes, on the NextGen pop up window to save document within the
Clinical/History/Notes tab
The latest form will appear in date order
SEALING NOTES
o Users are required to seal notes, if required specifically per form. Sealing a note will
prevent future editing of the form.
157. Right click once on the newly created note to display the shortcut menu
158. Left click once on Seal, the NextGen User Authentication screen will display
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159. Left click once in the Login ID field and enter your NextGen username
160. Left click once in the Password field and enter your NextGen password
161. Left click once on OK, a lock icon will display to the left of the date and note title
DOCUMENTING VERBAL NOTES
162. Follow steps in Accessing built in forms but select one of the blank forms to free text notes.
XIV. SCANNING DOCUMENTS
163. Left click once on the icon, to launch the Document Management database, a new
window will open
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CREATING A BATCH
164. Left click once on the icon, the Batch Information screen displays
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165. Confirm or select Scanner in the Acquire Profile field
166. Confirm the Secured to User field displays the current users name
167. Confirm all documents are ready to scan
168. Left click once on the Acquire button, the scanner configuration screen displays
169. Left click once on Scan, the documents will start scanning, the Document screen will
display
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o The last scanned page will always display first
VERIFYING THE SCANNED DOCUMENTS
170. Left click on the left and right arrows on the document toolbar, to scan
through the documents
Confirm all documents scanned correctly
If documents did not scan correctly, exit without saving and repeat all the steps
FILING THE SCANNED DOCUMENTS TO A PATIENT’S CHART
171. Left click once on the File Document icon, to file the scanned documents,
172. Left click once on the down arrow next to the Document Type field
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173. Left click once on App For Disc Serv & Supp Docs
174. Left click once the Norton icon of the File screen, to access the patient’s chart
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175. Left click on Access Active Patient, if the patient chart in PM is opened, select Access
Previous Patient for a listing of the last 5 charts accessed in PM
Select the correct patient
176. Left click once on the Application Date field and enter today’s date
177. Left click once on File, at the end of filing ALL documents in the current batch, a NextGen
screen, “There are no more documents in the batch. Would you like to post completed
documents” screen displays
NOTE: the File button will be selected for each document before the NextGen screen displays
to post the documents. Keep in mind, users are posting batches not individual documents
178. Left click once on Yes, the document management desktop will display
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179. Left click once on File from the menu bar, select Exit, the patient’ chart will display in PM
Documents filed under the App For Disc Serv & Supp Docs document type will display in
PM, in the document management manila folder, in the Clinical History/Notes Tab of the
patient’s chart
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Purpose:
A required process to collect and process payments. This action is required prior to
entering any payments in the payment transaction window.
Definition:
A batch is the total accumulation of captured transactions that is stored in the system.
Each batch must be posted at the end of each business day by any user collecting
payments.
1. Complete “Getting Started with NextGen - How to Access, Login and Exit the NextGen
Application” process
2. Understand “Getting Started with PM - Common NextGen PM Elements”
I. CREATING A BATCH
3. Left click once on , the Batch Posting screen displays
4. Left click once on Norton to open the shortcut menu
5. Left click once on New - Batch… , the Batch Maintenance screen displays
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II. BATCH DESCRIPTION
6. Left click once in Batch Desc field and type in, your first initial of your first name, full
last name and today’s date
SWilliams 07/06/2010
o If a coworker happens to have the same initials add a middle initial or the
second letter of your first name
o SBWilliams 07/06/2010
7. Utilize the Default Tracking field if user needs the tracking field in the payment entry to
be the same with this each payment transaction in this batch
Deposit number for all transactions in this batch
8. Utilize the Default Date field if user needs the transaction date to be the same for all
posted transactions of the batch, if not changed, the default date will be the created date
Deposit date is 07/12/2015
III. SECURING THE BATCH
9. Left click once on the down arrow, next to the Secured to User field to select your name
This is a very IMPORTANT STEP, if the batch is not secured to a user, the batch is
opened to any other user access.
It is very important for user to secure each daily batch to you only this will eliminate
from someone else to access and/or modify your batch.
10. Left click once on a user name, this will secure this batch posting to that specific user
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11. Left click once on OK, the Batch Maintenance screen closes and the Batch Posting
screen re-opens.
IV. SET AS ACTIVE BATCH
12. Right click once on the batch to pull up the shortcut menu
13. Left click once on Set as Active Batch
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A green check mark will confirm your batch is active
14. Left click once on the red located in the upper right hand corner of the Batch Posting
window.
15. Your batch is now complete for use when checking in a patient and collecting payments
16. Anytime a user logs out of NextGen, the user must “Set Batch as Active,” by following
steps # 11-12
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Purpose:
The Check-In Autoflow process will be used for Pre-Scheduled, Walk-ins, Lab/X-Ray Only,
and Nurse Only appointments.
Definition:
The act of granting clinical access to a patient who has successfully completed the financial
screening process or has healthcare coverage and who has either a scheduled appointment or
presents as a walk-in
A feature in NEXTGEN that activated when checking in a patient with an appointment and
guides users through the process of checking in a patient
1. Complete “Getting Started with NextGen - How to Access, Login and Exit the NextGen
Application” process
2. Understand “Getting Started with PM - Common NextGen PM Elements” process
3. Complete “Creating a New Batch and Set as Active” process
4. Understand “Determining Eligibility” process
5. Understand “Scheduling an Appointment” and “Confirming an Appointment” process
6. Understand “Creating and Managing Charts” process
I. ACCESSING THE APPOINTMENT
Follow “Confirming an Appointment” process
7. Left click once on the confirmed patient’s appointment to highlight the appointment
o Based on the event of the appointment, users will check-in patient’s properly and
collect the appropriate co-pays, nominal fees, or deposits
o Based on the age of the patient, users will complete the TVFC Eligibility form and
TVFC Form Date, refer to TVFC Eligibility Form memo
II. CHECK-IN/CREATE ENCOUNTER
8. Right click once on the confirmed person’s appointment to display the shortcut menu
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9. Left click once on Checkin/Create Encounter, alerts may display, read all alerts carefully and take
any action as applicable
Users at this time will also note the patient’s discount, if the patient’s event is covered by the
Sliding Fee
10. Left click once on red “X” of the alert to close and continue, the Create Encounter screen displays
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11. Confirm the General tab displays
12. Left click once on the down arrow of the Patient Type field to select a patient type
Established Patient
o Any patient that has been seen at least once within the last 3 years
New Patient
o Any patient that has never been seen or has not been seen within the last 3 years
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13. Confirm or select a Rendering and Referring provider, by left clicking once on the down arrow of
the Rendering and Referring fields, under the Providers section, the rendering and referring must
be the same.
