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Create a Claim Status Profile Library

The Claim Status Profile library enables you to set up rules to automatically complete the required fields and additional data for batch mode processing.

  1. In File Maintenance, select Libraries > Claim status Profile.
  2. Select the open menu button , and then select New.
    The Claim Status Profile window opens.
  3. Select the options and setting as described in the following table and then select OK.
  4. In Receiver Name [2100B Loop NM1 Segments], enter Last Name/Organization Name [NM103], First Name [NM104], Middle Name [NM105], and Identification Code [NM109].
  5. In Receiver Name [2100B Loop NM1 Segments], select Entity Type Qualifier [NM102], and Identification Code Qualifier [NM108].
  6. In Provider Name [2100C Loop NM1 Segments], enter Last Name/Organization Name [NM103], First Name [NM104], Middle Name [NM105], and Identification Code [NM109].
  7. In Provider Name [2100C Loop NM1 Segments], select Service Provider, Identification Code Qualifier [NM108], and Entity Qualifier Type [NM102].
  8. In Reference Identification [2200D Loop REF Segments], select Payer Claim ID Number [1K], Institutional Bill Type ID [BLT], Medical Record ID [EA], and Claim Submitted Charges (AMT).
  9. In Reference Identification [2200E Loop REF Segments], select Payer Claim ID Number [1K], Institutional Bill Type ID [BLT], Medical Record ID [EA], and Claim Submitted Charges (AMT).
Create a Claim Status Profile Library