Default Libraries
Select the following libraries for the practice as needed.
- Diagnosis Code Library: Select the Diagnosis Codes library to be used in the practice.
- Service Item Library: Select the Service Items library to be used in the practice.
- Claim Modifiers Library: Select the default Claim Modifiers library to be used for all payers in the practice, if applicable. Payer-specific libraries are linked to the payer in the Payers master file Practice tab > Libraries sub-tab.
- NDC Library: Select the NDC library to be used in the practice.
- Claim Edits Library: Select the default Claim Edits library to be used for all payers in the practice. Payer-specific libraries are linked to the payer in the Payers master file > Practice tab > Libraries sub-tab.
- Self Pay SIM Exception: Select the SIM Exception to be used for all self-pay patients in the practice, if applicable.
- Eligibility Profile Library: Select the default Eligibility Profiles library to be used for all RTS payers in the practice, if applicable. Payer-specific libraries are linked to the payer in the Payers master file > Practice tab > Libraries sub-tab.
- Behavioral Health Billing Library: Select the default Behavioral Health Billing library to be used for all payers in the practice, if applicable. Payer-specific libraries are linked to the payer in the Payers master file >Practice tab > Libraries sub-tab.
- Claim Print Library: Select the default Claim Printing library to be used for all payers in the practice. Payer-specific libraries are linked to the payer in the Payers master file > Practice tab > Libraries sub-tab.
- Remittance Profile Library: Select the default Remittance Profiles library to be used for all ERA payers in the practice, if applicable. Payer-specific libraries are linked to the payer in the Payers master file > Practice tab > Libraries sub-tab.
- Claim Status Profile Library: Select the default Claim Status Profile library to be used for all RTS payers in the practice, if applicable. Payer-specific libraries are linked to the payer in the Payers master file >Practice tab > Libraries sub-tab.
- Non-Coordinated SIM Library: Select the default Non-Coordinated SIM Library to be used in the practice, if applicable.
- Anesthesia Library: Select the default Anesthesia library to be used in the practice, if applicable.
- Consolidated Services Claim: Select the Consolidated Services Claim (CSC) library to be used in the practice, if the practice consolidates same day charges for a patient onto a single claim. The following rules apply:
When CSC claims and associated claims with a Hold or Consolidated status are present in the database, this library cannot be removed.
To remove the library, you must delete all CSC claims and associated Hold or Consolidated claims and then remove the library.
You must remove the library from the Consolidated Services Claim field before you can hide the library in the Consolidated Services Claim Library.
In File Maintenance, when you attempt to hide the CSC library attached to a practice, the application issues an alert. It states that you must remove the CSC library from Practice Preferences > Libraries before you can hide the library.
- Institutional Billing Library: Select the Institutional Billing library to be used the practice, if applicable. The payer and claim rules defined within an Institutional Billing library are applied only when the library is selected here. If no library is selected, then legacy UB billing logic is used in NextGen® Enterprise PM.
Note: This field is grayed-out and unavailable unless the Type of Facility and Bill Classification fields are populated for UB Claims in Practice Preferences >Claims .
- EDI Claim Profile Library: Select the default EDI Claim Profile library to be used in the practice, if applicable. This library provides support for the 2400 loops and segments requested by payers when the 2300 loop details are different per charge or the same per charge. The settings in this library apply to electronic 837P (professional), 837I (institutional) and 837D (dental) claims.
- Service Package Library: Select the default Service Package library to be used in the practice, if applicable. When a library is selected, you can do the following in NextGen® Enterprise PM.
Enter Service Unit Authorizations for payers that authorize packaged services for patients.
Generate the Service Unit Authorization report to review and monitor patients with service unit authorizations.
SIM Maintenance Options
SIM fields: show dept, modality and component: Select this check-box to display the Department, Modality and Component fields on the Service Item Library Maintenance window > General tab. These fields can be used for SIM-level reporting purposes in NextGen® Enterprise PM.
