Attaching Taxonomy Codes to Payers

File Maintenance Help for NextGen® Enterprise 8

Attaching a Taxonomy Code to the Alternate Payer

From the Master Files list, select System or PM > Payers. Select the payer. Select the Alt Payer tab. In the Location Specific Information section, select the taxonomy code from the Taxonomy Code field. Parent topic: Taxonomy Codes to Payers

File Maintenance Help for NextGen® Enterprise 8

Priority for Taxonomy Code Usage for Claims

If the Alternate Payer is a 1500 payer: Use the taxonomy code from the Alternate Payer tab Specific location. If blank on Alternate payer, use the Taxonomy Code from the Group master. If the Alternate Payer is a UB payer: Use the Taxonomy Code from the Alternate Payer Specific Location. If the Taxonomy Code is blank on Alternate Payer, use Taxonomy Code from the Enhanced UB Tab on the Payer. If the Taxonomy Code is blank on Enhanced UB Tab on Payer use the Taxonomy Code from the Group master. If the Main Payer is a 1500 payer: Use the Taxonomy Code from the Group master. If the Main Payer is a UB Payer: Use the Taxonomy Code from the Enhanced UB Tab on the Payer for the Specific Location. If the Taxonomy Code is blank on Enhanced UB Tab on Payer use the Taxonomy Code from the Group master. Parent topic: Taxonomy Codes to Payers

File Maintenance Help for NextGen® Enterprise 8

Examples of Payer Taxonomy Setup

The following table contains examples of split claims and descriptions of which taxonomy code is used based on whether the payer is the main or the alternate and where the codes exist in File Maintenance. The most specific setting is always selected instead of the other settings. Claims Used for: Main Payer/ Alt Payer Descriptions of Which Taxonomy Code Is Used 1500/1500 The main payer claims pull the taxonomy code from the Group master file. When the taxonomy code is attached to the alternate payer, the code overrides the group taxonomy in the Group master file in the 837 Professional 2000A loop PRV segment for all Alternate Payer claims for the specific location for the payer. If the Alternate Payer Taxonomy Code field is blank, the claim pulls the taxonomy code from the Group master file for alternate payer claims. UB/1500 When the taxonomy code is attached to the enhanced UB tab for a specific location for the main Payer, the taxonomy code overrides the group taxonomy in the Group

File Maintenance Help for NextGen® Enterprise 8

Taxonomy Codes to Payers

You can attach taxonomy codes for group billing in the Payer master file. These codes override the Group master file taxonomy code. You can attach these codes to: Payers at the practice level for specific locations. This setting is only for UB claims. Alternate payers for a specific location. Attaching Taxonomy Codes to Payers Attaching a Taxonomy Code to the Alternate Payer Priority for Taxonomy Code Usage for Claims Examples of Payer Taxonomy Setup Parent topic: Taxonomy Codes

File Maintenance Help for NextGen® Enterprise 8

Attach Taxonomy Codes to Providers

You can attach taxonomy codes to: providers as the provider default taxonomy code for the enterprise. providers at the practice level, which overrides the provider default taxonomy code. You can add taxonomy codes at this level by location on the payer rows, either default or specific. The most specific setting is always selected above the other settings. Note: If the provider has a different taxonomy code for different service locations and payers, then the taxonomy code must be attached for each service location and payer. To attach a default taxonomy code for the provider: From the Master Files list, select System or PM > Providers. Select the provider. Select the System tab. Select the taxonomy code from the Taxonomy Code field. Attach a Taxonomy Code for the Provider at the Practice Level Parent topic: Taxonomy Codes

Help Guide for NextGen® Enterprise PM 8

Attaching Taxonomy Codes

You can attach taxonomy codes to: Providers as the provider default taxonomy code for the enterprise Providers at the practice level, which overrides the provider default taxonomy code Providers at the CPT4 level, which overrides the practice level taxonomy code Locations Groups as the group default taxonomy code Groups at the location level, which overrides the group default taxonomy code Groups at the CPT4 level, which overrides the group location level taxonomy code Payers at the practice/UB level, which overrides the group level taxonomy code Payers at the alternate payer level, which overrides the group level taxonomy code DME Regions at the CPT4 level Parent topic: Taxonomy Codes Master File

Attaching Taxonomy Codes to Payers

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