o Most appointments are pre-scheduled with the “person” who will exam the patient. If the
resource is a “place” use the “Walk-in” provider, such as, if a patient is visiting the lab
14. Left click once on the name of the provider to select, the Rendering/Referring fields will display
the name of the selected provider
15. Left click once on the down arrow of the Supervisor field and select the appropriate provider name
o Medical provider – choose the Medical Director
o Dental providers – choose the Dental Director
16. Confirm or choose a Service Location by left clicking once on the down arrow of the Service
Location field
Galv Coastal Health & Wellness for all patients checking in Galveston
TC Coastal Health & Wellness for all patients checking in Texas City
17. Confirm a Guarantor is selected or correct (see accessing the appointment section of this
document)
Must be confirmed or changed at each encounter creation
This is preselected based on the Guarantor attached in the chart, see “Creating and Managing
Charts” process
III. HOW TO CHANGE A GUARANTOR FOR SPECIFIC ENCOUNTERS
18. Left click once on Norton, in the Gurantor section box to display shortcut menu
PERSON AS GUARANTOR (MINORS ONLY)
Minors (17 and under)ONLY choose the guardian who signed the financially
responsible section for the minor patient and who should be receiving the statement for
payment of the minor’s visit
19. Left click once on Person as Guarantor, the Encounter Guarantor Lookup screen displays.
Search for the guarantor and correctly select from the Matching Records list
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If this screen does not display
There is not a Person as Guarantor available and person is self
guarantor
For minors this determines that financial screening is
incomplete because a guarantor was never selected at the chart
level. Except if a minor is declared emancipated, this is
usually determined during financial screening
o Follow “Creating and Managing Charts” Relations/Role category, Guarantor section.
20. Left click once on OK and the Person as Guarantor will display
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EMPLOYER AS GUARANTOR (CONTRACT)
This option will ONLY to be used for persons seeking services under contracts, such
as, ACCT, TITLE V contracts, this is determined during financial screening
If a patient’s appointment today is covered under contract, user must change the
guarantor and choose the correct contract
21. Left click once on Employer as Guarantor (Contract), as in step #19 above, on the Create
Encounter screen, the Guarantor Search screen displays and the name of the contract will display
within the Matching Records list
22. Double left click on the contract, the Guarantor will change to Employer as Guarantor (Contract)
SELF AS GUARANTOR (SELF PAY)
Any person seeking service who is financially responsible for themselves, this is usually
determined during financial screening
23. Left click once on Self as Guarantor, as in step #19 above, on the Create Encounter screen, the
patient’s name will display in the Guarantor selection
***There are no other fields to access on the Create Encounter screen
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24. Left click once on OK, on the Create Encounter screen, this starts the AutoFlow process, starting
with the Update Patient Information screen
IV. APPOINTMENT LINK SELECTION
Patient’s may have more than one appointment in one day, if an Appointment Link Selection
screen appears, after the encounter is created, perform the following
o Confirm only the appointment the user is check-in is the only appointment linked to the
current encounter created
o DO NOT link more than one appointment to one encounter
o Left click once on Cancel to continue, autoflow begins and the Update Patient
Information screen will display
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V. AUTOFLOW BEGINS
CONFIRM DEMOGRAPHICS
25. Confirm demographics with the patient at each and every visit, by asking
What is your current address?
What is your current phone number?
Make any changes as applicable
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26. Left click once on the AutoFlow icon, UDS category screen displays
CONFIRMING UDS REQUIRED FIELDS
27. Confirm at each and every visit that all of the following Required UDS fields has been collected
Homeless Status
Migrant Worker Status
Language Barrier
Race
Ethnicity
Veteran Status
Primary Medical Coverage, if the patient has medical coverage
Self-pay check box is selected, if,
o Patient is underinsured and is eligible for a discounted rate, regardless if
patient has coverage
o Patient is uninsured and is eligible for a discounted rate and has NO coverage
Sliding fee schedule verification and family information is attached, if the patient is
covered by a discounted rate
28. Left click once on the AutoFlow icon, on the Modify Patient Information screen,
located on the bottom right of the screen, the Chart Details screen displays
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CHART DETAILS
O Based on the event of the appointment and patient age, user will add today’s date in the TVFC
Form Date if the patient qualifies for TVFC immunizations. The TVFC Form must be also
completed. Refer to TVFC Eligibility Form Memo and “Creating and Managing Charts”
process
29. Confirm or select a Marketing Plan - required
30. Left click once on the AutoFlow icon, on the Chart Details screen, located on the
bottom right of the screen, the Encounter Insurance Selection screen displays
ATTACHING AN INSURANCE TO AN ENCOUNTER
Based on the patient’s event of the appointment, users will select the insurance coverage for
the current patient, ONLY if the event is covered by an insurance
o Example: Event is for a dental follow up event however, the only insurance coverage
listed only covers medical events
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If persons are listed in Relations/Roles category for the current patient, these persons are also
listed in the encounter insurance selection screen, as displayed in the examples above.
