elearning 5.6 Education Plan Guide >> Biller

Transcription

1 elearning 5.6 Education Plan Guide >> Biller

2 Table of Contents This document is for informational purposes only. You cannot launch elearning courses from this page. Application Overviews - EPM Only v v5.6 Introduction to the EPM... 4 Getting Started in NextGen v v5.6 Application Launcher... 4 EPM Application Basics v v5.6 EPM - Navigating the Application Desktop... 4 v5.6 EPM - Common Buttons Fields and Features... 5 EPM User Preferences v v5.6 EPM User Preferences - General... 5 v5.6 EPM User Preferences - Administration... 5 EPM Demographics - Working with Demographic Information v v5.6 Demographics - Person Records vs. Patient Charts... 5 v5.6 Demographics - Overview of the People and Patient Lookup Windows... 6 v5.6 Demographics - Adding a New Demographic Record... 6 v5.6 Demographics - Overview of the Patient Information Window... 6 v5.6 Demographics - Overview of the Patient Chart... 6 EPM Insurance - Working with Insurance v v5.6 Insurance - Adding Insurance to a Person... 7 v5.6 Insurance - Adding an Authorization... 7 v5.6 Insurance - Adding an Employer with Insurance... 7 EPM Accounts- Working with Guarantor Accounts v v5.6 Guarantor Accounts... 7 EPM Encounters - Working with Encounters v v5.6 Encounters - Overview of Encounters v5.6 Encounters - The Create Encounter and Encounter Maintenance Windows... 8 v5.6 Encounters - Checking in Patients and Creating Encounters... 8 EPM Charge Entry - Working with Charges v v5.6 Charges - Working with Charges... 8 EPM Transaction Entry Basics v v5.6 Transactions - Overview of Payment Processing... 9 EPM Transaction Entry Advanced v v5.6 Advanced Transactions - Entering Insurance Transactions... 9 v5.6 Advanced Transactions - Overview of Credits... 9 v5.6 Advanced Transactions - Credits Setup... 9 v5.6 Advanced Transactions - Working with Line Item Credits v5.6 Advanced Transactions - Working with Refunds v5.6 Advanced Transactions - Account Level Transactions The NextGen Learning Center 5.6 Biller Education Plan Guide : Page 1

3 Table of Contents This document is for informational purposes only. You cannot launch elearning courses from this page. v5.6 Advanced Transactions - Working with Unapplied Credits v5.6 Advanced Transactions - Using Reason Codes EPM Billing Encounters and Working with Claims v v5.6 Claims - Billing Encounters v5.6 Claims - Rebilling Encounters and Regenerating Claims v5.6 Claims - Processing Claims v5.6 Claims - Professional/CMS 1500 Claims EPM Statements - Setting Up Statements v v5.6 Statements - Setting Up Your Statement Process v5.6 Statements - Setting up Payer Specific Dunning Messages EPM Statements - Working with Statements v v5.6 Statements - Generating Statements in a Batch v5.6 Statements - Generating an Individual Statement on Demand EPM Working with AutoFlow v v5.6 AutoFlow - Checkin and Checkout Setup v5.6 AutoFlow - Checking Out Patients The NextGen Learning Center 5.6 Biller Education Plan Guide : Page 2

