Location Information - Practice Tab Field Descriptions

Field	Description
Mammo Certification	Enter the mammography certification number for the service location. This number displays in box 32 of the HCFA 1500.
CLIA ID	Enter the Clinical Laboratory Improvements Amendment ID for the service location. It is required at the Line item (FA0) level of the claim for each Medicare claim filing CLIA covered procedures. This will override the Authorization Number found in box 23 of the HCFA 1500. Each Lab can have a unique CLIA ID, relating to Service Location. If the CLIA number is included on non-CLIA procedures, then Medicare will ignore the CLIA ID.
DME Provider Nbr	Enter your DME provider number if each service location for the practice has a different DME provider number for DMERC billing.
DME NPI	Enter the same DME NPI for all DME regions.
UB Grace Days	Enter the number of days to add to the last day of the month of the encounter date so that the system can determine the default hold date. For example, if the last day of the month of the encounter date is June 30th and the UB Grace Days field is set to 3, then the hold date would be July 3rd.
Location Tax ID	Enter the Tax ID for the location. This ID can be used in conjunction with the Populate Location Tax ID (NM108 and NM109) option in the Submitter Profile Library.
Facility Location	Select this check box to have the location appear as an option in the Facility list in the Create Encounter and Encounter Maintenance windows.
Suppress Rendering/Attending Loop	This option shows whether the Attending (2310A) and Rendering (2310B) loops are suppressed. For more information, go toNextGen Healthcare Success Communityand download the latestClaims User Guide forNextGen® Enterprise PM.
Claim Type tab	Select this subtab if you want to assign claim-specific IDs for the facility: Medicare Facility ID – Enter the ID for the facility that is used by Medicare. BCBS Facility ID – Enter the ID for the facility that is used by Blue Cross/Blue Shield. Medicaid Facility ID – Enter the ID for the facility that is used by Medicaid. This field provides the option to print the Medicaid ID in box 32 of the HCFA form. HCFA Box 32 – Select this check box if the facility is valid for box 32 of the HCFA 1500. This facility will then be available for selection on the Facility field in Encounter Maintenance.
Payer tab	Select this subtab if you want to assign payer-specific facility IDs to the location. Facility IDs on this tab override any facility IDs on the Practice tab > Claim Type subtab and any facility IDs on the System tab.

File Maintenance Help for NextGen® Enterprise 8

Location Information - Defaults 2 Tab Field Descriptions

The following table provides descriptions for the fields located on the Defaults 2 tab of Location Information window. Field Description National Provider ID Enter the National Provider Identifier for the location. Note: The NPI is the standard unique identifier for health care providers to use in filing and processing health care claims and other transactions. Facility Entity ID Select the facility type that describes the location. You cannot modify this list of IDs because the IDs are predetermined. The Facility Entity ID controls the qualifier in the 837 electronic claim file for the service location loop. The IDs and their corresponding qualifiers are: <blank> – 77 Facility – FA Independent Lab – IL Service Location – 77 Testing Laboratory – TL Note: Some payers require a Facility Entity ID. Site ID Number Enter the site ID for the service location. CLIA ID Enter the Clinical Laboratory Improvements Amendment ID for the service location. It is required at the Line item (FA0) level

File Maintenance Help for NextGen® Enterprise 8

Add Claim Type Facility IDs

Open a location master file. Do one of the following: To create facility IDs at the system level, select the Location Defaults tab. To create facility IDs at the practice level, select the Practice tab, and then select the Use practice level claims data check box. Note: Facility IDs on the Practice tab override the ones on the Location Defaults tab. Select Claim Type subtab to create claim type facility IDs. On the Claim Type subtab, do the following: Enter the ID for the facility that is used by Medicare in the Medicare Facility ID field. Enter the ID for the facility that is used by Blue Cross/Blue Shiled in the BCBS Facility ID field. Enter the ID for the facility that is used by Medicaid in the Medicaid Facility ID field. This field provides the option to print the Medicaid ID in box 32 of the HCFA form. Select the HCFA Box 32 check box if the facility is valid for box 32 of the HCFA 1500 or boc 32b of the CMS 1500. This facility will then be available for selection in NextGen® Ent

