Providers System Tab

Field	Description
Provider Payers	This field lists payers and payer numbers added to the provider. After you add a provider, you should add values in the Provider Payers list. For more information on payers and payer numbers, refer to Payer Name and Number.
Taxonomy Code	This field displays a default taxonomy code to classify providers according to type or specialty. For more information on taxonomy codes, refer to creating taxonomy codes and attaching taxonomy codes.
Specialty Code1/ Specialty Code2	This field displays the provider's specialty codes. You can modify specialties in the Specialties master file.
Provider Subgrouping 1/ Provider Subgrouping 2 (User-defined fields)	This field displays provider subgrouping category types that you can use as reporting filters. To modify the information, you can refer to the Provider Subgrouping 1 and Provider Subgrouping 2 fields on the General tab of the Enterprise Preferences window.
Employer	This field displays the provider's employer. The employers listed are maintained in the Employers master file. For more information, refer to Employers.
Primary Location	This field displays the provider's primary location that you are required to provide to insurance companies.
Hospital Affiliations	This field displays the hospital that the provider is affiliated with.
Letter Code	This field is currently not used.
Enable PQRI Claim Edits	This field enables Physician Quality Reporting Initiative (PQRI) claim edits for rendering providers.
Language	This field displays the provider's primary language.
Language (Sec)	This field displays the provider's second language, if any.
Language (Third)	This field displays the provider's third language, if any.
External ID	This field displays the alphanumeric key that other applications use to map fields. When another application needs data from a NextGen Healthcare application, the External ID identifies the NextGen Healthcare application file location. The other application can then access the file, obtain the information, and map it to a corresponding field.
Export Service	This field allows charges for services performed by the provider to be carried over to a third-party billing system. If you do not select the checkbox, the application does not permit charges to be billed.
Other License	This field displays any additional license or certification numbers the provider has.
Other License Description	This field contains descriptions of any additional license or certifications.
National Provider ID	This field displays the provider's National Provider Identifier (NPI). Note: If the provider will be used for closed loop referrals, you must assign the provider an NPI issued by the National Plan and Provider Enumeration System (NPPES) at https://nppes.cms.hhs.gov. If you reuse NPI values for multiple providers, then a closed loop referral might not reach the correct provider. For more information, go to NextGen Healthcare Success Community, and download the Referral Workflow Guide for NextGen® Share.
Default Tax ID	This field displays the provider's tax ID. If the Default Tax ID is blank, the Local 82 ID number is automatically populated.
Provider Licensing	This field lists the products the provider is currently licensed to use. If you have an unlimited license, you cannot clear the checkboxes.

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Providers Demographics Tab

The Demographics tab contains the provider name, address, and other profile information. Field Description Last/ First/ Middle Names Enter the name of the provider. It is very important that you only enter the provider's middle initial in the Middle Name field. If you enter an entire name in the Middle Name field (even though the field is labeled Middle Name instead Middle Initial), the application will take the last letter of the name you entered and enter it as the middle initial in box 17 of the HFCA 1500 form. Business/ Home/ Other1/ Other2 Select the type of address information you want to enter for the provider. Address/ City/ State/ Zip/ Country/ County The first space is for street number and name. The second space is for other address details such as suite number. If the ZIP code table is set up, you can enter the ZIP code, and the city, state, county, and country automatically display. Country Select the drop-down arrow and select the applicable country. County Select the dro

File Maintenance Help for NextGen® Enterprise 8

Providers System Tab

On the System tab, you can add a provider or modify provider details using the following field descriptions. Field Description Provider Payers This field lists payers and payer numbers added to the provider. After you add a provider, you should add values in the Provider Payers list. Taxonomy Code This field displays a default taxonomy code to classify providers according to type or specialty. Specialty Code1/ Specialty Code2 This field displays the provider's specialty codes. You can modify specialties in the Specialties master file. Provider Subgrouping 1/ Provider Subgrouping 2 (User-defined fields) This field displays provider subgrouping category types that you can use as reporting filters. To modify the information, you can refer to the Provider Subgrouping 1 and Provider Subgrouping 2 fields on the General tab of the Enterprise Preferences window. Employer This field displays the provider's employer. The employers listed are maintained in the Employers master file. Primary Locat