4 Overview This guide is designed to provide a brief description of the elearning courses offered by the NextGen Learning Center. elearning provides a self-directed, web-based learning environment that allows users to take courses at their own pace. The purpose of the elearning courses is to introduce users to the NextGen and QSI applications. They are designed to provide a basic level of understanding on how to set up and use the Electronic Health Records (EHR), Enterprise Practice Management (EPM), and Electronic Dental Record (EDR) applications, and are intended as precursors to instructor-led training. Presentation elearning content is presented in courses that are often grouped into curricula and education plans. A course is a unit of instruction on a particular topic. Most courses focus on one main topic, and will take approximately minutes to complete. Once you have finished a course, you can refer back to it at any time by going to the My Courses Completed page of your elearning account. In the Learning Center, a course is represented by a red book. A curriculum is a grouping of one or more courses related to a larger, more general subject area. In the Learning Center, a curriculum is represented by a red book with a blue band. An education plan is a grouping of several curricula that apply to a particular role or job function, such as System Configuration Training or Biller. In the Learning Center, an education plan is represented by a red book with a blue band inside a yellow box. Searching This Guide To search for a specific course or topic, hit Ctrl+f on your keyboard to bring up a search box. Type a keyword or part of the course name, and then hit Enter. If Adobe Acrobat is able to locate the search criteria, it will highlight it on your screen. To scroll through all of the instances of the criteria, hit Enter on your keyboard. Continuing Medical Education NextGen Healthcare is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education (CME) for physicians. NextGen Healthcare designates each CME activity for credit in category 1 of the AMA s Physician s Recognition Award system. Activities are designated for AMA PRA Category 1 Credit, and the physician should claim only those hours of credit that he/she actually spent in the educational activity. If a course qualifies for CME credit, it will be designated as follows in this guide, CME: Yes. Contacting elearning The elearning Resource Center (erc) website is available 24-hours a day to assist you with your elearning needs. Click the Support button in the top right corner of your elearning account screen for access to help files, downloads, articles, enrollment forms and more. To contact the Learning Center directly, please send an to learning@nextgen.com. The NextGen Learning Center 5.6 Biller Education Plan Guide : Page 3

5 5.6 Biller Education Plan Guide The Biller education plan will teach you specific tasks related to billing. It contains some SCT and some CGT courses, and is suitable for all employees who perform billing tasks. The estimated time to complete this education plan is 20 hours. Application Overviews - EPM Only v5.6 This curriculum focuses on how to access the NextGen applications and databases. v5.6 Introduction to the EPM Time: 45 minutes This course will teach you to identify the important features and functionalities of the NextGen EPM application and help you to understand application s key role in billing and collections workflow cycle. Describe the NextGen EPM (Enterprise Practice Management) application and some of its advantages. List the main steps in NextGen Medical Billing process. Practice the NextGen billing process in a simulated environment. Identify some of the main features of the EPM application. Explain how NextGen manages EPM s database. Getting Started in NextGen v5.6 This curriculum focuses on how to access the NextGen applications and databases. v5.6 Application Launcher Time: 15 minutes This course is designed to help you to navigate through the Application Launcher that is used to access the NextGen applications. Open the Application Launcher from your desktop or from the Windows toolbar. Review the Legal Disclaimer window. Sign on to a NextGen application by using your user name/password combination-or your PIN. Customize the NextGen Menu with your desired applications. Create desktop shortcuts for the NextGen applications. EPM Application Basics v5.6 This curriculum focuses on the EPM application desktop menus and toolbars, along with shortcuts that can be used to access application functions. v5.6 EPM - Navigating the Application Desktop Time: 15 minutes Application Version: 5.6 This course is intended to familiarize the student with the visual interface for the Enterprise Practice Management (EPM) application. Define components of the desktop in order to navigate the EPM application easily and efficiently. The NextGen Learning Center 5.6 Biller Education Plan Guide : Page 4

6 v5.6 EPM - Common Buttons Fields and Features Time: 20 minutes Application Version: 5.6 This course is designed to provide an overview of the common buttons-fields, and features found in the Enterprise Practice Management (EPM) application. Identify and use the common buttons and standard features within the EPM application. Customize a display to suit your needs. EPM User Preferences v5.6 This curriculum covers setting up and controlling access to the general user preferences that give the individual user options for designating how items look and respond in the NextGen EPM application. v5.6 EPM User Preferences - General Time: 30 minutes Prerequisites: v5.6 EPM - Navigating the Application Desktop This course covers how to set general user preferences within the Enterprise Practice Management (EPM) application. Define the EPM General User Preferences as they apply to the NextGen Enterprise Practice Management (EPM) application. Customize EPM General User Preferences to enable you to be more efficient. v5.6 EPM User Preferences - Administration Time: 45 minutes Application Version: 5.6 This course covers how to set Practice level Default User Preferences for the Enterprise Practice Management (EPM) application. Define the EPM User Preferences Administration as it applies to the NextGen Enterprise Practice Management (EPM) application. Create Default User Preferences in the File Maintenance application. Assign Default User Preferences to a group or individual in the System Administrator application. Modify a group's permission to set User Preferences. EPM Demographics - Working with Demographic Information v5.6 This curriculum focuses on familiarizing the learner with how to locate a person s record in the EPM application along with how to add and update their demographic information. v5.6 Demographics - Person Records vs. Patient Charts Time: 15 minutes Application Version: 5.6 The purpose of this course is to explain the differences-in form and use, between the Person Record and the Patient Chart. The NextGen Learning Center 5.6 Biller Education Plan Guide : Page 5

