NextGen Knowledge Center

Set Up Default Payment/Adjustment Transaction Codes

  1. Access File Maintenance.
  2. Select System Master Files > PM > Payers.
    The Payers List window opens.
  3. From the list, select and open the desired payer.
    The Modify Payer Information window opens.
  4. Select the Practice tab, and then select the Transactions sub-tab.

  5. Use the following table to select Transactions parameters for the payer.
  6. To save changes and close the window, select OK.
    FieldDescription
    Default PaymentSelect a third-party payment transaction code for the payer. The code defaults to the Pay Code field on the Payment Entry screen for manually entered payments and for ERA payments received from the payer. This field is required.
    Default AdjustmentSelect a third-party adjustment transaction code for the payer. The code defaults to the Adj Code field on the Payment Entry screen for manually entered adjustments and for ERA adjustments received from the payer. This field is required.
    Default Payment for Bad DebtSelect a third-party bad debt payment transaction code for the payer. The code defaults to the Pay Code field on the Payment Entry screen for manually entered payments and for ERA payments received from the payer on encounters in Bad Debt status.

    If a transaction code is not selected, then the Default Payment code is used for payments from the payer on Bad Debt encounters.

    Default Adjustment for Bad DebtSelect a third-party bad debt adjustment transaction code for the payer. The code defaults to the Adj Code field on the Payment Entry screen for manually entered adjustments and for ERA adjustments received from the payer on encounters in Bad Debt status.

    If a transaction code is not selected, then the Default Adjustment code is used for adjustments from the payer on Bad Debt encounters.

    Reversals & Corrections PaymentSelect a third-party payment transaction code for the payer. The code defaults to the Pay Code field on the Payment Entry screen for ERA reversal and correction payments received from the payer in the 835 file with a Claim Status of 22.

    If a transaction code is not selected and the Remittance Profile Library is setup to allow posting of reversal/correction payments, then the Default Payment code is used for ERA reversal/correction payments from the payer.

    Reversals & Corrections AdjustmentSelect a third-party adjustment transaction code for the payer. The code defaults to the Adj Code field on the Payment Entry screen for ERA reversal and correction adjustments received from the payer in the 835 file with a Claim Status of 22.

    If a transaction code is not selected and the Remittance Profile Library is setup to allow posting of reversal/correction adjustments, then the Default Adjustment code is used for ERA reversal/correction adjustments from the payer.

    Reason Code LibrarySelect the Reason Code Library to be used for the payer, if applicable. If a library is not selected, then the Default Reason Code Library, from the Transaction in the Practice Preferences, is used for the payer.
    Default COB Reason CodeIf you use payer-specific proprietary reason codes when you manually post payments, select a default HIPAA-compliant reason code library.
    Additional Transactions 1-6Select one of the following options:
    • Payment - Select the applicable payment code for the transaction.
    • Adjustment - Select the applicable adjustment code for the transaction.

    After you select an option, the next transaction field becomes available.