ADA Claims Tab on Claims

Field	Description
Submitter Profile	Select the submitter profile that you want to apply to ADA Claims.
Electronic Transmitter ID	Enter the payer-assigned electronic transmitter ID to generate a claim with an electronic transmitter ID. Note: This field only displays when you select a submitter profile.
Practice Payer Opt Val	Enter the practice/payer-specific value.
Payer Alias	Enter an alternative payer name when a name that differs from the name that appears in the payer's Payer master file is required.
Primary, Secondary, and Tertiary Media Types	Enter the primary media type as either electronic or paper as accepted by the clearinghouse. If you set it as electronic, then you can also set how the secondary and tertiary claims should be submitted.
When Primary, force Secondary claims to paper	Enable this check box if you want the claim being sent to the secondary insurance to be generated on paper after payment from the primary insurance has been received. This action overrides the Electronic Secondary Media Type setting.
When Secondary, force Tertiary claims to paper	Enable this check box if you want the claim being sent to the tertiary insurance to be generated on paper after payment from the primary and secondary insurances have been received. This action overrides the Electronic Tertiary Media Type setting.
Suppress Claim	Enable this check box to suppress claims by payer when creating claims in batch mode only.
Exclude Patient Paid Amount from Claim	Enable this check box to suppress patient paid amounts from UB EDI files. Segment AMTF5 is not present in the NextGen In-line Edits file. Note: When the check box is disabled, the amount is not suppressed and segment AMTF5 is present in the NextGen In-line Edits file.
Flag All Prior Claim Line Items for Rebill	Enable this check box to include line items with a $0.00 amount with the other line item charges when you rebill an archived claim.
Suppress Claim for Non-Qualifying Encounter	Enable this check box to suppress claims for this payer when creating claims for non-qualifying encounters to a federally qualified health center.

File Maintenance Help for NextGen® Enterprise 8

UB Claims Tab on Claims

To access the UB Claims tab, you must select a facility and a bill classification on the Encounters Practice Preferences. Field Description Submitter Profile Select the submitter profile that you want to apply to UB Claims. Electronic Transmitter ID Enter the payer-assigned electronic transmitter ID to generate a claim with an electronic transmitter ID. Note: This field only displays when you select a submitter profile. Field Locator 51 This is a free form text field. If you are a regular UB user, enter the number that was provided to you by the payer in this field. Practice Payer Opt Val Enter the practice/payer-specific value. Payer Alias Enter an alternative payer name when a name that differs from the name that appears in the payer's Payer Master file is required. Primary, Secondary, and Tertiary Media Types Enter the primary media type as either electronic or paper as accepted by the clearinghouse . If you set it as electronic, then you can also set how the secondary and tertiary

File Maintenance Help for NextGen® Enterprise 8

Fields in the Claims Tab of Modify Payer Information

Field Description Submitter Profile Select the submitter profile that you want to apply to 1500 or form template claims. Electronic Transmitter ID Enter the payer-assigned electronic transmitter ID to generate a claim with an electronic transmitter ID. Note: This field only displays when you select a submitter profile. If there are multiple payers with the same transmitter ID, then a message displays stating there is more than one payer with the same ID. Practice Payer Opt Val Enter the practice/payer-specific value. Payer Alias Enter an alternative payer name when a name that differs from the name that appears in the Payers master file is required. Primary, Secondary, and Tertiary Media Types Enter the primary media type accepted by the clearing house as being electronic or paper. If you set it as electronic, then you can also set how the secondary and tertiary claims should be submitted. When Primary, force Secondary claims to paper Enable this check box if you want the claim being s

Help Guide for NextGen® Enterprise PM 8

ADA Claims Tab on Claims

This window is in the Payer master file. To access the window select Payers and then select the payer. On the Modify Payer Information window select Practice > Claims > ADA Claims sub-tab. Field Description Submitter Profile Select the submitter profile that you want to apply to ADA Claims. Electronic Transmitter ID Enter the payer-assigned electronic transmitter ID to generate a claim with an electronic transmitter ID. Note: This field only displays when you select a submitter profile. Practice Payer Opt Val Enter the practice/payer-specific value. Payer Alias Enter an alternative payer name when a name that differs from the name that appears in the payer's Payer master file is required. Primary, Secondary, and Tertiary Media Types Enter the primary media type as either electronic or paper as accepted by the clearinghouse. If you set it as electronic, then you can also set how the secondary and tertiary claims should be submitted. When Primary, force Secondary claims to paper Enable t

Help Guide for NextGen® Enterprise PM 8

ADA Claims Tab on Claims

This window is in the Payer master file. To access the window select Payers and then select the payer. On the Modify Payer Information window select Practice > Claims > ADA Claims sub-tab. Field Description Submitter Profile Select the submitter profile that you want to apply to ADA Claims. Electronic Transmitter ID Enter the payer-assigned electronic transmitter ID to generate a claim with an electronic transmitter ID. Note: This field only displays when you select a submitter profile. Practice Payer Opt Val Enter the practice/payer-specific value. Payer Alias Enter an alternative payer name when a name that differs from the name that appears in the payer's Payer master file is required. Primary, Secondary, and Tertiary Media Types Enter the primary media type as either electronic or paper as accepted by the clearinghouse. If you set it as electronic, then you can also set how the secondary and tertiary claims should be submitted. When Primary, force Secondary claims to paper Enable t

File Maintenance Help for NextGen® Enterprise

ADA Claims Tab on Claims

This window is in the Payer master file. To access the window select Payers and then select the payer. On the Modify Payer Information window select Practice > Claims > ADA Claims sub-tab. Field Description Submitter Profile Select the submitter profile that you want to apply to ADA Claims. Electronic Transmitter ID Enter the payer-assigned electronic transmitter ID to generate a claim with an electronic transmitter ID. Note: This field only displays when you select a submitter profile. Practice Payer Opt Val Enter the practice/payer-specific value. Payer Alias Enter an alternative payer name when a name that differs from the name that appears in the payer's Payer master file is required. Primary, Secondary, and Tertiary Media Types Enter the primary media type as either electronic or paper as accepted by the clearinghouse. If you set it as electronic, then you can also set how the secondary and tertiary claims should be submitted. When Primary, force Secondary claims to paper Enable t

Help Guide for NextGen® Enterprise PM 8

Practice Tab

To set up electronic dental claims, use the ADA Claims tab on the Practice tab on the Claims tab of the Modify Payer Information window. Field Description Submitter Profile Select the submitter profile that you want to apply to ADA claims. Electronic Transmitter ID Enter the payer-assigned electronic transmitter ID to generate a claim with an electronic transmitter ID. Note: This field only displays when you select a submitter profile. Practice Payer Opt Val Enter the practice/payer-specific value. Payer Alias Enter an alternative payer name when a name that differs from the name that appears in the payer's Payer master file is required. Primary, Secondary, and Tertiary Media Types Enter the primary media type accepted by the clearinghouse as being electronic or paper. If you set it as electronic, then you can also set how the secondary and tertiary claims should be submitted. When Primary, force Secondary claims to paper Select this check box if you want the claim being sent to the se

ADA Claims Tab on Claims

Recommendations

UB Claims Tab on Claims

Fields in the Claims Tab of Modify Payer Information

ADA Claims Tab on Claims

ADA Claims Tab on Claims

ADA Claims Tab on Claims

Practice Tab

ADA Claims Tab on Claims

UB Claims Tab on Claims

Fields in the Claims Tab of Modify Payer Information

ADA Claims Tab on Claims

ADA Claims Tab on Claims

ADA Claims Tab on Claims

Practice Tab