7 Describe the difference between a Person record and a Patient chart. Access patient-related demographic data within the NextGen application. v5.6 Demographics - Overview of the People and Patient Lookup Windows Time: 20 minutes The purpose of this course is to familiarize the student with the components of the People Lookup and the Patient Lookup windows. Access the People and Patient Lookup windows. Define the components of the People and Patient Lookup windows. v5.6 Demographics - Adding a New Demographic Record Time: 15 minutes The purpose of this course is to instruct the student how to add a new person's demographic information to the Master Person Index (MPI). Add a new person to the Master Person Index (MPI). Define the components of the Patient Information window. v5.6 Demographics - Overview of the Patient Information Window Time: 20 minutes The purpose of this course is to familiarize the student with the components of the Patient Information window. Access the Patient Information window. Define the components of the Patient Information window. v5.6 Demographics - Overview of the Patient Chart Time: 40 minutes Application Version: 5.6 The purpose of this course is to familiarize the student with the components of the Patient Chart. Discuss the use of the Person / Patient Information window. List the tabs found on the Person / Patient Information window. Identify the types of information stored on each tab. Add a person to the database who is not a patient. Update existing patient demographics. EPM Insurance - Working with Insurance v5.6 This curriculum focuses on familiarizing the learner with insurance maintenance. The NextGen Learning Center 5.6 Biller Education Plan Guide : Page 6

8 v5.6 Insurance - Adding Insurance to a Person Time: 45 minutes Application Version: 5.6 This course provides an overview of the Insurance Maintenance window and covers how to attach insurance to a person's demographic record. Attach insurance to a person's demographic record. Define the components and fields of the Insurance Maintenance window. v5.6 Insurance - Adding an Authorization This course covers how to add a pre-certification or authorization code to a patient's insurance. Create an Authorization Code using both Encounter and Units modes. Define the components of the Authorization Code Tracking window. Identify the different methods for accessing an Authorization Code. v5.6 Insurance - Adding an Employer with Insurance Time: 15 minutes Application Version: 5.6 This course covers how to add an employer with insurance to a patient's chart. Attach an employer with insurance to a person's demographic record. EPM Accounts- Working with Guarantor Accounts v5.6 This curriculum focuses on setting up and using guarantor accounts in the EPM application. v5.6 Guarantor Accounts Time: 40 minutes Application Version: 5.6 This course provides an overview of guarantor accounts in the Enterprise Practice Management (EPM) application. Identify a guarantor. Describe a guarantor's account. Recall the information found on an account. Recall the steps to search for an account. EPM Encounters - Working with Encounters v5.6 This curriculum focuses on familiarizing the learner with creating and working with encounters in the EPM application. The NextGen Learning Center 5.6 Biller Education Plan Guide : Page 7

9 v5.6 Encounters - Overview of Encounters Time: 15 minutes Application Version: 5.6 This course is intended to introduce the student to encounters in the Enterprise Practice Management (EPM)application. Identify the use of an encounter in the NextGen Enterprise Practice Management (EPM) application. v5.6 Encounters - The Create Encounter and Encounter Maintenance Windows The purpose of this course is to introduce the student to the Create Encounter and Encounter Maintenance windows. Define the components of the Create Encounter and Encounter Maintenance windows. v5.6 Encounters - Checking in Patients and Creating Encounters Time: 45 minutes This course covers checking in and creating encounters for both new and existing patients in the Enterprise Practice Management (EPM) application. You will also learn how to create encounters for patients without appointments. Identify the use of an encounter in the EPM application. Define the components of the Create Encounter and Encounter Maintenance windows. Access the Checkin / Create Encounter AutoFlow process from the NextGen EPM Appointment Book. Complete information on the Create Encounter and Patient Information windows. Check in and create encounters for new and existing patients. EPM Charge Entry - Working with Charges v5.6 This curriculum focuses on familiarizing the learner with how to create and work with charges in the Enterprise Practice Management (EPM) application. v5.6 Charges - Working with Charges Time: 20 minutes This course is intended to familiarize the student with the Charge Posting window. It also covers how to enter-delete, and void charges. Define the components of the Charge Posting window. Enter a new charge for an encounter. Describe the difference between deleting and voiding a charge. Delete a charge. Void a charge. The NextGen Learning Center 5.6 Biller Education Plan Guide : Page 8