If a person is covered by a contract, the contract will be listed here as an internal payer.
Contracts are selected as Employer as Guarantor as well.
Based on Visit Type
Self Pay Insured
Commercial, Medicare, Medicaid, Contracts
Left click once on the
Autoflow
icon
Left click once on the insurance name to highlight
the insurance, in the Available Insurance field, if
the person is covered by an insurance o If the insurance file folder displays a red X the
insurance is expired or patient is no longer
covered, this is determined during financial
screening
Left click once on the arrow pointing right, the name
of the insurance will display in the Selected
Insurance field
Left click once on the Autoflow icon
CHARGE POSTING
31. Alerts may display, read all alerts carefully and take any action as applicable and close. The Charge
Posting screen displays. Enter the applicable nominal fee charge, as needed.
***Entering the Nominal Fee of $15.00 charge only applies to patients who have 100% discount. If
this applies, continue. If not applicable, skip to Patient Balance section.
32. Left click once on the New button, located in the middle of the charge posting window
33. Left click once in the Svc Item field to charge the NomFee - Nominal Fee of $15.00
This charge only applies to patients who have a 100% discount.
A $15.00 NomFee line item in the body of the Charge Posting screen, including Date, Svc
Item description, Charge amount and a Line Item Balance will display
Based on current Contract Fees – other Charges could be entered, such as, STD/HIV
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34. Left click once on the AutoFlow icon, a NextGen Warning screen displays
Warning: The diagnosis has not been entered for this charge and could cause reimbursement
to be denied. Do you want to continue?
35. Left click once on OK to proceed, the Patient Balance screen will display
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PATIENT BALANCE
The patient balance is displayed based on the guarantor attached to the encounter
The totals listed above and the encounter/invoice information is the account total due
for the guarantor.
o Self As Guarantor
o Employer as Guarantor (Contracts)
36. Inform the total balance due to the patient.
a. Including today’s nominal fee or co-pay, there is a current Amount Due of $30.00, would
you like to make any payments today
37. Left click once on the AutoFlow icon, on the patient balance screen,
If a charge was entered the Payment Entry screen will display
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If a charge was NOT entered, the patient appointment will display. This will occur for all
patients without a Nominal Fee and only collecting a deposit or co-pay
38. Right click once on the patient name, to display the shortcut menu.
PAYMENT ENTRY
39. Left click once on the “Add Transaction” shortcut to display the Payment Entry screen
ONLY if payments are collect should a user access the Payment Entry screen.
40. Left click once in the down arrow of the Payer field to select Patient
41. Left click once in the Pay Amt field and confirm the Pay Amt displayed is correct or enter the
correct dollar amount based on patient collection:
a. Nominal Fee - $15.00
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b. Co-Pay ($20, $25, $30, $35) (commercial insurance)
For Co-Pays, no charge will be associated with this transaction apply payment as
UNAPPLIED TO THE ENCOUNTER ONLY
c. For NO PAYMENTS, left click once on clear to clear the dollar amount
42. Left click once on the down arrow of the Pay Code field, to select the pay code
a. Cash Payment, self pay patients
b. Check Payment, self pay patients
c. Credit Card/Debit Card Payment, self pay patients
d. COPAY Cash Payment, private insurance
e. COPAY Check Payment, private insurance
f. COPAY Credit Card/Debit Card Payment, private insurance
43. Left click once in the Tracking field, for Credit Card/Debit Card and Check payments ONLY
a. Enter an authorization number for all Credit Card/Debit Card payments
b. Enter a check number only for all Check payments
44. Left click once on Save
**NOTE: For all payments not associated to a charge or an overpayment of the charge, an
unapplied payment screen will display
UNAPPLIED TO THE ENCOUNTER ONLY
45. Left click once on the AutoFlow icon, the Itemized Bill for Encounter # screen
displays, this is the patient’s RECEIPT
VI. PRINTING THE RECEIPT
46. Left click once on Print, the Itemized Bill for Encounter # will print to the defaulted printer,
make sure the default printer is where Receipts print, this copy is for patient
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47. Left click once on Print again, the Itemized Bill for Encounter # will print to the defaulted
printer, make sure the default printer is where Receipts print, this copy is the user to reconcile with
End of Day Balancing.
48. Left click once on Close, continue to follow patient services procedures
(Anytime Autoflow is interrupted, access the patient appointment and right click to access the
“Check-in” option)
VII. AUTOFLOW INTERRUPTION
Any time autoflow is interrupted, meaning, any screen is closed prior to ending with
printing the patient receipt.
