Set Up a Default Location for Provider Numbers

File Maintenance Help for NextGen® Enterprise 8

Set Up a Default Location for Provider Numbers

To set up a provider that has the same individual Provider number for payers at all or several practice locations: From the Master Files - System list, select Providers. Double-click a provider name. The Modify Provider Information dialog box displays. Select the Practice tab. In the Service Location field, select <Default>. Select one of the following options based on the information below: To set up the provider on the default payer, double-click on the Default row in the Group Information section. Because this is the setup for the default payer, the Payer Name field is disabled. To set up a specific payer for the provider, right-click in the Group Information section, then select New. Because this is the setup for a specific payer, a payer must be selected in the Payer Name field. If this is a new payer, select the arrow in the Payer Name field and select the payer. If this is the default payer, you cannot select a new payer. Enter the provider's number in the Provider Number field.

File Maintenance Help for NextGen® Enterprise

Assigning Exceptions for the Provider, Payer, and Location

A provider can have exceptions to how charges are normally paid. To be able to apply these exceptions to a charge, you must assign them to the provider for each service location/payer combination. For each combination, you can assign one contract exception and one SIM exception. You can attach a SIM and a contract exception to the provider at a specific location for all payers or for specific payers. A SIM or contract exception for a specific payer overrides the default exception. To assign exceptions to the provider, payer, and location: From the Master Files - System list, select Providers. Double-click on a provider from the list or highlight the provider and select the Open Menu button. The Modify Provider Information dialog box displays. Select the Practice tab. Under Service Location, select the applicable location. A list of payers displays in the Group Information section. If you want to set the default for all payers, double-click the Default row in the Group Information secti

File Maintenance Help for NextGen® Enterprise 8

Assigning Exceptions for the Provider, Payer, and Location

A provider can have exceptions to how charges are normally paid. To be able to apply these exceptions to a charge, you must assign them to the provider for each service location/payer combination. For each combination, you can assign one contract exception and one SIM exception. You can attach a SIM and a contract exception to the provider at a specific location for all payers or for specific payers. A SIM or contract exception for a specific payer overrides the default exception. To assign exceptions to the provider, payer, and location: From the Master Files - System list, select Providers. Double-click on a provider from the list or highlight the provider and select the Open Menu button. The Modify Provider Information dialog box displays. Select the Practice tab. Under Service Location, select the applicable location. A list of payers displays in the Group Information section. If you want to set the default for all payers, double-click the Default row in the Group Information secti

Help Guide for NextGen® Enterprise PM 8

Set Up a Default Location for Group Provider Numbers

To set up a group that has the same Group Provider number for payers at all or several practice locations, do the following: In File Maintenance, under Master Files, select Practice > Groups. The Groups List window opens. Double-click a group.The Group Information window opens. From the Service Location list, select the <Default> option. Select one of the following options based on the following information: To set up the group on the default payer, double-click the Default row listed under the Payer Name column. The Group Information window opens additional fields. This set up is for the default payer and the Payer Name field is disabled. To set up a specific payer for the group, right-click in the Group Information section, then select New. The Group Information window opens additional fields. Because this setup is for a specific payer, the Payer Name field is available. From the Payer Name list, select a payer. In the Group Number field, enter the group number. In the Opt Group Val

File Maintenance Help for NextGen® Enterprise

Add or Modify Provider Practice Payer

The following table describes the fields on the Add /Modify Provider Practice Payer window: Field Description Payer Name Select the payer for whom you are setting up this group information. Name/ Organization Enter the name or organization for the provider. Suspended Eff Dt Enter the date after which the payer can no longer be billed for a claim. Provider Number Enter the provider number for the payer. Street/ 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 type in the ZIP code, and the city, state, county, and country automatically display. Loc ID This field displays when the payer state is New York. Enter a two-digit numeric code to identify the location. Due to New York Medicaid requirements, this field is required when you attach a payer with a claim type of Medicaid and the payer state is New York (NY). The number in this field is then used

File Maintenance Help for NextGen® Enterprise

Set Up a Default Location for Group Provider Numbers

In File Maintenance, under Master Files, select Practice > Groups. The Groups List window opens. Double-click a group.The Group Information window opens. From the Service Location list, select <Default>. Select one of the following options based on the following information: To set up the group on the default payer, double-click on the Default row listed under the Payer Name column. The Group Information window displays additional fields. Because this setup is for the default payer, the Payer Name field is disabled. To set up a specific payer for the group, right-click in the Group Information section, then select New. The Group Information window displays additional fields. Because this setup is for a specific payer, the Payer Name field is available. Select a payer in the Payer Name field. Enter the group number in the Group Number field. Enter the value for the alternate group number for a specific payer at a specific location in the Opt Group Val field. This number may be used for

Set Up a Default Location for Provider Numbers

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