Add or Modify a Reason Code

File Maintenance Help for NextGen® Enterprise

Write Off Remaining Line Item Balances at ERA Import

Open File Maintenance and select Libraries > Reason Codes. The Reason Code List window opens. Select the open menu button to add or open an existing reason code. The Reason Code Library Maintenance window opens. Under Code Item, select Write off Remaining Balance. Open the appropriate Remittance Profile library. Under Adjustment Calculation, select the Create write-off adjustments at time of import setting. Note: This setting works in conjunction with the Write Off Remaining Balance option in the Reason Codes library. When you select both settings, an additional transaction is automatically created when an ERA file is imported that brings the line item balance to $0. This transaction is part of the ERA batch and can therefore be deleted. Parent topic: Libraries

File Maintenance Help for NextGen® Enterprise

Assign a Reason Code Library to a Payer

Open File Maintenance and select Master Files > System > Payers. The Payers List window opens. Double-click the desired payer or right-click the open menu button and select Open. Select the Practice tab and then select the Transactions subtab. Select the desired Reason Code library for the payer, and then select OK. Parent topic: Libraries

File Maintenance Help for NextGen® Enterprise

Set Priority for Reason Codes

Reason codes are displayed on the Payment Entry window of NextGen® Enterprise PM in the order set in File Maintenance. You can sort this order based on priority. Open File Maintenance and select Libraries > Reason Codes. The Reason Codes List window. Select a library, and then right-click and select Reason Code Priority. A list of reason codes for a library are displayed in a window. Use the arrows to promote or demote a reason code. Note: For a new reason code library or for any new reason codes added to an existing reason code library, the sequence number is initially blank. After the priorities are changed in the priority window, the sequence number or priority numbers are displayed for all reason codes. When priorities are set for a new reason code library, the sequence numbers usually start from 0, 1, 2, and so on. It is possible for two different reason codes to have the same sequence number. When you unhide a reason code, it goes back to its original sequence number. Parent topi

File Maintenance Help for NextGen® Enterprise 8

Reason Codes Library

You can create and maintain reason codes in a Reason Codes library. A reason code is a brief description that is added to a transaction to explain how that transaction was handled. When ERA files are involved, reason codes are returned in the file by the payer to describe how the service was reimbursed. Reason code libraries group related reason codes together. For example, you can have a reason code library that contains the reasons that a claim can be cancelled. You can generate the Reason Codes Master report from the Reason Codes library. For more information go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM. Reason Code Library Maintenance You can add or modify an existing reason code on the Reason Code Library Maintenance window. Write Off Remaining Line Item Balances After the Batch is Posted Write Off Remaining Line Item Balances at ERA Import Assign a Reason Code Library to a Payer Select Reason Codes Options in Pra

File Maintenance Help for NextGen® Enterprise 8

Reason Code Library Maintenance

You can add or modify an existing reason code on the Reason Code Library Maintenance window. You can also attach the library to payers. Open File Maintenance. Select Libraries, and then Reason Codes. The Reason Code List window opens. Double-click on an existing library to open it or select open menu button on the Reason Code List window and select New. The Reason Code Library Maintenance window opens. Complete the fields to enter the reason codes into the library. Select the Next button to add a reason code to the library or select the OK button to modify an existing reason code. Reason Code Library Maintenance Field Descriptions The table lists all the fields and its descriptions in the Reason Code Library Maintenance window. Parent topic: Reason Codes Library

File Maintenance Help for NextGen® Enterprise

Reason Code Library Maintenance Field Descriptions

Field Description COB Rsn Code Enter the HIPAA-compliant reason code to automatically populate the Coordination of Benefits Information window on the Payment Entry screen. Entering a COB reason code enables you to use the proprietary code for the transaction and the HIPAA-compliant code for the claim. This field can be used instead of or in conjunction with the default COB reason code in the Payer master file. Line Item Select this button if the reason code is returned by the payer at the charge or CPT4 code level. These reason codes are available for selection in the Line Item Reasons column at the bottom of the Payment Entry screen. Claim Level Select this button if the reason code is returned by the payer at the claim level and it applies to the entire transaction. These reason codes are available for selection in the Claim Reasons field at the top of the Payment Entry screen under the Claim Level Codes list Adjudication Select this button if the reason code is returned by the payer

Add or Modify a Reason Code

Recommendations

Write Off Remaining Line Item Balances at ERA Import

Assign a Reason Code Library to a Payer

Set Priority for Reason Codes

Reason Codes Library

Reason Code Library Maintenance

Reason Code Library Maintenance Field Descriptions

Write Off Remaining Line Item Balances at ERA Import

Assign a Reason Code Library to a Payer

Set Priority for Reason Codes

Reason Codes Library

Reason Code Library Maintenance

Reason Code Library Maintenance Field Descriptions