Users can access all autoflow screens by right clicking on the correct patient name from the
appointment listing to display the shortcut menu
Access all screens from the shortcut menu
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Purpose:
To collect any outstanding balances on patient accounts
Definition:
To accurately collect and apply patient payments for outstanding balances
1. Complete “Getting Started with NextGen - How to Access, Login and Exit the NextGen
Application” process
2. Understand “Getting Started with PM - Common NextGen PM Elements” process
3. Understand “creating and Managing Charts”
4. Understand “Check-in with AutoFlow” process
5. Complete “Creating a New Batch and Set as Active” process
I. ACCESSING THE ACTIVE BATCH
6. Left click once on , the Batch Posting screen and the users secured batch displays
7. Double left click once the user secured batch to access the Payment Entry screen
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16. II. ACCESSING THE ACCOUNT/ENCOUNTER
ACCOUNT SOURCE
Most patient payments must be posted to the Account source with the exception to
payments made to Denture Contract encounters, the source will be Encounter not
Account
ENCOUNTER SOURCE
Only Denture Contract payments will be applied to an encounter source. See both current
“Denture Contract Service Agreement Process” and “Denture Contract Updates
Memo” procedures to probably apply payments
8. Left click once on the down arrow of the Source field, select Account/Encounter
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9. Left click once on the Search icon, to search for the account/encounter name, the
Account/Encounter List screen displays
10. Left click once in the Last (name) field and enter the person’s last name
11. Left click once in the Birth Date field and enter the person’s date of birth
12. Left click once on the Find button to display a search result of Matching Records of all
persons with the same last name and date of birth
o PERSON IS NOT LISTED IN ACCOUNT/ENCOUNTER LIST
If user determines the person is not listed in Account/Encounter List, this
person does not have an account and the account may be in someone else’s name
Access the patient’s chart, relations/role category or communicate with person to
whom the account holder may be, then proceed with person is listed process
below
O PERSON IS LISTED IN ACCOUNT/ENCOUNTER LIST
If user determines the person is listed in Account/Encounter List
13. Confirm the searched person is the correct person by verifying the last name, first name, and
DOB
14. Double left click on the person’s last name to select the patient and apply payments to their
account, the Payment Entry screen displays with patient’s account displaying
Alerts may display, read carefully, take any action as applicable and close
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ACCOUNT SOURCE
Any charge not paid will display with a balance
ENCOUNER SOURCE
Encounter source is encounter specific, the most recent encounter with a balance will
display first
o Left click once on the down arrow of the Enc/Clam# field and select the
appropriate encounter to enter the payment
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III. ENTERING THE PAYMENT
ONLY if payments are collect should a user access the Payment Entry screen
15. Left click once on the down arrow of the Pay Code field and select the appropriate payment
method.
16. Left click once in the Tracking field, for Credit Card/Debit Card and Check payments
ONLY
Enter an authorization number for all Credit Card/Debit Card payments
Enter a check number only for all Check payments
17. Left click once in the Pay Amt field and enter the total amount user is collecting
o UNAPPLIED PAYMENTS
If user is collecting more than the balance is displaying, an Unapplied
Payment screen will display
Account Source
Encounter Source
Left click once on OK
Account Source
o An unapplied amount will display in the Acct Credit field
Encounter Source
o An unapplied amount will display in the Enc Credit field
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PAYMENTS POSTED TO OUTSTANDING LINE ITEMS
Payments will post to the oldest line item with a balance first, as account
payments are collected
Left click once on Save
IV. PRINTING THE RECEIPT
18. Left click once on the printing icon, to print the patient’s receipt, the shortcut menu
will display
19. Left click once on Account Receipt, the Print Account Receipt screen will display
20. Left click once on Print, the Account Receipt will print to the defaulted printer, make sure
the default printer is where Receipts print, this copy is for patient
NEXTGEN PM Patient Services PAYMENTS ONLY
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21. Left click once on Print again, the Account Receipt will print to the defaulted printer, make
sure the default printer is where Receipts print, this copy is for the user to reconcile with End
of Day Balancing.
22. Left click once on Close, continue to follow patient services procedures
23. Left click once on icon, to close the Print Account Receipt screen, the Payment Entry
screen displays
24. Close all windows and proceed with other Patient Services processes
Patient Info
Account holder
List of
Encounters
payment
posted to Total Payment
NEXTGEN PM Patient Services
MEDICAL/DENTAL RECORD COPY PAYMENTS ONLY
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Purpose:
To accurately charge a patient for copies of medical or dental records for personal
use
Definition:
To act of entering charges and payments for copies of medical or dental records to
patients for personal use.
1. Complete “Getting Started with NextGen - How to Access, Login and Exit the NextGen
Application” process
2. Understand “Getting Started with PM - Common NextGen PM Elements” process
3. Complete “Creating a New Batch and Set as Active” process
4. Understand “Scheduling an Appointment” process
5. Understand “Check-In – With AutoFlow” process
I. SCHEDULING THE PATIENT ON THE MEDICA/DENTAL RECORDS SCHEDULE
Utilizing the “Scheduling an Appointment” process, access the Medical/Dental Records
resource on the appointment book
Schedule the patient on the Medical/Dental Record resource, utilizing the Medical/Dental
Record Copy event
Follow the “Check-In – With AutoFlow” process
II. CREATING THE MEDICAL RECORD ENCOUNTER
When users create the encounter for Medical/Dental Records, alerts may display, read all
alerts carefully and take any action as applicable, perform the following
o Users at this time WILL NOT consider any type of coverage including the
sliding fee discount. Patients are charged a 100% fee for release of records. See
Medical Records Fee.
NEXTGEN PM Patient Services
MEDICAL/DENTAL RECORD COPY PAYMENTS ONLY
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6. Left click once on red “X” of the alert to close and continue, the Create Encounter
screen displays
7. Left click once in the Patient Type field and select “Established Patient”
8. Left click once in the Rendering and Referring fields and select “Walk-In Only”
9. Left click once in the Supervisor field and select the medical supervisor
III. ENTERING THE MEDREC CHARGE
When users access the Charge Posting screen during the “Check-in – with AutoFlow”
process, perform the following
10. Left click once on the New button
11. Left click once in the Svc Item”field and type in “MEDREC” – Medical Record Copies
12. Left click once in the Unit/Override field and enter the total dollar amount due based on
the Medical Records Fee
13. Left click on Save
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IV. PAYMENT ENTRY
When users access the Payment Entry screen, Follow the Payment Entry process and
enter the total dollar payment due, ALL MEDICAL/DENTAL RECORD PAYMENTS
MUST BE COLLECTED FOR PATIENTS TO RECEIVE COPIES
14. Left click on Save
NEXTGEN PM Patient Services
MEDICAL/DENTAL RECORD COPY PAYMENTS ONLY
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V. PRINTING THE RECEIPT
15. Left click once on the printing icon, to print the patient’s receipt, the shortcut
menu will display
16. Left click once on Encounter Bill, the Itemized Bill for Encounter #, will display
17. Left click once on Print, the Itemized Bill for Encounter # will print to the defaulted
printer, make sure the default printer is where Receipts print, this copy is for patient
18. Left click once on Print again, the Itemized Bill for Encounter # will print to the
defaulted printer, make the your default printer is where Receipts print, this copy is for
the user to reconcile with End of Day Balancing.
