Create a Claim Status Profile Library
In File Maintenance, select
Libraries
>
Claim Status Profile
.
Select open menu button and select
New
.
The
Claim Status Profile
window opens.
Select the options and setting as described in the following table and then select
OK
.
Recommendations
Explore
File Maintenance Help for NextGen® Enterprise 8
Claim Status Profile Library
The Claim Status Profile library is required for submitting claim status inquiries. This library enables you to set up rules to automatically complete the required fields and additional data for batch mode processing. Create a Claim Status Profile Library Creating a Claim Status Profile Library You can create a claim status profile library using the field's description.
Help Guide for NextGen® Enterprise PM 8
Set Up a UB Claim Form in the General tab of Service Items Library
In File Maintenance, select Libraries > Service Items and select the applicable library from the list. Enter the service item number in the Search field. The Service Item Library Maintenance window opens. On the General tab, select UB92 in the Form field. SelectOK. Parent topic: Setting Up UB Claim Forms
File Maintenance Help for NextGen® Enterprise 8
Create an Eligibility Profiles Library
In File Maintenance, select Libraries > Eligibility Profiles. Select open menu button and select New. The RTS Eligibility Profile window opens. Select one or more types of service in the Type of Service field. Select a search option in the Patient Search Option field. Refer to Appendix A to select the options and settings as described in the tables and then select OK. To default the eligibility profile to payers by financial class, select Default to Payers. Select a financial class in the Financial Class field. Select Default to All or Default if Blank. A NextGen message opens. Select Yes. Parent topic: Eligibility Profiles Library
File Maintenance Help for NextGen® Enterprise 8
Open the Libraries
In File Maintenance, select Libraries > System. Select one of the library types. The List window displays the libraries for the selected library type. Do one of the following: To add a new item, select open menu button , and then select New. To modify an existing item, select the item in the list, select open menu button and then select Open. You can also double-click to open the item. Parent topic: Libraries
Help Guide for NextGen® Enterprise PM 8
Activate Claim Edits
The Claim Edits Library contains a list of the available claim edits you can apply to the claims you generate. In File Maintenance, select Libraries > Claim Edits and select the applicable Claim Edits Library. The Claim Edit Library Maintenance window opens. Select the claim edit you want to activate by selecting in the Active column. A check mark displays to indicate the claim edit is active. To edit the Help Text, select the Help Text field and enter the new description for the Help Text. To change the edit severity level, select in the Severity field, and select one of the following severity levels: Warning Critical Custom Required After you make your selections, select OK. Parent topic: Claim Edits Library
Help Guide for NextGen® Enterprise PM 8
Set Up a UB Claim Form in the Payer tab of the Service Item Library
In File Maintenance, select Libraries > Service Items. Select the applicable library from the list. Enter the service item number in the search field. When the Service Item Library Maintenance window opens, select the Payer tab. In the Form column, select UB. Enter the Effective date and the Expiration date for the payer. Enter other information applicable to the payer. Select Ok. Parent topic: Setting Up UB Claim Forms
