Force Service Items to Paper at the Payer Level

File Maintenance Help for NextGen® Enterprise 8

Force Service Items to Paper at the Practice Level

When you force a service item to paper at the practice level, a paper claim generates for that service item, even when the payer is set for electronic transmission. Open the Service Item library. The Service Item Library Maintenance window opens. In the Search list on the left, begin typing the service item you want to search for. The matching results are listed. Note: You can enter an asterisk (*) to see all the records. Select on the applicable service item from the Search list. On the General tab, select the Force to Paper check box. Parent topic: Forcing Service Items to a Paper Claim

File Maintenance Help for NextGen® Enterprise 8

Forcing Service Items to a Paper Claim

In the Service Item Library Maintenance window, you can force specific service items to a paper claim when claims generate at the practice and payer levels. In addition, forcing specific service items to paper at either level overrides the claim Media Type set on the Add/Modify Payer Information window. Force Service Items to Paper at the Practice Level Force Service Items to Paper at the Payer Level Parent topic: General Tab

Help Guide for NextGen® Enterprise PM 8

Force Claims to Paper by ICD Code

You can select diagnoses that force the claim to paper for specific payers when associated with a SIM code. To force claims to paper for specific ICD codes for a payer, perform the following steps: From File Maintenance, access Libraries > Service Items. The Service Item Library Maintenance window opens. Enter the CPT4 code and then select Payer. On the Payer tab, do the following: Select a payer in the Payer field. Enable the Force to Paper check box. Select the Open Record/Force to Paper ICDs button. The Diagnosis Codes window opens. On the Diagnosis Codes window do the following: Search for the ICD codes that you want to force to paper. Use the blue arrow to move the codes from the Available list to the Included list. When a payer, with an ICD code set to force to paper, is included in a Service Item, a paper claim is generated for the charge that includes the SIM. Parent topic: Generating Secondary Electronic Claims

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

Help Guide for NextGen® Enterprise PM 8

Set Up a Service Item for Regular UB Users

Access the service item from the Service Item Library to attach a payer and set the Form field to UB. Access File Maintenance. Select Libraries > Service Items. Right-click a Service Item library, and then select Open. To create a new SIM, select an existing SIM or select the open menu button. Select the Payer tab and select the applicable payer. Enter an effective date in the Eff field and an expiration date in the Exp field. Select the General tab, and then select UB from the Form field. Select the Add button, and then select OK. Parent topic: Set Up UB Claims for Regular UB Users

File Maintenance Help for NextGen® Enterprise 8

Billing a SIM Item Directly to the Patient

The Force Patient Responsibility check box on the General tab of the Service Item Library Maintenance window enables you to charge the entire amount for the service item specified to the patient. The charge does not appear on the HCFA 1500, UB, and ADA forms. Note: When this option is selected, a Y displays in the Rsp column on the Service Item Listing report, which indicates that the service item specified is set up for the patient to be responsible for this charge. A blank in the column indicates that the Force Patient Responsibility check box is not selected. Although you can apply Force Patient Responsibility to most service items, there are a few exceptions, such as service item 99070, which should be billed to Medicaid. Parent topic: General Tab

Force Service Items to Paper at the Payer Level

Recommendations

Force Service Items to Paper at the Practice Level

Forcing Service Items to a Paper Claim

Force Claims to Paper by ICD Code

Set Up a UB Claim Form in the Payer tab of the Service Item Library

Set Up a Service Item for Regular UB Users

Billing a SIM Item Directly to the Patient

Force Service Items to Paper at the Practice Level

Forcing Service Items to a Paper Claim

Force Claims to Paper by ICD Code

Set Up a UB Claim Form in the Payer tab of the Service Item Library

Set Up a Service Item for Regular UB Users

Billing a SIM Item Directly to the Patient