19. Left click once on Close, continue to follow patient services procedures
NEXTGEN PM Patient Services POSTING THE BATCH AND END OF DAY BALANCING
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Purpose:
All transactions collected from prescheduled appointments, medical/dental
records payments or payment only collections. This step must be completed at the
end of each business day
Definition:
The act of electronically posting a batch and balancing all collection of payments
at the end of each business day by each user documenting transactions. Users
must confirm, total batch dollars match total dollars collected in drawer, prior to
posting the batch.
1. Complete “Getting Started with NextGen - How to Access, Login and Exit the NextGen
Application” process
2. Understand “Getting Started with PM - Common NextGen PM Elements” process
3. Complete “Creating a New Batch and Set as Active” process
I. ACCESSING THE ACTIVE BATCH
4. Left click once on , the Batch Posting screen and the users secured batch displays
5. Right click once on the users batch needing to post, to display the shortcut menu
NEXTGEN PM Patient Services POSTING THE BATCH AND END OF DAY BALANCING
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I. ACCESSING THE BATCH LISTING REPORT
6. Left click once on Print, Batch Listing, the batch listing report will display.
The report will list all transactions associated to the batch. All transactions types
should be listed separately
o All cash payments will be listed with at total dollar of cash collected
o All check payments will be listed with a total dollar of checks collected
NEXTGEN PM Patient Services POSTING THE BATCH AND END OF DAY BALANCING
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II. PRITING THE BATCH LISTING REPORT
7. Left click once on the Print Report icon, to print the report
8. Left click once on icon, to close the Batch Listing report
9. Compare each total, by transaction type on the report with the cash drawer, all dollars should
match.
III. BALANCING THE BATCH TO THE CASH DRAWER
LEDGER
10. Left click once on Norton to open the shortcut menu
11. Left click once on Ledger, the Transaction Ledger will display
A list of all accounts and encounters payments received will display
Review the list to confirm the total dollar amounts and transaction codes
(payment type) are correct
o MODIFYING AN INCORRECT TRANSACTION
If a transaction is incorrect
NEXTGEN PM Patient Services POSTING THE BATCH AND END OF DAY BALANCING
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o Double left click on the incorrect account or encounter transaction, the
payment entry screen will display
o Left click once on Open to access the saved transaction and be able to
make corrections
Make corrections as needed
Pay Amount
Pay Code
Etc..
o Left click once on Save, to save the changes
o Left click once on icon, to close the Payment Entry screen and
return to the Transaction Ledger screen
HEADER
12. Left click once on the Header button, located on the bottom left hand side of the Transaction
Ledger screen, the Batch Maintenance screen displays
13. Left click once in the Total Billed field on the Batch Maintenance screen and enter the total
billed displayed in the Billed field on the Transaction Ledger screen
NEXTGEN PM Patient Services POSTING THE BATCH AND END OF DAY BALANCING
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14. Left click once in the Total Allowed field on the Batch Maintenance screen and enter the total
allowed displayed in the Allowed field on the Transaction Ledger screen
15. Left click once in the Total Paid field on the Batch Maintenance screen and enter the total
payment displayed in the Payment field on the Transaction Ledger screen
16. Left click once in the Total Adjusted field on the Batch Maintenance screen and enter the total
adjustment displayed in the Adjustment field on the Transaction Ledger screen
17. Left click once on OK, on the Batch Maintenance screen, the batch maintenance screen closes
and the Transaction Ledger screen displays
18. Left click once on Close on the Transaction Ledger screen, the Batch Posting screen displays.
Users will notice the Status of the existing batch should now indicate “balanced”
If the status does not indicate “balanced” users must repeat all steps in the Header
section.
IV. POSTING THE BATCH
19. Left click once on Norton to open the shortcut menu
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20. Left click once on Post, to post the currently selected batch, the NextGen Confirm post of batch
screen displays
21. Left click once on OK, the batch will now post
22. Left click once on OK
23. Continue to follow all other patient services procedures
Complete a deposit slip
Complete the Daily Transaction Log
Forward all documents to the proper departments
NEXTGEN Patient Services
DENTURE CONTRACTS
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Coastal Health & Wellness Clinic
Denture Contract Service Agreement Process
I. PATIENT APPOINTMENT
Patient can request a denture contract appointment with either the Dental
Receptionist, Contact Center or Check-Out desk. All denture contract associated
appointments must be identified with the “Denture Contract” event. Selecting the
“Denture Contract” event informs the Check-In staff when not to collect the
nominal fee. Also, apply the appointment to the Denture Contract category/time
slot to schedule denture contract appointments.
II. DENTAL PROVIDER Completes a Comprehensive Exam
Determine patient’s needs and procedures needed to implement a denture
treatment plan, including extractions and all necessary pre-work.
Educate patient on procedures and steps to complete a denture treatment plan
Electronically complete the Pre-Denture Assessment Form, by:
(a) checking the check boxes to the left of the denture CDT codes
(b) enter a tooth number in the free text field to the right of the extraction
CDT code description
ex:
Electronically sign and date Pre-Denture Assessment Form
Print a completed copy of the Pre-Denture Assessment Form for the patient
Explain to the patient if a Denture Contract Agreement is not signed within
30 days of the Pre-Denture Assessment Form, the patient must be
reevaluated and a new Pre-Denture Assessment Form must be completed
by the dental provider
Explain to the patient to deliver the Pre-Denture Assessment Form to a
Business Representative through the Check-out staff. The Business
Representative will assist the patient with executing a Denture Contract
Agreement and discuss payment options
Electronically enter all denture contract appropriate CDTs as “PLANNED”
at the patient’s first denture contract appointment
Will “COMPLETE” all “PLANNED” denture contract CDTs when the
appliance is delivered or a procedure is performed, such as, an extraction,
impression, wax bite, etc..
