Libraries
NextGen® Enterprise PM provides some default libraries. These libraries are a subset of preloaded code sets or diagnosis codes. You can select the codes for your practice or enterprise and set them up in a library.
Multiple practices in an enterprise can subscribe to an existing library instead of each practice setting up a new library that contains the same information. You can print a list of the libraries by selecting the open menu button , then select Print. The report filter for the library opens. Select your report settings, and then select OK.
A Diagnosis Code Library is a subset of the full ICD9CM list in master files. This subset can simplify the selection and maintenance of codes.
- Open the Libraries
You can use the libraries in File Maintenance for default settings and user-defined data. - Default Practice Libraries
You can set some libraries as default libraries to be used by a practice. - Copy Libraries
If you have a library with similar records, you can copy the original library and give it a new name. - Provide Practice Access for Libraries
Although the libraries are available across the entire enterprise, you can control access to a library record using Practice Access. - Add or Modify an Anesthesia Library
The anesthesia library is used by practices for anesthesia concurrency billing in NextGen® Enterprise PM. - Select a Practice-Level Anesthesia Library
You can select a prctice level anesthesia library to enable the anesthesia concurrency billing functionality in NextGen® Enterprise PM. - ASA Crosswalk for Charge Posting
The ASA Crosswalk library enables you to create a table of cross-references between anesthesia CPT codes and surgical procedure CPT codes. - Add or Modify a Behavioral Health Billing Library
The Behavioral Health Billing library defines parameters for variance charges and other claim and billing parameters which can be calculated and added to encounters during the billing process for specific payers. - Set up Budget Statement Library
You can set up messages that appear on statements based on budget status. - Claim Edits Library
Claim edits are a set of conditions that must be met when you generate a claim. - Add or Modify a Claim Modifiers Library
Claim modifiers provide critical additional detail, ensuring that claims are processed accurately and the providers receive correct reimbursement for services. - Hide a Claim Modifier
- Select a Default Claim Modifiers Library
- Claim Printing Library
The Claim Printing library enables you to specify options that define which information prints on claim forms. - Create a Claim Status Profile Library
The Claim Status Profile library is required for submitting claim status inquiries. - Create a CSC Library
The Consolidated Services Claim (CSC) library enables you to establish rules for consolidating multiple encounter charges into a single consolidated services claim. - Access a Consolidated Services Claim Library
You can access the consolidated services claim library to consolidating multiple encounter charges into a single consolidated services claim. - Claim Header Rules and Claim Consolidation Rules
The Claim Header Rules establish a provider hierarchy and identify the attending provider for consolidated service claims (CSC). - Access Contract Library Maintenance
You can use the Contract Library Maintenance window to create contract defaults, co-payments, deductibles, physician referrals and authorizations. - Setting Up a New Contract Exception
You can use the contract library to create a new contract exception or to add or modify an exception through an existing contract exception name. -
You can set up the Diagnosis Codes library by creating a subset of the full ICD-CM International Classification of Diseases- Clinical Modification list, and select the diagnosis codes used by your practice. -
The General Equivalence Mappings (GEMs) utility enables you to import the ICD-10 to ICD-9 GEMs file and provides options for you to create practice-specific mappings. - Add or Modify EDI Claim Profile Library
You can add or modify the EDI Claim Profile library to store and configure EDI claim settings in one central library. - Set Up Professional EDI Claim Profile Rules
Professional Electronic Data Interchange (EDI) claim rules for payers determine how the details appear in the rendering provider loop, in service facility location loops, and in the referring provider full middle name for 837P claims files. - Set Up Institutional EDI Claim Profile Rules
Institutional Electronic Data Interchange (EDI) claim rules for payers determine how the details appear in the referring provider full middle name and in the rendering provider loop for 837I claims files. - Set Up Dental EDI Claim Profile Rules
Dental Electronic Data Interchange (EDI) claim rules for payers determine how the details appear in the referring provider full middle name, in the rendering provider loop, and in the service facility location loop for the 837D claim files. - Create an Eligibility Profile Library
You can create an Eligibility Profile library for submitting eligibility inquiries in batch mode. - Add or Modify an Encounter Rate Billing Library
