Reason Code Library Maintenance

File Maintenance Help for NextGen® Enterprise 8

Assign a Reason Code Library to a Payer

The Reason Code Library field on the Modify Payer Information window enables you to create and attach a library with reason codes that are unique to a specific payer. In File Maintenance, select Master Files, then System, and then Payers. The Payers List window opens. Double-click the desired payer or right-click open menu , and select Open. Select the Practice tab and, then Transactions subtab. Select the desired Reason Code Library for the payer, and then select OK. Parent topic: Reason Codes Library

File Maintenance Help for NextGen® Enterprise 8

Select Reason Codes Options in Practice Preferences

You can select reason codes options in the Transactions practice preference. Do one of the following: In NextGen® Enterprise PM, select Admin > Preferences > Practice. In File Maintenance, select Master Files > System > Practices. Double-click the practice, and then select Preferences. The Practice Preferences window opens. In Preference List, select Transactions. Select options for various fields under Reason Codes Options, as per your practice needs. Parent topic: Reason Codes Library

File Maintenance Help for NextGen® Enterprise 8

Reason Codes Library

You can create and maintain reason codes in a Reason Codes library. A reason code is a brief description that is added to a transaction to explain how that transaction was handled. When ERA files are involved, reason codes are returned in the file by the payer to describe how the service was reimbursed. Reason code libraries group related reason codes together. For example, you can have a reason code library that contains the reasons that a claim can be cancelled. You can generate the Reason Codes Master report from the Reason Codes library. For more information go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM. Reason Code Library Maintenance You can add or modify an existing reason code on the Reason Code Library Maintenance window. Write Off Remaining Line Item Balances After the Batch is Posted Write Off Remaining Line Item Balances at ERA Import Assign a Reason Code Library to a Payer Select Reason Codes Options in Pra

File Maintenance Help for NextGen® Enterprise 8

Reason Code Library Maintenance Field Descriptions

Use the following table to enter reason codes into the library. Field Description Reason Code Library Enter the name for the library. Hide Library Select this check box to hide the library in the Reason Code List. Search Method: Description Select this option to run a search by reason code description. Search Method: Code Select this option to run a search by reason code. Search for keyphrase anywhere in the item Select this check box to search for a string of letters anywhere in the reason code description instead of searching based on the letters at the beginning of the description. This check box is available when you are modifying an existing reason code library. Type the first letter(s) of the Reason Code to locate Enter the first few letters of the reason code description to display the reason code you are searching for. If you selected the Search for keyphrase anywhere in the item check box, enter letters that occur within the description. Reason Codes List Lists the reason code

Help Guide for NextGen® Enterprise PM 8

Add a Transaction Level Reason Code during Payment Entry

Transaction level reason codes are selected in the Payment Entry window in the Clm Reasons field. You can enter multiple reason codes at the transaction level. Transaction codes are set up for the practice in the Reason Code Maintenance window in File Maintenance. Open NextGen® Enterprise PM. On the main toolbar, select Posting . The Batch Posting window opens. Double-click the desired batch header record. The Payment Entry window opens. Type the encounter number in Enc/Clm#, and press Enter. The account guarantor, patient, medical record number, and the billed account displays in the Payment Entry window. In the Clm Reasons list, select the codes that match the payer's reason code on the remittance advice. Select Save. Parent topic: Entering Reason Codes during Payment Entry

Help Guide for NextGen® Enterprise PM 8

Select Transaction Status for Default Option

When you select any of the default options that are available in the Reason Code Library Maintenance window, and you want to ensure that the remaining balance of respective transactions remains in the same payer bucket to follow up with the primary payer, you must select Transaction Status option as applicable. In File Maintenance, select Libraries > Reason Codes. The Reason Codes List window opens. Select the required reason code from the list and right-click to open or select open menu and select New for new reason code. The Reason Code Library Maintenance window opens. Select the required default reason code check box: Default for Contract <> Payment Allowed Amount Default for Contract <> ERA Payment Amount Default for ERA Credit Balance Creation Select any one of the following option in the Transaction Status field. This will ensure that the remaining balance of respective transactions will remain in the same payer bucket. None Deny Appeal Settled moved to primary Note: If you do n

Reason Code Library Maintenance

Recommendations

Assign a Reason Code Library to a Payer

Select Reason Codes Options in Practice Preferences

Reason Codes Library

Reason Code Library Maintenance Field Descriptions

Add a Transaction Level Reason Code during Payment Entry

Select Transaction Status for Default Option

Assign a Reason Code Library to a Payer

Select Reason Codes Options in Practice Preferences

Reason Codes Library

Reason Code Library Maintenance Field Descriptions

Add a Transaction Level Reason Code during Payment Entry

Select Transaction Status for Default Option