CDT Description D7140 Extraction, Coronal Remnants Deciduous Tooth 1, 2 ,3, 4
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DENTURE CONTRACTS
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Coastal Health & Wellness
Pre-Denture Assessment Form
CDT Code CDT Description
D7111 Extraction, Coronal Remnants Deciduous Tooth
D7140 Extraction, Erupted Tooth or Exposed Root (Elevation &/or /Forceps Removal)
D7210 Surgical Removal of Erupted Tooth
D7220 Removal of Impacted Tooth - Soft Tissue
D7230 Removal of Impacted Tooth - Partially Bony
D7250 Surgical Removal of Residual Tooth Roots
D7310 Alveoloplasty in Conjunction w/Extractions - 4 or more teeth or tooth spaces per Quadrant
D7311 Alveoloplasty in Conjunction w/Extractions - 1 to 3 teeth or tooth spaces per Quadrant
D7320 Alveoloplasty Not in Conjunction w/Extractions 4 or more teeth or tooth spaces per Quadrant
D7321 Alveoloplasty Not in Conjunction w/Extractions - 1 to 2 Teeth or Tooth Spaces per Quadrant
D5520 Replace Missing or Broken Teeth
D5640 Replace Broken Teeth - Per Tooth
D5110 Complete Denture - Maxillary
D5120 Complete Denture - Mandibular
D5130 Immediate Denture - Maxillary
D5140 Immediate Denture - Mandibular
D5211 Maxillary Partial Denture - Resin Base
D5212 Mandibular Partial Denture - Resin Base
D5213 Maxillary Partial Denture - Cast Metal Framework with Resin Denture Bases
D5214 Mandibular Partial Denture - Cast Metal Framework with Resin Denture Bases
D5281 Removable Unilateral Partial Denture
D5410 Adjust Complete Denture - Maxillary
D5411 Adjust Complete Denture - Mandibular
D5421 Adjust Partial Denture - Maxillary
D5422 Adjust Partial Denture - Mandibular
D5510 Repair Broken Complete Denture Base
D5610 Repair Resin Denture Base
D5620 Repair Cast Framework
D5630 Repair or Replace Broken Clasp
D5650 Add Tooth to Existing Partial Denture
D5660 Add Clasp to Existing Partial Denture
D5710 Rebase Complete Maxillary Denture
D5711 Rebase Complete Mandibular Denture
D5730 Reline Complete Maxillary Denture - Chairside
D5731 Reline Complete Mandibular Denture - Chairside
D5740 Reline Partial Maxillary Denture - Chairside
D5741 Reline Partial Mandibular Denture - Chairside
D5750 Reline Complete Maxillary Denture (Lab)
D5751 Reline Complete Mandibular Denture (Lab)
D5820 Interim Partial Denture (Maxillary)
D5821 Interim Partial Denture (Mandibular)
D5899 Gold Denture Crown Per Tooth NOTE: This assessment is valid for thirty days. In other words, you have 30 days to execute a contract and payment plan with
CHW. The denture contract must be paid in full within 90 days of the date signed. Once you have paid in full, personnel from
the dental office, will call you to make an appointment to start your denture work. After you get your dentures, the first 3
adjustments and/or relines of new dentures are at no charge. Any additional adjustments and/or relines will be charged to you
based on the dental fee schedule.
__________________________________________________________________________
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DENTURE CONTRACTS
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Provider Signature Date
III. BUSINESS REPRESENTATIVE/DESIGNEE
Based on the Pre-Denture Assessment Form completed by the Dental
Provider, discuss with the patient the total denture contract cost using the
current Denture Contract - Fee Schedule form. The Plan is determined
based on the Patient’s Sliding Fee on the day the patient signs the Denture
Contract Service Agreement.
Plan Patient Sliding Fee
Denture Contract 0% Pay 100% discount
Denture Contract 20% Pay 80% discount
Denture Contract 40% Pay 60% discount
Denture Contract 60% Pay 40% discount
Denture Contract 80% Pay 20% discount
Denture Contract 100% Pay 0% discount
Follow “Document a Patient’s Denture Contract Electronically” training
guide.
Complete the Denture Contract Service Agreement electronically within the
patient’s dental record
Verify IDENTITY OF PARTIES, patient name, DOB, address and phone
number are correct
Enter the patient’s sliding fee percentage
Enter information into the following appropriate fields:
Line II – TERM OF THE AGREEMENT
- Enter an “Effective date” (today’s date) and an “Expiration date”
(90 days from the Effective date) in a date format MM/DD/YYYY
Line III – PROFESSIONAL DENTAL SERVICES TO BE RENDERD
BY CHW CLINIC
- Enter the CPT codes documented on the Pre-Denture Assessment
Form Example: – D7111 (1,4,8,20, and 27) - Extraction, Coronal
Remnants Deciduous Tooth
- D5211 – Maxillary Partial Denture - Resin Base
Line IV – PAYMENT FOR SERVICES
- Enter in the total cost of the dentures based on the current Denture
Contract - Fee Schedule and the Plan Chart in numeric format in
whole dollars, such as, 545
Review and explain the entire Denture Contract Service Agreement with the
patient.
