Set Up the Claim Edits Library

File Maintenance Help for NextGen® Enterprise

Configure Claim Edits

Some claim edits display in blue when they are active and require additional parameters to set up the description. If the parameters are not set up, then the claim edit displays in red and the library cannot be saved. In addition, several claim edits have variable numeric values that can be changed. Typically, these claim edits display in black and do not require changes because the value in the description is valid. If the claim edit line item charge is equal to $0.00, it does not require a change because zero is a valid value. In File Maintenance, select Libraries, and then select Claim Edits. The Claim Edits List window opens. Double-click the claim edit or select the Open Menu, and then select New. The Claim Edit Library Maintenance window opens. Right-click the claim edit description that displays with blue text, and then select Open. Claim Edit Library Maintenance Window The Claim Edit Options window opens. The parameters that display on this window depends on the claim edit desc

File Maintenance Help for NextGen® Enterprise

Claim Edit Help Text

In File Maintenance, select Libraries, and then select Claim Edits. The Claim Edits List window opens. Select Open Menu, and then select New. The Claim Edit Library Maintenance window opens. Double-click Help Text. Modify the text that you want to display in relation to the claim edit. Select OK. To change the help text back to the default setting, open the Claim Edit Library Maintenance window, right-click the help text, and then select Reset Help Text. Select OK. Parent topic: Claim Edits Library

File Maintenance Help for NextGen® Enterprise

Clear Parameter Settings in a Claim Edit

In File Maintenance, select Libraries, and then select Claim Edits. The Claim Edits List window opens. Double-click the claim edit or select the Open Menu, and then select New. The Claim Edit Library Maintenance window opens. Right-click the claim edit, and then select Clear. The claim edit reverts to the default and displays in blue if it remains active. Select OK. The modification to the claim edit is saved. Parent topic: Claim Edits Library

Help Guide for NextGen® Enterprise PM 8

Set Up the Claim Edits Library

In File Maintenance, select Libraries, and then select Claim Edits. The Claim Edits List window opens. Select Open Menu, and then select New. The Claim Edit Library Maintenance window opens. In Claim Edit Library, enter the name of the library. In Default Severity, select a severity level to be used as the default value for new claim edits. The severity of the new claim edit matches your selection in the Default Severity field. The severity level can be manually changed for the edit. The new field does not apply to edits that are already enabled. Note: Do not use the Quick Start field on the Claim Edit Library Maintenance window to avoid incorrect results. Parent topic: Claim Edits Library

File Maintenance Help for NextGen® Enterprise

Claim Edits Library

The Claim Edits Libraries enable you to select the claim edits to run when billing encounters and generating claims. A default Claim Edits Library must be created and attached at the Practice Preferences level before you can bill encounters and generate claims. After, a default library is created and attached at the Practice Preferences level, you can then create payer-specific Claim Edits Libraries and attach them at the Payer Master level. These payer-specific claim edits libraries override the default Claim Edits Library. The application maintains a list of available claim edits in the Claim Edits Library, which you can access within File Maintenance. From the list of claim edits, you can do the following: Choose the edits you want to activate Customize the text of the edit messages Set a severity level for each edit You can set up multiple Claim Edit Libraries to use for different payer requirements. Reference: For a listing of claim edit options, refer to the section on Claim Edit

File Maintenance Help for NextGen® Enterprise 8

Set Up the Claim Edits Library

Open the Claim Edits Library type. Select open menu button and then select New. The Claim Edit Library Maintenance window opens. Use the following list to complete the required and optional fields. Claim Edit Library(required) - Enter the name of the library. Quick Start - Do not use the Quick Start field on the Claim Edit Library Maintenance window. When a selection is made, it provides incorrect results and should not be used. Default Task Type - Select a Worklog task to associate with the selected claim edits that have check marks next to them in the list. The task you select will be created as the default task when one of these claim edits is encountered during the claims build process or the claim edits process. Note: Each edit can have a specific task or the default task assigned to it. You can override the default task type used for a specific claim edit by selecting a task type in the Task Type column for the active claim edit. Default Severity(required) - Select a severity lev

Set Up the Claim Edits Library

Recommendations

Configure Claim Edits

Claim Edit Help Text

Clear Parameter Settings in a Claim Edit

Set Up the Claim Edits Library

Claim Edits Library

Set Up the Claim Edits Library

Set Up the Claim Edits Library

Configure Claim Edits

Claim Edit Help Text

Clear Parameter Settings in a Claim Edit

Set Up the Claim Edits Library

Claim Edits Library

Set Up the Claim Edits Library