Set Up a Default Location for Group Provider Numbers
- In File Maintenance, under Master Files, select Practice > Groups.
The Groups List window opens.
- Double-click a group.
The Group Information window opens.
- From the Service Location list, select <Default>.
- Select one of the following options based on the following information:
- To set up the group on the default payer, double-click on the Default row listed under the Payer Name column.
The Group Information window displays additional fields. Because this setup is for the default payer, the Payer Name field is disabled.
- To set up a specific payer for the group, right-click in the Group Information section, then select New.
The Group Information window displays additional fields. Because this setup is for a specific payer, the Payer Name field is available. Select a payer in the Payer Name field.
- To set up the group on the default payer, double-click on the Default row listed under the Payer Name column.
- Enter the group number in the Group Number field.
- Enter the value for the alternate group number for a specific payer at a specific location in the Opt Group Val field. This number may be used for a default location and a default payer. This field is used for paper and electronic claims.
- Enter the effective and expiration dates for the group.
Note: When a group is attached to a provider using the location and payer combination, the system first checks the effective and expiration dates for the provider. If the provider’s dates are valid for the claim being processed, then the attached group’s dates are checked. If the claim’s date of service falls on or between the Group’s dates, then the Group information will be used to process the claim.
- Select the option to determine whether the Attending (2310A) and Rendering (2310B) loops should be suppressed.
For more information about suppressing the 2310A Attending and 2310B Rendering loops, go toNextGen Healthcare Success Communityand download the latestClaims User Guide forNextGen® Enterprise PM.
- Select a taxonomy code for the group at the location level. For details, see the sections about creating taxonomy codes and about attaching taxonomy codes.
- Select a location in the Bill-To Location field if you want to use a specific practice location's information instead of the billing provider information for the NM1, NM3, and NM4 segments (billing name, address, and city-state-zip). When you select a location, the submitter profile Pay-To options are ignored for that particular claim.
Note: These options display on the Exception Options tab of the submitter profile under Billing/Pay-To Provider (2010AA/2010AB Loops):
- Populate Billing address with Service Location and Pay-To with Billing information
- Populate Pay-To Provider with Group and Billing Provider with Rendering
- Enter the tax ID for the group.
- Enter the information in the remaining fields.
- If you want to attach a taxonomy code at the procedure level for specific procedure ranges, select CPT4 Group Information
.
- Select OK.