Ensure the patient clearly understands (repeats back) the following:
Line II – Term of the agreement - the Effective date and Expiration date
Line III – Professional dental services to be rendered by the CHW Clinic
Line IV – Payment for services –
(a) the total cost of the Denture Contract Service Agreement
(b) Full payment must be received prior to denture services
beginning
(c) making payments is acceptable
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DENTURE CONTRACTS
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Line V – Denture Adjustments
Line VI - No Refunds – explain this section very clearly
Line VII – Entire Agreement
Line VIII – Termination of Agreement
Line IX – Amendments
Line X – Governing Law
Line XI – Written Notice
After explaining the Line items to the patient, continue to follow the “Document a
Patient’s Denture Contract Electronically” training guide and collect electronic
signatures
Add the appropriate Denture Contract % Plan to the patient’s PM chart
Access patient in PM
Left click once on the Modify Patient file folder, the Modify Patient
Information dialog window will open with access to the insurance
button.
Left click once on the Insurance button to access the Insurance Listing
dialog box
Left click once on the Norton button of the insurance listing window,
select New Insurance, to add the new Denture Contract % Plan
Left click once in the Payer Name field and enter the appropriate Denture
Contract % Plan (see chart listed above)
Double click once on the appropriate Denture Contract % Pay Plan
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DENTURE CONTRACTS
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Left click once in both the Effective and Expiration Date fields and enter a
1 year period. The effective date will be the date the contract was signed
and expiration date will be 1 year from the signed date.
Left click once on OK, the Denture Contract % Pay Plan should now
display in the patient’s chart
Close the patient’s PM chart
Offer to make a payment today
Creating a DENCON Encounter
Access patient in PM
Left click once on the Encounter tab (located far right of
the patient chart)
Left click once the on the Norton button and select New. A
Create Encounter screen will display
Left click once on the down arrow of the Patient Type and
select Established Patient
Left click once on the down arrow of the Rendering and
Referring fields and select the dental provider who signed
the Dental Assessment Form
Left click once on the down arrow of the Supervisor field
and select Dr. Foster.
Left click once on the down arrow of the Service Location
and select the appropriate location in which services were
rendered.
Left click once in the Denture Contract field and enter the
total dollar of the Denture Contract Agreement
Left click once in the DC Expiration Date field and enter
a 1 year expiration date from the time the patient signed the
Denture Contract Agreement
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DENTURE CONTRACTS
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Left click once on OK on the create encounter window
Make note of the encounter number located in the
Encounter Information box (667502)
Right click once on the newly created encounter to display
the shortcut menu and select Charges, the charges window
will display
Left click once on New button of the charges window
Left click once in the Svc Item field and enter the dummy
charge of DENCON and use the Tab key on your keyboard
to select the charge
NEXTGEN Patient Services
DENTURE CONTRACTS
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Left click once on the Save button, a diagnosis not entered
warning dialog box will display
Left click once on OK of the alert
Close the charges window
Creating a DENCON Alert
Left click once on the Clinical/History/Notes tab located
to the left of the Encounters tab
Left click once on Alerts
Right click once in the details (white field) to the right of
the selected Topics list, to display the shortcut menu and
select New to create a new Alert
Left click once in the Alert field and enter “Denture
Contract”
Left click once in the Expiration Date field and enter an
expiration date ending in 90 days. This expiration date is
specific to the signed 90 day contract.
Left click once in the Alert Entry field and enter the
following: “PLEASE APPLY ALL DENTURE
CONTRACT DEPOSITS TO ENCOUNTER# 676751
WITH A TOTAL OF $364.00. CONTRACT EXPIRES
12/06/2017”
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DENTURE CONTRACTS
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IV. CHW Billing Will be responsible for notifying the patient in the event full payment has not
been paid in full by letter, at least 30 days prior to the Denture Contract Service
Agreement expiring.
o If only partial payments have been made by the expiration date (not paid
in full), follow the Refund section of the Denture Contract Service
Agreement. For any special requests from patients, in reference to the
Refund section of the contract, consult with management.
Will notify Patient Information Manager, Business Office Manager, and the
Dental Director through email with patient information for those contracts paid in
“full”
Will manage all contracts prior to 9/1/17 plan changes with the old method of
using the A, B, or C plan. These encounters should be identified with the
“Denture Contract” payer.
V. Dental Receptionist/Contact Center
Will contact the patient when a confirmation email from CHW Billing is received
indicating the Denture Contract Service Agreement has been paid in “full”
Will schedule the patient for the first denture contact appointment by using the
“Denture Contract” event for all newly paid in “full” Denture Contract Service
Agreement. Also, apply the appointment to the Denture Contract category/time
slot to schedule denture contract appointments.
VI. Patient Services
Patient Services staff will continue to use the Denture Contract Event to confirm a
patient’s Denture Contract appointment at the time of check-in
Will add the “Denture Contract % Pay” payer to the patient’s encounter at the
time of check-in.
o Keep in mind, CHW will continue to honor denture contract
agreements prior to this change, this means, some patients will
continue to have the old “Denture Contract” payer
**NOTE: When a patient checks-in for a denture contract appointment and a denture contract
payer is not in the patient's chart, please report this to billing by emailing: Cynthia Franklin,
Mary Orange, Theresa Cruz & Luz Amaro. Denture contract payers must be managed by billing.
NEXTGEN Patient Services
DENTURE CONTRACTS
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Do not add any Denture Contact payers to patient's chart.** no denture contract payer attached,
will not affect the patient’s appointment, nor any dental documentation.
Patient Services will no longer hand write Denture Contract payment receipts.
Patient Services to apply all Denture Contract payments to the Denture Contract
encounter indicated by CHW billing within the patient’s chart alert
VII. Check Out
Will contact a Business Representative/Designee if a patient presents with the
Pre-Denture Assessment form and if the patient is willing to sign a Denture
Contract Service Agreement.