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General Preferences for Enterprises

The following table describes the fields in the General tab on the Enterprise Preferences window. Field Description Provider Subgrouping 1 and Provider Subgrouping 2 These user-defined fields are used as labels for reports at the enterprise or provider level. These labels appear as field names on the System tab on the Add/Modify Provider Information window. The tab labels also appear on various reports as filters and column headings. For more information, go to the NextGen Healthcare Success Community, and download the Reports User Guide for NextGen® Enterprise PM. Reason Code Subgrouping 1 and Reason Code Subgrouping 2 You can enter the labels to use in the report filters and report columns. These labels appear as field names in the Reason Code Library Maintenance window. Location Subgrouping 1 and Location Subgrouping 2 You can enter the labels to use in the report filters and report columns. These labels appear as field names on the Location Defaults tab in the Location Information

File Maintenance Help for NextGen® Enterprise 8

Setting Up General Default Information for Enterprises

The following table describes the fields on the General tab in Enterprise Preferences: Field Description Provider Subgrouping 1 and Provider Subgrouping 2 These user-defined fields are used as labels for reports at the enterprise or provider level. These labels appear as field names on the System tab on the Add/Modify Provider Information window.The tab labels appear for various report filters , and as column headings on reports. For more information, go to the NextGen Healthcare Success Community and download the Reports User Guide for NextGen® Enterprise PM. Reason Code Subgrouping 1 and Reason Code Subgrouping 2 You can enter the labels that you want to use in report filters and report columns. These labels appear as field names, on the Reason Code Library Maintenance window.The tab labels appear for various report filters , and as column headings on reports. Location Subgrouping 1 and Location Subgrouping 2 You can enter the labels you want to use in report filters and report colum

File Maintenance Help for NextGen® Enterprise 8

Providers Demographics Tab

The Demographics tab contains the provider name, address, and other profile information. Field Description Last/ First/ Middle Names Enter the name of the provider. It is very important that you only enter the provider's middle initial in the Middle Name field. If you enter an entire name in the Middle Name field (even though the field is labeled Middle Name instead Middle Initial), the application will take the last letter of the name you entered and enter it as the middle initial in box 17 of the HFCA 1500 form. Business/ Home/ Other1/ Other2 Select the type of address information you want to enter for the provider. Address/ City/ State/ Zip/ Country/ County The first space is for street number and name. The second space is for other address details such as suite number. If the ZIP code table is set up, you can enter the ZIP code, and the city, state, county, and country automatically display. Country Select the drop-down arrow and select the applicable country. County Select the dro

Help Guide for NextGen® Enterprise PM 8

Authorization Inquiry

Select Authorization Inquiry from one of the defined access paths. The Authorization Inquiry appears. Enter field information according to the following table: Field Description Patient Insurances (Required) Select the patient's insurance(s). Note: In order for the payer to display in the Patient Insurances field, it must be listed on the Insurance Listing window for the specified patient and it must be added to the Eligibility/Referral system. Requesting Physician (Required) Select the physician requesting for NextGen® Eligibility Verification. Requesting Location Select the location for the requesting physician. If there are no additional locations in the practice, this field does not display. Note: If the list in the Requesting Location field is empty, you do not have a valid provider number for that location and payer. Check the Group Information section of the Provider master file to see if the payer name and a provider number exist for the Requesting Physician Select Authorizatio

Providers System Tab

Recommendations

Providers Demographics Tab

Providers System Tab

General Preferences for Enterprises

Setting Up General Default Information for Enterprises

Providers Demographics Tab

Authorization Inquiry

Providers Demographics Tab

Providers System Tab

General Preferences for Enterprises

Setting Up General Default Information for Enterprises

Providers Demographics Tab

Authorization Inquiry