File Maintenance Help for NextGen® Enterprise 8

Configurations in Claim Practice Preferences

The following table provides descriptions for the fields located in Claims Practice Preferences. Field Description Enable Qualifying Encounter Billing Activates qualifying encounter billing for all encounters with line items marked as a qualifying SIM Note: To complete the setup for qualifying encounter billing, you must configure one or more SIMs to be a qualifying SIM. Suppress zero balance claims Suppresses claims with a $0 (zero) balance during batch billing. Suppress CLIA ID from mammography claims Makes mammography certification codes and Clinical Laboratory Improvement Amendments (CLIA) IDs mutually exclusive on electronic claims. When you select this option, NextGen® Enterprise PM identifies a mammography code on a claim and prints the mammography code, and not the CLIA ID for Medicare claims. When you clear this option, both the mammography code and the CLIA codes are printed on the claim. Note: To suppress CLIA ID from mammography claims, you must set a SIM as mammography cod

Help Guide for NextGen® Enterprise PM 8

Configurations in Claim Practice Preferences

The following table provides descriptions for the fields located in Claims Practice Preferences. Field Description Enable Qualifying Encounter Billing Activates qualifying encounter billing for all encounters with line items marked as a qualifying SIM Note: To complete the setup for qualifying encounter billing, you must configure one or more SIMs to be a qualifying SIM. Suppress zero balance claims Suppresses claims with a $0 (zero) balance during batch billing. Suppress CLIA ID from mammography claims Makes mammography certification codes and Clinical Laboratory Improvement Amendments (CLIA) IDs mutually exclusive on electronic claims. When you select this option, NextGen® Enterprise PM identifies a mammography code on a claim and prints the mammography code, and not the CLIA ID for Medicare claims. When you clear this option, both the mammography code and the CLIA codes are printed on the claim. Note: To suppress CLIA ID from mammography claims, you must set a SIM as mammography cod

File Maintenance Help for NextGen® Enterprise 8

Location Information - Practice Tab

The Practice tab on the Location Information window contains practice-specific claims and address information for the Location master file. If you enter information on this tab, it applies only to the practice that you are currently logged into and overrides similar information entered at the system level on the Location Defaults tab. Note: If you have the system level data set up and you also have a record for your practice data, the practice data will be assigned even if it is blank. This is especially important for the Facility Location check box. If the Facility Location check box and the HCFA Box 32 are not selected on the Practice tab and a record exists, then that location will not display on the Encounter Maintenance window for that practice regardless of the setting at the system level. Practice Tab for Location Information Define the Medicaid ID by Payer or Program at the Location Level You can define a Medicaid ID by payer or program at the location level. Parent topic: Crea

File Maintenance Help for NextGen® Enterprise 8

Add or Modify Provider Practice Payer

The following table describes the fields on the Add /Modify Provider Practice Payer window: Field Description Payer Name Select the payer for whom you are setting up this group information. Name/ Organization Enter the name or organization for the provider. Suspended Eff Dt Enter the date after which the payer can no longer be billed for a claim. Provider Number Enter the provider number for the payer. Street/ City/ State/ Zip/ Country/ County The first space is for street number and name. The second space is for other address details such as suite number. If the ZIP code table is set up, you can type in the ZIP code, and the city, state, county, and country automatically display. Loc ID This field displays when the payer state is New York. Enter a two-digit numeric code to identify the location. Due to New York Medicaid requirements, this field is required when you attach a payer with a claim type of Medicaid and the payer state is New York (NY). The number in this field is then used

Location Information - Practice Tab Field Descriptions

Recommendations

Location Information - Defaults 2 Tab Field Descriptions

Add Claim Type Facility IDs

Configurations in Claim Practice Preferences

Configurations in Claim Practice Preferences

Location Information - Practice Tab

Add or Modify Provider Practice Payer