Will assist with scheduling follow up “Denture Contract” appointments
Will assist with collecting Denture Contract % Plan payments
NEXTGEN Patient Services
DENTURE CONTRACTS
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DENTURE CONTRACT SERVICE AGREEMENT
I. IDENTITY OF PARTIES
This Service Agreement is between the Coastal Health & Wellness with clinics located at 9850-C Emmett F Lowry
Expressway, Texas City, TX 77591 and 4700 Broadway, Galveston, Texas 77551 AND
┌ ┐
Patient Information Label
└ ┘
II. TERM OF AGREEMENT
This is a 90 day Service Agreement beginning on ____________ (Effective date) and shall end on ____________
(Expiration date) unless this agreement is terminated according to Section VIII.
III. PROFESSIONAL DENTAL SERVICES TO BE RENDERED BY CHW CLINIC Completed by Dental Provider on the Pre - Denture Assessment Form.
IV. PAYMENT FOR SERVICES
In consideration of Denture Service(s), the Patient agrees to pay CHW the sum of
$ ______ .00 for the denture work to be performed under this Service Agreement.
FULL PAYMENT (stated above) must be received before denture services will be performed.
Making payments through installments is acceptable. However, the balance of denture charges must be paid prior to
the 90 day expiration date of this contract.
V. DENTURE ADJUSTMENTS
Patient is eligible for three adjustments within the first three months. After the three months, Patient will be charged at
the established fee schedule for any additional adjustments including the clinic fee for the visit.
VI. REFUNDS
NO REFUNDS will be issued after denture services begin.
REFUNDS will only be issued prior to denture services beginning. Refunds will be made only after the Patient has met
all other CHW financial obligations, including balances which may have occurred for dental and/or medical services
rendered by the CHW clinics.
VII. ENTIRE AGREEMENT This Agreement supersedes all previous agreements between the parties, contains the entire understanding between the
parties, and may not be changed, except in writing, duly executed by each of the parties.
VIII. TERMINATION OF AGREEMENT
This Agreement may be terminated by either party by furnishing a written notice to the other party.
This Agreement will terminate if Patient is no longer allowed to receive medical and/or dental services from CHW,
except if Patient’s denture contract services have begun. Patient will receive refunds according to Section VI.
IX. AMENDMENTS
Any changes to this Agreement must be made and adopted as written amendments signed and approved by both parties.
X. GOVERNING LAW
This interpretation and enforcement of this contract shall be governed by the laws of the State of Texas.
XI. WRITTEN NOTICE
All notices required by this Agreement must be in writing and either mailed by certified or registered mail, return
receipt requested, to the address listed below, or hand delivered.
Coastal Health & Wellness
ATTN: Director of Contracts and Compliance
PO Box 939
La Marque, Texas 77568
For the Patient
Patient’s Address for Service has been provided in Section I of this Service Agreement
By signing this Agreement, the parties have agreed to all the terms and conditions of this Agreement and Patient fully
understands the Dental Provider’s recommendation for treatment on the Pre - Denture Assessment Form.
Patient or Patient’s Legal Representative CHW Business Representative
Date Date
NEXTGEN Patient Services
CLAIMREMEDI
Verifying Healthcare Coverage
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Purpose:
ClaimRemdi is the electronic system to verify eligibility for Commercial,
Medicare, and Medicaid coverage, to accurately bill patients receiving services.
I. ACCESSING CLAIMREMEDI
1. Left click once on , to search for the following address
https://claimremedi.providersportal.com, the Log window will display
II. LOGGING IN
2. Left click once in the User Name field and enter a username
3. Left click once in the Password field and enter a password
4. Left click once on Log In, the Home and Welcome Galveston County Health District.
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CLAIMREMEDI
Verifying Healthcare Coverage
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III. CHANGE PASSWORD
5. Left click once on the down arrow next to the user name
to access Settings
6. Left click once on Password on the Settings toolbar
7. Left click once in the New Password field and enter a new password
NEXTGEN Patient Services
CLAIMREMEDI
Verifying Healthcare Coverage
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8. Left click once on the Confirm New Password field and enter the new password again
9. Left click once on the Save button, a confirmation will display.
IV. NEW ELIGIBILITY
10. Left click once on Submit, located on the left hand side of the screen, the shortcut
menu will display
11. Left click once on Eligibility, the Submit Eligibility screen will display
12. Left click once on the drop down arrow of the Payer field , to display Coastal Health
& Wellness list of available payers to verify healthcare coverage
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13. Left click once on a payer to verify eligibility, the payer’s required fields will display
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14. Follow the Search Options, Payer Help and/or Key for each selected payer
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15. Enter all required information, as applicable
16. Left click once on the Check Eligibility white arrow , located at the right
of the payer selected and top of the Submit Eligibility screen, the verification page
will display.
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Tab Contains Information
Coverage Active or inactive, displays healthcare
coverage. The bottom of the result page
will display the latest HMO/PPO
information. Financial Co-Payment and Deductible information, is
in Professional (Physician) section
Exclusions Information on what services are excluded
on the plan
V. COVERAGE
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VI. FINANCIAL
VII. EXCLUSIONS
VIII. DOCUMENTING ELIGIBILITY DATA
17. Enter all eligibility status information into the patient’s chart and attach the insurance
to the patient’s encounter as instructed in the checkin process.
IX. ELIGIBILITY SEARCH RESULTS
The eligibility search results display verifications already verified by other staff
members. If an eligibility has already been searched, it is best to re-access the same
eligibility check. Every eligibility check conducted is considered a transaction.
18. Left click once on the down arrow of the Search option to display the shortcut menu
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19. Left click once on Eligibility, a list of eligibility search results will display
X. SIGNING OUT
20. Left click once on the down arrow next to the user name
to access the Sign Out, left click once and close
out the current window