You can configure the billing process for payers who require a flat encounter rate. You can also configure the business rules applicable to a payer. - Create a GPCI (Geographic Practice Cost Index) Library
You can use GPCI codes to adjust payment rates to account for differences in the price of doing business in different localities. - Import a GPCI Comma Delimited Flat File
You can import a comma-delimited flat file to add GPCI values to an existing GPCI library. - Add or Modify an Institutional Billing Library
You can use the institutional billing library to set up rules that are applied when creating electronic 837I and paper UB04 claims for payers in NextGen® Enterprise PM. - Add or Modify an NDC (National Drug Code) Library
You can use the NDC Library to create an NDC drug product list and manage billing for drugs given in the clinic. You can also define the relationships between NDC and CPT4 codes. - Billing Rules for in the Non-Coordinated SIM Library
You can set up billing rules for payer-specific service items in the Non-Coordinated SIM library. -
You can enter non-NSF Place of Service (POS) values and attach them to payers in the Place of Service library. You can create libraries with alternate values for the non-NSF POS values for paper and electronic claims. - Add or Modify a Reason Code
You can create and maintain reason code in the Reason Codes library. - Write Off Remaining Line Item Balances After a Batch is Posted
You can write off the remaining balance after a batch is posted. - Write Off Remaining Line Item Balances at ERA Import
You can write off remaining line item balances at ERA import. - Assign a Reason Code Library to a Payer
You can create and attach a library with reason codes that are unique to a specific user. - Select Reason Codes Options in Practice Preferences
- Generating Worklog Tasks Using Reason Codes
You can create an automatic, self-generating task list or worklog by using your Reason Code Library. - Set Priority for Reason Codes
You can prioritize and sort the order in which reason codes are created in the Reason Code library. -
You can configure the ERA import profiles in Remittance Profiles so that your system properly interprets the ERA information it receives from a payer or clearinghouse. - Attach a Remittance Profile Library to Payers
You can attach a remittance profile library to individual or multiple payers based on their financial class. - Create Custom RVUs (Relative Value Units) for CPT4 Codes
You can create custom RVUs for CPT4 codes that can be used for defining payment allowances for physicians. - Import a Medicare RVU Comma Delimited Flat File
You can import an RVU comma delimited flat file to add RVU values to the CPT4 codes specified in the RVU flat file. -
You can set up CPT4 codes for each practice, along with prices and claim form designations in the service items library. - Add a Service Package Library
You can create a single library with multiple service package configurations, each with different CPT4 and modifiers, service unit limits, and service duration limits that can be used by a practice. A service package configuration is linked to a patient's insurance in NextGen® Enterprise PM. - Add a Service Swap Library
You can add a new service swap library and use in the practice. - Import a Service Swap Library
You can import the service swap library from a file and use them in the practice. - Set Up a SIM Pricing Region
You can create a service item library to use with the SIM pricing region library. - Select a Default SIM Pricing Region Library for an Enterprise
You can set a default pricing region library at an enterprise level in Enterprise Preferences. - Set Up SIM Pricing Template Library
You can find price-related information in the SIM Pricing Template library. - Configure SIM Library
You can configure the SIM Library to include adding SIM libraries for the update, sending a SIM library to NextGen® Background Business Processor, update existing SIM effective price, and so on. - Add or Modify a Statement Library
You can use the Statement library to group individual statement messages based on the age of the outstanding insurance balance or the statement counter (the number of statements sent) for the outstanding insurance balance. - Link Statements Libraries to a Payer
You can link statement libraries to the desired payer while modifying payer information. - Set Up Submitter Profiles
You can create a submitter profile for each clearinghouse and direct payer to submit electronic claims. -
You can define the tax exemption status for each financial class and SIM for each applicable state and also determine which sales taxes apply for specific SIMs between different locations. - Set Up Tax Rates
You can set up sales tax rates that are used to automatically calculate and post taxes for specific charges entered into NextGen® Enterprise PM. -
You can define a sales tax rate that is used to automatically calculate and post taxes for specific charges entered into NextGen® Enterprise PM. - Set Up an Alternate Type of Service Codes Library
You can enter alternate type of service codes that meet specific payer requirements for the claim media type, either paper or electronic. - Attach an Alternate Type of Service Library to a Payer
After setting up an alternate type of service codes library, you can attach it to a payer.