Reason Codes Library Report

Column	Description	Data Originates From
Library Name	Reason Code library name	Reason Code Library field
Code Desc	Standard description	Description field
Code	Code	Code field
Type	Indicates the code type and how the code is applied ( D = Line Item, T = Transaction, A = Adjudication).	Code Type options ( Line Item, Transaction, or Adjudication)
Seq #	Charge sequence number
NYHCRA Exempt
Hid	Indicates with Y or N whether the code is hidden.	Hide Reason Code check box
Force Item Rebill		Force Item Rebill field
Writeoff Rem Bal		Write Off Remaining Balance field
Disp on Pt Statmt		Display on Patient Statement field
Def Contract Allowed	Difference between the contractual allowed amount and payment allowed amount.	Default for Contract <> Payment Allowed Amount check box
Def Contract Reimbursement	Difference between the contractual reimbursement amount and Electronic Remittance Advice (ERA) payment amount	Default for Contract <> ERA Payment Amount check box
ERA Auto Adjust	Indicates whether an adjustment generates when the reason code is used.	Skip Adjustment Code field
Trans Detail Status	Reason code transaction detail status	Trans Detail Status field
Ovr Ln Itm		Override Line Item Codes check box
Tran Adj Cd		Adjustment Code field
NYHCRA

File Maintenance Help for NextGen® Enterprise 8

Service Item Library Listing Report

The Service Item Library Listing report includes information from the Service Items library in File Maintenance. Information on the report pulls from the Service Item Library Maintenance window. The report includes the following information: Column Description Data Populates From Lib Name Library Name SIM Library Name field Sv It Service Item ID Service Item # field Sv It Desc Service Item Description Description field CPT 4 CPT4 Code CPT4 Code field Form Form General tab > Form field Mod1 Modifier 1 General tab > first modifier field to the right of the CPT4 Code field Mod2 Modifier 2 General tab > second modifier field to the right of the CPT4 Code field CPT4 Desc CPT 4 Description CPT4 Codes master file Place Of Serv Place Of Service General tab > Place Of Service field Department Service Item Department General tab > Department field Modality Service Item Modality General tab > Modality field Component Service Item Component General tab > Component field Eff Dt Effective Date Gener

Help Guide for NextGen® Enterprise PM 8

Reason Code Options

The following table lists each option available in the Reason Codes Library with a description of how it works and how it may be used. Reason Code Option How it Works How it is Used Force Item Rebill Select this check box to flag line items with the reason code to "Rebill" to the current payer. Note: This option applies to Line Item reason codes only. When trends are identified for a reason code that always require rebilling. Write Off Remaining Balance Select this check box to adjust the remaining balance to $0.00 for line items with the reason code. The adjustment occurs when the transaction batch is posted. Note: This option applies to Line Item reason codes only. Sometimes used with payers of last resort, such as Medicaid. Note: ERA uses the Adjustment Code selected below to make the adjustment. Manual payment entry uses the Write Off Remaining Payer Balance adjustment code selected in Practice Preferences > Transactions to make the adjustment. Display on Patient Statements Select

Help Guide for NextGen® Enterprise PM 8

ERA Import Posting Report Columns

The following columns are available on the ERA Import Posting report. Column Name Description File ERA file Prac Name Practice name Chk Nbr Check number Auto Balance Batch Whether auto balance batch activity has been enabled or disabled Posted Sts Posted status Pat Name Patient name Clm Nbr Claim number Enc Nbr Encounter number Svc Date Service date CPT4 CPT4 code M1 Modifier 1 M2 Modifier 2 Clm Sts Cod Claim status code description Trx Status Transaction status Description Description Bill Amt Bill amount Pd Amt Paid amount Adj Amt Adjustment amount. Displays the adjustment amount for an encounter where the billed amount is equal to the ERA allowed amount and the reason code requiring discrepancy transaction was not applied. Discrepancy Amt Appears when the Calculate discrepancy adjustment related to Advanced SIM option is enabled in Remittance Profile library Ded Amt Deductible amount. Amount paid by the patient before the payer's payment. Disallow Amt Disallow amount Chg-All Amt Cha

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

Refunds by Line Item Report Columns

The following columns are available on the Daily by Line Item Refunds report: Column Name Description Data Populates From Prac Name Practice Name Practice associated with the patient's encounter Loc Name Service Location Name Charge Posting Location SubGrp 1 Location Subgrouping 1 Note: Subgrouping name is from Enterprise Preferences > General tab. Locations Master File Location SubGrp 2 Location Subgrouping 2 Note: Subgrouping name is from Enterprise Preferences > General tab. Locations Master File Post Date Post Date Transaction Detail Proc Dt Process date Transaction Detail Ovr Proc Dt Override Process Date Transaction Detail Bt Dt Batch date Batch Header Bt Nbr Batch Number Batch Header Bt Desc Batch Description Batch Header Track Desc Tracking Description Transaction Detail E/I/A/B Encounter Account Invoice Budget Transaction Detail Src Type Source Type Transaction Detail Name Patient Name Patient Information Per Nbr Person Number Patient Information Addr 1 Address 1 Patient Infor

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

Reason Codes Library Report

Recommendations

Service Item Library Listing Report

Reason Code Options

ERA Import Posting Report Columns

Reason Code Library Maintenance Field Descriptions

Refunds by Line Item Report Columns

Reason Codes Library

Service Item Library Listing Report

Reason Code Options

ERA Import Posting Report Columns

Reason Code Library Maintenance Field Descriptions

Refunds by Line Item Report Columns

Reason Codes Library