Assign a Provider Number at a Practice/Location/Provider/CPT4 Code Level

File Maintenance Help for NextGen® Enterprise 8

Default Location Setting for Provider & Group Numbers

You can set a default location for provider and group numbers. This setting is a one-time setup for an individual Provider Number or Group Provider Number because these numbers are often the same for payers at all or several locations. The Provider Number you enter can be no longer than 30 characters. Set Up a Default Location for Provider Numbers Parent topic: Providers Practice Tab

File Maintenance Help for NextGen® Enterprise 8

Group Information Setup for a Provider

Group information is set up for the rendering provider for each service location. Each provider has a default group information record that is automatically included for generic use. However, you can set up specific information for a payer. If you have group information set up for a specific payer, then it becomes the default information for box 33 of the HCFA 1500. Note: If you do not have group information set up for the payer or the default level, then the provider information in the top half of the window is printed in box 33 of the HCFA 1500. To set up group information: On the Add/Modify Provider Information window, select the Practice tab. Under Service Location, select a location. A list of payers for that location displays in the Group Information section. If you want to copy the information for one payer to other locations in the Service Locations list, right-click the payer and then select one of the following: Copy to All Locations to copy the payer to all other locations.

File Maintenance Help for NextGen® Enterprise 8

Set Up CPT4 Codes at the Provider Master Level

To set up CPT4 codes at the provider master level: From the Master Files > System list, select Providers. Select the appropriate provider. Select the Practice tab. Select the drop-down arrow in the ServiceLocation field and select the location where the service is performed. A list of payers displays in the Group Information section. Under Group information, double-click the payer to which you want to add CPT4 codes. The Modify Provider Practice Payer window displays. Select the Open Record button next to the CPT4 Provider Nbrs field. The Valid Provider Numbers for [Payer Name] window displays. Select the Open Menu button and select New. Note: You can open and delete existing records. You can edit existing provider numbers, but you cannot edit the CPT4 code range. The Provider Number for CPT4 Range window displays. In the CPT4 field, enter the CPT4 code at the beginning of the range you want to set up. Use the to display the CPT4 Code Search window to search for a CPT4 code by code or

File Maintenance Help for NextGen® Enterprise 8

Rules for Claim Population

When a paper or electronic claim is generated, the claim pulls data (box 33 on the HFCA 1500) from the fields on the Provider Number for CPT4 Range dialog box based on the following rules: If data has been entered in the CPT4 and Provider Number fields, the claim pulls the provider number from this dialog box. If the Group Name field is blank, the Group # is blank on the claim. If data has been entered in the Group Name field, the claim pulls the group name, address, and phone number from the Group Information dialog box. If the Group Name field is blank, but data has been entered in the Name/Organization and address fields, then the claim pulls the Name/Organization and address information from this dialog box. If the Group Name, Name/Organization, and address fields are blank, then the claim pulls the Name/Organization, and address information from the provider/payer/location setup on the Practice tab of the Provider master. Parent topic: Assign a Provider Number at a Practice/Locati

File Maintenance Help for NextGen® Enterprise 8

Attach a Taxonomy Code for the Provider at the Practice Level

To attach a taxonomy code for the provider at the practice level: From the Master Files list, select System or PM > Providers. Select the provider. Select the Practice tab. Select the Rendering provider at this practice check box. Select a service location from the Service Location field, and then double-click on the applicable payer listed under Group Information. If you select the default location and a specific payer, then the code applies for this payer at all locations. If you select a specific location and the default payer, then the row applies for all payers at that location. If you select a specific location and specific payer, then the code applies only to this payer at this location. The Modify Provider Practice Payer window displays. Select the taxonomy code from the Taxonomy Code field. If you want to set taxonomy codes for specific procedure ranges, select the CPT4 Provider Nbrs button. The Valid Provider Numbers for [Payer Name] window displays. Select the Open Menu butt

Help Guide for NextGen® Enterprise PM 8

Attach CPT4 Codes to Field Locator 51

In File Maintenance, select Master Files - System and then Payers. Select the payer from the Payers List window. The Add/Modify Payer Information window opens. Select the Practice Parameters tab and then UB tab. Select the Open Menu button at the bottom of the window and select New. The Field Loc 51 for a CPT4 Range window opens. Enter the CPT4 code you want to attach to the provider in the CPT4 field. If you want to enter a range of CPT4 codes, your entry in this field serves as the beginning of the range. This field is required. Note: Select the Question Mark icon to perform a CPT4 Code search. You can search by code or by description. To enter a range of CPT4 codes, enter a second CPT4 code in the Thru CPT4 field. Enter the provider number in the Field Locator 51 field. This field is required. Select OK. Parent topic: UB Claims

Assign a Provider Number at a Practice/Location/Provider/CPT4 Code Level

Recommendations

Default Location Setting for Provider & Group Numbers

Group Information Setup for a Provider

Set Up CPT4 Codes at the Provider Master Level

Rules for Claim Population

Attach a Taxonomy Code for the Provider at the Practice Level

Attach CPT4 Codes to Field Locator 51

Default Location Setting for Provider & Group Numbers

Group Information Setup for a Provider

Set Up CPT4 Codes at the Provider Master Level

Rules for Claim Population

Attach a Taxonomy Code for the Provider at the Practice Level

Attach CPT4 Codes to Field Locator 51