IB Library with TOB by Rev Code Report

Column	Description	Data Populates From
Lib Name	Library Name	Institutional Billing Library Name field
Desc	Description	Description field
Default	Default	Use as default billing rules for Institutional Claims check box Y or N
Type of Bill Rules	Type of Bill Rules	Define Type of Bill by Revenue Code Category window > Description field
Payer Name	Payer Name	Valid Payers section
Eff Dt	Effective Date	Define Type of Bill by Revenue Code Category window > Effective Date field
Exp Dt	Expiration Date	Define Type of Bill by Revenue Code Category window > Expiration Date field
Rev Cd Cat	Revenue Code Category	Define Type of Bill by Revenue Code Category window > Revenue Code Category field
Fac Type	Facility Type	Define Type of Bill by Revenue Code Category window > Type of Facility field
Bill Class	Bill Classification	Define Type of Bill by Revenue Code Category window > Bill Classification field
Crt Dt	Created Date	Modification Information > Creation Date & Time field
Created By	Created By	Modification Information > Creator field
Mod Dt	Last Modified Date	Modification Information > Modified Date & Time field
Modified By	Last Modified By	Modification Information > Last Modified By field

File Maintenance Help for NextGen® Enterprise 8

IB Library with Payer Exception Claim Rules Report

The Institutional Billing Library with Payer Exception Claim Rules report includes information from the Institutional Billing library in File Maintenance. Information on the report pulls from the Institutional Billing Maintenance window > Payer Exception Claim Rules tab. The report includes the following information: Column Description Data Populates From Lib Name Library Name Institutional Billing Library Name field Desc Description Payer Exception Claim Rules window > Description field Eff Dt Effective Date Payer Exception Claim Rules window > Effective Date field Exp Dt Expiration Date Payer Exception Claim Rules window > Expiration Date field Rev Cd Rev Code Payer Exception Claim Rules window > Revenue Code field Rev Cd Cat Revenue Code Category Payer Exception Claim Rules window > Revenue Code Category(s) field Ovride Rev Cd Qual Override Rev Code Qualifier Payer Exception Claim Rules window > Override Rev Code Qualifier field Sum Claim Create Summary Claim Payer Exception Claim R

File Maintenance Help for NextGen® Enterprise 8

Institutional Billing Library Listing Report

The Institutional Billing Library Listing report includes information from the Institutional Billing library in File Maintenance. Information on the report pulls from the Institutional Billing Maintenance window. The report includes the following information: Column Description Data Populates From Lib Name Library Name Institutional Billing Library Name field Eff Dt Effective Date Effective Date field Exp Dt Expiration Date Expiration Date field Desc Description Description field Use as Default Billing Rules Use as default billing rules for Institutional claims Use as default billing rules for Institutional Claims check box Y or N Valid Payers Valid Payers Valid Payers section Multiple entries are separated by semi-colons Crt Dt Created Date Modification Information > Creation Date & Time field Created By Created By Modification Information > Creator field Mod Dt Last Modified Date Modification Information > Modified Date & Time field Modified By Last Modified By Modification Informati

File Maintenance Help for NextGen® Enterprise 8

IB Library with Claim Rules by TOB Report

The Institutional Billing Library with Claim Rules by TOB report includes information from the Institutional Billing library in File Maintenance. Information on the report pulls from the Institutional Billing Maintenance window > Claim Rules by TOB tab. The report includes the following information: Column Description Data Populates From Lib Name Library Name Institutional Billing Library Name field Desc Description Claim Rules By Type of Bill Range window > Description field Eff Dt Effective Date Claim Rules By Type of Bill Range window > Effective Date field Exp Dt Expiration Date Claim Rules By Type of Bill Range window > Expiration Date field Tob From Type of Bill From Claim Rules By Type of Bill Range window > TOB From field Tob To Type of Bill To Claim Rules By Type of Bill Range window > TOB To field Adm Diag Admitting Diagnosis Claim Rules By Type of Bill Range window > Populate Admitting Diagnosis check box Y or N Patient Reason Visit Patient Reason for Visit Claim Rules By Ty

File Maintenance Help for NextGen® Enterprise 8

Setup the Define TOB by Rev Code

The TOB by Rev Code tab on the Institutional Billing Maintenance window allows the Type of Bill (TOB) for claims to be defined by revenue code for the selected payers. The system creates a claim break based on TOB. Therefore, all SIM codes that have a revenue code with the same TOB are grouped together on one claim. Note: TOB populates the 2300 CLM05 segment on electronic 837I claims, and FL 4 on paper UB04 claims. From the Institutional Billing Maintenance window, select the Define TOB by Rev Code tab. In the Type of Bill by Revenue Code section, do one of the following: To add a new TOB by revenue code rule, select open menu button and select New. To modify an existing TOB by revenue code rule, select the row for the rule in the list, select open menu button and select Open. The Define Type of Bill by Revenue Code Category window opens. In the Effective Date and Expiration Date fields, enter an effective date and an expiration date for the rule. These fields are required. Dates canno

File Maintenance Help for NextGen® Enterprise 8

Consolidated Services Claim Library Listing Reports

The Consolidated Services Claim Library Listing report includes information from the Consolidated Services Claim library in File Maintenance. Information on the report pulls from the Consolidated Services Claim Maintenance window. The report includes the following information: Column Description Data Populates From Lib Name Library Name Consolidated Services Claim Library Name field Description Consolidated Services Claim Rules Consolidated Services Claim Maintenance window > Description field Eff Dt Effective Date Consolidated Services Claim Maintenance window > Effective Date field Exp Dt Expiration Date Consolidated Services Claim Maintenance window > Expiration Date field Encounter with Greatest Dollar Value Select Responsible Attending with greatest dollar value across same-timespan encounters Displays Y or N Consolidated Services Claim Maintenance window > Claim Header Rules tab > Select Responsible Attending from Encounter with greatest dollar value when two providers of the sam

File Maintenance Help for NextGen® Enterprise 8

EDI Claim Profile Listing Report

The EDI Claim Profile Library Listing report includes information from the EDI Claim Profile library in File Maintenance. Information on the report pulls from the EDI Claim Profile Maintenance window. Note: This report uses enhanced reporting functionality. The report includes the following information: Column Description Data Populates From Lib Name Library Name EDI Claim Profile Name field Eff Dt Effective Date Effective Date field Exp Dt Expiration Date Expiration Date field Desc Description Description field Use as Default EDI Rules Default EDI Rules Use as default EDI rules for all payers check box Y or N Valid Payers Valid Payers Valid Payers section Multiple entries are separated by semi-colons Created By Created By Who/When > Modification Information > Creator field Crt Dt Create Date Who/When > Modification Information > Creation Date & Time field Modified By Last Modified By Who/When > Modification Information > Last Modified By field Mod Dt Last Modified Date Who/When > Modi

IB Library with TOB by Rev Code Report

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