DMERC Billing

File Maintenance Help for NextGen® Enterprise 8

DMERC Billing

Support for DMERC (Durable Medical Equipment Regional Carriers) billing for Medicare payers enables you to bill one of the four standard DME Regional Carriers for DME service items. The four standard DMERCs are: HealthNow New York® Inc. Adminastar Federal, Inc. Palmetto Government Benefits Administration CIGNA Setting Up DMERC Billing Set Up DMERC at System Level Real-Time Address Validation for DME Regions Set Up Practice-Specific Information for DME Claims Parent topic: Master Files - System

File Maintenance Help for NextGen® Enterprise 8

Setting Up DMERC Billing

The following areas in the application must be set up to use DMERC billing: Service Items libraries DME Regions master files Parent topic: DMERC Billing

File Maintenance Help for NextGen® Enterprise

Setting Up DMERC Billing

The following areas in the application must be set up to use DMERC billing: Service Items libraries DME Regions master files Parent topic: DMERC Billing

NextGen® Therapy Suite Help 30.3.13.0

Document a DME Supply Item

Select the Types field, and then select the supply category. DME Item Types picklist The grid displays all items of that type and their supply CPT codes. Note: All Types and supply CPT codes tied to Types are configured in the Billing Configuration template. Select the supply item from the grid. The item description, code, and price appear in a row of fields to the right of the grid. Item details added to secondary grid Indicate a Qty. This is required. Select the R, L, or B option for right side, left side, or both. This drives RT, LT, or both modifiers that attach to the CPT code. If applicable, document Position of Orthosis, Type of prosthesis, and Extremity involved. If applicable, document additional information in Comments. Parent topic: Document a DME Only Visit

NextGen® Orthopedic Suite Help 80.2.14.0

Document Details of External Equipment

You can document the order details for durable medical equipment (DME) that must be purchased from external sources for orthopedic patients. Open the Home or any other applicable template, select Orders from the upper navigation bar, and then select Single Order. Expand the External DME panel. Select the item to order from the Item grid. The selected item appears in the Item field. Note: You can add, update, and delete items in the Item grid. By default, the current date appears in Date. Select the duration of the item, the date of the injury, and the date of surgery. Enter the reason for the order. Add External Equipment You can add durable medical equipment (DME) that must be purchased from external sources. Update External Equipment You can update the details of durable medical equipment (DME) that must be purchased from external sources. You can also delete any unnecessary DME. Parent topic: Order Tests, Therapies, Equipment, and Referrals in the Single Order Template Related tasks

File Maintenance Help for NextGen® Enterprise

Real-Time Address Validation for DME Regions

When both the user and the practice are setup for real-time address validation, the city, state, zip, country and county fields are automatically sent to the USPS address for real-time address validation. This process applies to the address entered on the DME Regional Carrier Information window. After you select OK the address is automatically sent to the USPS address validation API and compared to the addresses in the USPS database. The address fields that are sent for validation are address 1, address 2, city, state, and zip. The name of the entity is not sent. Refer to the topic Real-time Address Validation in Master Files for an overview of real-time address validation. The USPS address validation API responds with one of several messages stating: Valid address. Refer to Validate an Entity's Address - Match Found procedure for detailed information. Address cannot be found. This address may be undeliverable. Refer to Validate an Entity's Address - Address Not Found procedure for det

DMERC Billing

Recommendations

DMERC Billing

Setting Up DMERC Billing

Setting Up DMERC Billing

Document a DME Supply Item

Document Details of External Equipment

Real-Time Address Validation for DME Regions

DMERC Billing

DMERC Billing

Setting Up DMERC Billing

Setting Up DMERC Billing

Document a DME Supply Item

Document Details of External Equipment

Real-Time Address Validation for DME Regions