Forcing Service Items to a Paper Claim

File Maintenance Help for NextGen® Enterprise 8

Suppress Billing for Individual SIMs

From the File Maintenance desktop, select Libraries > Service Items. The Service Items Libraries window opens. Double-click a service item library. The Service Item Library Maintenance window opens. On the General tab, select the Suppress Billing check box. Parent topic: General Tab

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

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

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

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 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

Forcing Service Items to a Paper Claim

Recommendations

Suppress Billing for Individual SIMs

Billing a SIM Item Directly to the Patient

Force Service Items to Paper at the Practice Level

Force Service Items to Paper at the Payer Level

Force Claims to Paper by ICD Code

Set Up a UB Claim Form in the General tab of Service Items Library

Suppress Billing for Individual SIMs

Billing a SIM Item Directly to the Patient

Force Service Items to Paper at the Practice Level

Force Service Items to Paper at the Payer Level

Force Claims to Paper by ICD Code

Set Up a UB Claim Form in the General tab of Service Items Library