10 EPM Transaction Entry Basics v5.6 This curriculum focuses on familiarizing the learner with how to enter and balance transaction batches in the Enterprise Practice Management (EPM) application. v5.6 Transactions - Overview of Payment Processing Time: 45 minutes This course is an overview of how to process payments and their related adjustment and refund transactions. Create transaction batches. Enter basic payment and adjustment transactions. Balance transaction batches and post the transactions to the A/R. EPM Transaction Entry Advanced v5.6 This curriculum covers more in depth features of transaction entry in the Enterprise Practice Management (EPM) application. v5.6 Advanced Transactions - Entering Insurance Transactions Time: 30 minutes Covers how to enter transactions received from third party payers in the NextGen Enterprise Practice Management (EPM) application. State the names and define the fields in Payment Entry that are specific to insurance transactions. Enter a transaction from a third party payer with a contract attached. Enter a transaction from a third party payer using reason codes and alternate statuses on a line item basis. v5.6 Advanced Transactions - Overview of Credits Time: 15 minutes Application Version: 5.6 This course introduces the student to the types of credits found in the Enterprise Practice Management (EPM) application. Identify the different types of credits found in the EPM application. v5.6 Advanced Transactions - Credits Setup Time: 60 minutes Application Version: 5.6 This course covers setting up security rights and master files necessary to create and use credits in the Enterprise Practice Management (EPM) application. The NextGen Learning Center 5.6 Biller Education Plan Guide : Page 9

11 Set up security associated with credits. v5.6 Advanced Transactions - Working with Line Item Credits Time: 60 minutes Application Version: 5.6 This course covers how to transition a credit from one line item to another in the NextGen Enterprise Practice Management (EPM) application. State the definition of a line item credit. Transition a line item credit using two transaction codes-a debit and a credit. Transition a line item credit using an individual transaction code with "allow sign over-ride" rights. v5.6 Advanced Transactions - Working with Refunds This course covers how to create a refund transaction in the Enterprise Practice Management (EPM) application. Create a refund for a patient. Create a refund for a payer (insurance company). v5.6 Advanced Transactions - Account Level Transactions This course covers how to enter transactions at the account level. Access an archived statement for an account. Enter a transaction for multiple encounter line items at one time. View account-level transaction details in the Account Profile window. v5.6 Advanced Transactions - Working with Unapplied Credits Time: 45 minutes This course covers how to work with and apply unapplied credits at the Encounter and Account level in the Enterprise Practice Management (EPM) application. Create an unapplied credit. Apply an unapplied credit to a charge on the Charge Posting window. Transfer an unapplied credit from an encounter to an account. Apply an unapplied credit using the Unapplied Amounts by Account-Invoice, and Encounter report. v5.6 Advanced Transactions - Using Reason Codes The NextGen Learning Center 5.6 Biller Education Plan Guide : Page 10

12 This course is intended to instruct the user how to use reason codes in payment entry in the Enterprise Practice Management (EPM) application. State the difference between transaction-adjudication, and line item reason codes. Enter reason codes during transaction entry. EPM Billing Encounters and Working with Claims v5.6 This curriculum focuses on familiarizing the learner with how to bill encounters and process claims in the Enterprise Practice Management (EPM) application. v5.6 Claims - Billing Encounters This course covers how to bill encounters using the NextGen EPM (Enterprise Practice Management) application. Understand the basic steps and concepts used in the EPM billing process. Look up and bill encounters in a batch. Access and bill a single encounter on demand. v5.6 Claims - Rebilling Encounters and Regenerating Claims This course is intended to instruct the student how to rebill encounters and regenerate archived claims using the Next- Gen EPM application. Rebill an encounter where a charge needs to be submitted to a secondary or tertiary insurance. Rebill an encounter where a new charge has been added to an encounter. Rebill an encounter where you have selected charges to be billed again. Look up archived claims and regenerate them for printing-either in a batch or one at a time as needed ('on demand'), or for electronic submission. v5.6 Claims - Processing Claims The purpose of this course is to instruct the student how to process claims in the NextGen EPM application. Understand the basic steps and billing concepts used in processing claims. Look up and print claims in a batch and on demand. Build an electronic claim send file for submission. The NextGen Learning Center 5.6 Biller Education Plan Guide : Page 11

