Add Duplicate NEIC Number to Existing Payers

File Maintenance Help for NextGen® Enterprise 8

Search for Payers Using Payer Number or NEIC Number

The Payers List window enables you to search for a payer. In File Maintenance, select Master Files > System > Payers. The Payers List window opens. Select the NEIC/Payer Number column header, and enter the payer number or NEIC number in the Payers List Search field. To view a payer, select the payer and select Enter. The Modify Payer Information window for the selected payer opens. Parent topic: Payers Master File

File Maintenance Help for NextGen® Enterprise 8

Payer Defaults - 1 Tab

Field Description Payer Name Enter the name of the payer. When entering data into this field, the following three rules must be met: The first character must be alphabetic. The name must be at least two characters long. Valid characters of the name include: 0123456789 ABCDEFGHIJKLMNOPQRSTUVWXYZ & (ampersand) . (period) , (comma) - (dash) <space> When you modify the payer name, a message appears indicating the number of person or patient records associated with the payer. The message provides the following options: Yes: To update the payer master record in File Maintenance and on the associated person/patient records in NextGen® Enterprise PM. No: To update the payer master record in File Maintenance only. Cancel: To return to the payer record. Note: Define generic payer names for less frequently used plans to avoid creating an excessive payer file. For example, define Commercial Insurance COB1, COB2, and COB3 with blank addresses that may be added at the time of assignment. You can def

File Maintenance Help for NextGen® Enterprise 8

Add or Modify a Payer

From the Master Files - System list, select Payers. The Payers List window opens. To add a payer, select open menu , and then select New. The Add Payer Information window opens. Enter all the required information under the following tabs: Payer Defaults - 1 Defaults - 2 System Practice Alt Payer External Co-Pays Select OK to save the changes. To modify a payer, select the payer from the list, select open menu , and then select Open. The Modify Payer Information window opens. Do the required changes and then select OK. Parent topic: Payers Master File

File Maintenance Help for NextGen® Enterprise 8

Payers Master File

Payers are the third-party entities, other than guarantors or employers, that you expect to receive reimbursement from. Some examples of payers are commercial insurance companies, Medicaid, and Medicare. In the Payers master file, you can specify the contract associated with the payer, the participating providers, how to submit claims, and other general payer information. You can generate Payers Master File reports from the Payers master file. For more information, go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM. Auditing Payers Master File Add or Modify a Payer Search for Payers Using Payer Number or NEIC Number You can search for a payer using NEIC number or payer number. Add Duplicate NEIC Number to Existing Payers You can add an NEIC number for a payer, that exists for other payers. Hide a Payer Payer Defaults - 1 Tab Real-time Address Validation for a Payer Practice Tab Configuring Alternate Payers You an use the Alt

File Maintenance Help for NextGen® Enterprise 8

Checking for Duplicate Payers

You can turn on a NextGen® Enterprise PM setting that checks for duplicate payer names. This setting makesNextGen® Enterprise PMcompare the payer name that a user types to all other payer names in the Payer master file. If this option is enabled when a new insurance is attached to a person, a check is performed for an existing payer based on the payer name, address, or contact phone number. The user can then select from a list of existing payers or can ignore the list and type the new plan name. In addition, you can prevent users from ignoring the list and force them to make a selection. The duplicate check: Is performed only for payers that allow the plan name to be modified. Only occurs the first time an insurance plan is attached; after that, the check no longer occurs. Parent topic: General Practice Preferences

File Maintenance Help for NextGen® Enterprise 8

Alternate Payers

The Payers-Alt Payers master file allows you to create an alternate payer and associate the alternate payer to a payer in the Payers master file. You can associate the same alternate payer to multiple payers or associate multiple alternate payers to a payer. When you bill an encounter with a payer having alternate payers, separate claims can be generated simultaneously. For example, you set up a payer to bill medical services such as an office visit (99213). Now, when you bill a behavioral health service for substance abuse therapy, the claim may go to a trading partner where the diagnosis is F11.10. But when the same substance abuse therapy is rendered for a patient with a mental health disorder, such as depression, the claim goes to the Department of Mental Health. You can also hide or show an alternate payer by selecting open menu and then selecting Hide or Un-hide. You can generate Alternate Payer Listing report from the Payers-Alt Payers master file. For more information, go to Ne

Add Duplicate NEIC Number to Existing Payers

Recommendations

Search for Payers Using Payer Number or NEIC Number

Payer Defaults - 1 Tab

Add or Modify a Payer

Payers Master File

Checking for Duplicate Payers

Alternate Payers