Force Service Items to Paper at the Practice Level

File Maintenance Help for NextGen® Enterprise 8

Force Service Items to Paper at the Payer Level

When you force a service item to paper at the payer 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, select the service item. The matching results are listed. Note: You can enter an asterisk (*) to see all the records. Select the applicable service item from the Search list. Select the Payer tab. In the Payer field, select the payer from the drop-down list, then 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

File Maintenance Help for NextGen® Enterprise 8

Service Items Library

The Service Items library is the center of the billing functions. Within the Service Items library you can set up CPT4 codes for each practice, along with prices, and claim form designations. You can also group Service Items together under one main number or name. Libraries are available enterprise-wide, but each practice must designate which Service Items library to use by selecting it in the Libraries Practice Preferences. You can generate the Service Item Library Listing report from the Service Items library. For more information go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM. Set Up the Service Item Library You can set up your Service Item Library by setting up CPT4 codes for each practice, along with the prices and claims. General Tab Other Tab - SIM Library Payer Tab - SIM Library Labels Tab - SIM Library Notes/Significant Events Tab - SIM library Drugs Tab - SIM library Add a New Service Item Editing the Provider

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

Help Guide for NextGen® Enterprise PM 8

Service Items Library

The Service Items library is the center of the billing functions. Within the Service Items library you can set up CPT4 codes for each practice, along with prices, and claim form designations. You can also group Service Items together under one main number or name. Libraries are available enterprise-wide, but each practice must designate which Service Items library to use by selecting it in the Libraries Practice Preferences. You can generate the Service Item Library Listing report from the Service Items library. For more information go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM. Set Up the Service Item Library Set Up Anesthesia SIMs Parent topic: Setting Up Claims

Force Service Items to Paper at the Practice Level

Recommendations

Force Service Items to Paper at the Payer Level

Forcing Service Items to a Paper Claim

Force Claims to Paper by ICD Code

Service Items Library

Billing a SIM Item Directly to the Patient

Service Items Library

Force Service Items to Paper at the Payer Level

Forcing Service Items to a Paper Claim

Force Claims to Paper by ICD Code

Service Items Library

Billing a SIM Item Directly to the Patient

Service Items Library