13 v5.6 Claims - Professional/CMS 1500 Claims Time: 60 minutes Application Version: 5.6 Prerequisites: v5.6 Using File Maintenance, v5.6 Libraries - Claim Edits, v5.6 Libraries - Claim Printing, v5.6 Libraries - Submitter Profiles, v5.6 Creating Practices, v5.6 Overview of the Payers System Master File, v5.6 System Master Files - Transaction Codes, v5.6 Practice Master File - Groups and v5.6 Overview of the Providers System Master File This course takes you through the major steps of setting up NextGen to be able to submit printed and electronic claims using the HCFA/CMS 1500 claim forms. Assign default claim-related libraries to the practice. Fill in the relevant payer information. Establish any provider billing groups you plan to use. Fill in the relevant provider information. EPM Statements - Setting Up Statements v5.6 This curriculum focuses on familiarizing the learner with how to set up statements in the Enterprise Practice Management (EPM) application. v5.6 Statements - Setting Up Your Statement Process Time: 60 minutes This course covers setting up the statement process in the Enterprise Practice Management (EPM) application. Describe the differences between the two types of statements and how to set them up. Identify the use of the different parts of the NextGen statement. Select options to customize the NextGen statement to meet your practice s policies and procedures. Select options to determine how often NextGen qualifies a guarantor for a statement. v5.6 Statements - Setting up Payer Specific Dunning Messages This course covers setting up dunning messages for a specific payer or financial class. List features of payer-specific dunning messages. Create dunning messages in the Statement Messages System Master File. Define aging categories and assign dunning messages in a Statement Library. Attach a Statement Library to a financial class in the Statement Parameters Mapping System Master File. Attach a Statement Library to a payer. EPM Statements - Working with Statements v5.6 This curriculum focuses on familiarizing the learner with how to generate statements in a batch and on demand in the Enterprise Practice Management (EPM) application. The NextGen Learning Center 5.6 Biller Education Plan Guide : Page 12

14 v5.6 Statements - Generating Statements in a Batch Time: 45 minutes This course is intended to introduce the student to the statement batch process in the Enterprise Practice Management (EPM) application. List the options to use when generating statements in a batch. List ways to suppress statements or encounter information and how to determine if a print statement indicator is turned off. List ways to troubleshoot problems that occur when running statements. v5.6 Statements - Generating an Individual Statement on Demand Time: 30 minutes This course covers generating a single statement as needed. List when to run a statement on demand from the account-chart, and encounter level. List the options to use when printing an individual statement on demand. List ways to troubleshoot problems when printing an individual statement on demand. EPM Working with AutoFlow v5.6 This curriculum focuses on familiarizing the learner with how to set up and use the AutoFlow feature in the Enterprise Practice Management (EPM) application. v5.6 AutoFlow - Checkin and Checkout Setup Time: 40 minutes Application Version: 5.6 This course covers setting up the Checkin and Checkout AutoFlow processes in the Enterprise Practice Management (EPM) application. Define an AutoFlow Sequence as it applies to the NextGen Enterprise Practice Management (EPM) application. Identify and collect the information needed to set up AutoFlow Sequences. Create and modify AutoFlow Sequences. v5.6 AutoFlow - Checking Out Patients This course covers how to check out a patient in the Enterprise Practice Management (EPM) application using the Auto- Flow function. Check out a patient using the AutoFlow feature. The NextGen Learning Center 5.6 Biller Education Plan Guide : Page 13

15 The NextGen SM Learning Center 3340 Peachtree Road NW, Suite 2700, Atlanta, GA p: f: The NextGen Learning Center is a service mark of NextGen Healthcare. All rights reserved.