Set Up a SIM Used as an Anesthesia and a Dental SIM

File Maintenance Help for NextGen® Enterprise 8

Set Up a Dental and Medical SIM

Service Items can be set up and billed as dental or medical SIMs. They must be set up at the Payer level in the Service Item Library. Open a SIM in a Service Item Library. Select the General tab. Ensure that 1500 or UB is selected in the Form drop-down list. Select the Payer tab. Select the applicable dental payer from the Payer drop-down list. You must designate this payer as a dental payer on the Payer tab of the Service Item Library Maintenance window. See Payer tab for more information. In the table, enter the applicable effective and expiration dates in the Eff and Exp fields. Select ADA from the Form drop-down list. Enter any additional information that is applicable. Select OK. Parent topic: Dental SIMs

File Maintenance Help for NextGen® Enterprise 8

Set Up ADA SIMs

Service items that are only used as Dental SIMs are designated as a Dental SIM by selecting ADA from the Form drop-down list on the General tab of the Service Item Library Maintenance window for that SIM. Service items designated as Dental SIMs can only be billed on an ADA Dental claim or as patient responsibility; they do not populate an 1500/837 Professional or UB/837 Institutional form. Open a SIM in a Service Item Library. In the File Maintenance window, select the General tab. Select ADA from the Form drop-down list. Select OK. Parent topic: Dental SIMs

File Maintenance Help for NextGen® Enterprise 8

Dental SIMs

To accurately use the Dental billing feature, the service items that are used for billing dental charges need to be designated Dental SIMs in the Service Item Library. A service item is designated a Dental SIM three different ways depending on the following ways it is used: SIMs only used as a Dental SIM SIMs used as a Medical and a Dental SIM SIMs used as an Anesthesia SIM and a Dental SIM Set Up ADA SIMs Set Up a Dental and Medical SIM Set Up a SIM Used as an Anesthesia and a Dental SIM Parent topic: Add a New Service Item

Help Guide for NextGen® Enterprise PM 8

Set Up Anesthesia SIMs

Before you can use anesthesia billing, service items billed as anesthesia services must be designated as anesthesia SIMs. You must also designate the appropriate claim form type and the number of base units. In File Maintenance, select Libraries and then Service Items. The Service Items Libraries window opens. Double-click the appropriate service item library. The Service Item Library Maintenance window opens. Under Service Item #, select the open menu button, and then select New. Enter an applicable name for the new anesthesia SIM, in the Description field. In the CPT4 Code field, select or enter the correct CPT4 code. On the General tab, complete the following fields. Field Description Form Select the 1500 or UB claim form type for the selected SIM. Note: Anesthesia billing is not supported for ADA claims in NextGen® Enterprise PM. If you select ADA in the Form field, both the Base Unit field and the Anesthesia SIM check box clear and become unavailable. Anesthesia SIM Select this ch

Help Guide for NextGen® Enterprise PM 8

Set Up Payer-Specific Requirements

Not all payers require an ADA claim form. Some payers may require a 1500 form. To set up a SIM code to use 1500 forms for a payer, do the following: From the Service Item Library Maintenance window, select the applicable service item. Select the Payer tab. Payer In the Payer field, select the payer. In the Eff and Exp columns, enter the effective and expiration dates for the SIM code/payer. In the Form column, select 1500. To save changes and close the window, select OK. Parent topic: Service Items Library for Dental Billing

Help Guide for NextGen® Enterprise PM 8

Set Up SIM Options for OB Anesthesia Billing

To accommodate OB epidural billing needs, the Anesthesia Library > SIM Options tab includes a number of settings that may be helpful. Access File Maintenance. Select Libraries, and then Anesthesia. The Anesthesia Library List window opens. Double-click to open the desired library. The Anesthesia Library Maintenance window opens. In the Concurrency and Claim Rules section, do one of the following: To create a new rule, select the Open Menu button and select New. The Anesthesia Library Payer Maintenance window opens. For more information, see Set Up Concurrency and Claim Rules for Anesthesia Billing To modify an existing rule, select the row from the list, select the Open Menu button and select Open. The Anesthesia Library Payer Maintenance window opens. Select the SIM Options tab. In the Service Items Range Options section, do one of the following: To create a new SIM range, select the Open Menu button and select New. The SIM Range window opens. For more information, see Set Up SIM Opti

Set Up a SIM Used as an Anesthesia and a Dental SIM

Recommendations

Set Up a Dental and Medical SIM

Set Up ADA SIMs

Dental SIMs

Set Up Anesthesia SIMs

Set Up Payer-Specific Requirements

Set Up SIM Options for OB Anesthesia Billing

Set Up a Dental and Medical SIM

Set Up ADA SIMs

Dental SIMs

Set Up Anesthesia SIMs

Set Up Payer-Specific Requirements

Set Up SIM Options for OB Anesthesia Billing