Set Up the Groups Master File

Help Guide for NextGen® Enterprise PM 8

Set Up the Groups Master File

Set up the Groups master file if a group needs to have specific information printed in box 33 of the HCFA 1500. The group must be selected in the Provider master file to be used. For more information on how the group works with the Provider master file to be displayed in the HCFA 1500, refer to Providers. Access the list of Practice master files. In the Master Files field, select Groups. The Groups List window opens. Select the open menu button, and then select New. The Group Information window opens. Enter information in the Group Information window as applicable. Select OK. Fields in the Group Information Window The following table describes the fields available in the Group Information window: Set Up a Default Location for Group Provider Numbers Add Multiple Default Rows for Billing Group You can add multiple default rows for a location and default payer of the billing group. Tax ID Number for Billing Group You can enter multiple tax IDs for a location and default or non-default pay

File Maintenance Help for NextGen® Enterprise 8

Add Multiple Default Rows for Billing Group

You can select the New Default Line check box to add multiple default rows for a location and default payer of the billing group. During the billing process, the program reviews all the existing default rows under the specified location. The effective and expiration dates of the default rows must not overlap. In File Maintenance, select Master Files > Practice > Groups. The Groups List window opens. Double-click a group. The Group Information window opens. Select a location in the Service Location field. Right-click the Default row and select New. The group details section opens with additional fields. Select the New Default Line check box. The Payer Name field displays the default value. Enter the values in the required fields. Select OK. Parent topic: Set Up the Groups Master File

File Maintenance Help for NextGen® Enterprise 8

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. 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

File Maintenance Help for NextGen® Enterprise 8

Tax ID Number for Billing Group

The Tax ID Number field in the group details section enables you to enter multiple tax IDs for a location and default or non-default payer of a billing group. You can use the unique effective date and expiration date range to indicate which tax ID must be used for billing. If you enter the tax ID at the payer level, then the Master File Group report displays the payer-level tax ID in the Tax ID # column. If you do not enter the tax ID at the payer level, then the Master File Group report displays the header-level tax ID. When you bill an encounter and create a paper or electronic claim, the application pulls the tax ID from the group details section and displays as applicable in the paper or electronic claim. The tax ID appears in the following locations for paper claims: Box 25 on a 1500 paper claim FL5 on a UB paper claim Box 51 on an ADA paper claim The tax ID appears in the following locations for electronic claims: 2010AA REF*EI segment in the 837P 2010AA REF*EI segment in the 837

Help Guide for NextGen® Enterprise PM 8

Add Multiple Default Rows for Billing Group

You can select the New Default Line check box to add multiple default rows for a location and default payer of the billing group. During the billing process, the program reviews all the existing default rows under the specified location. The effective and expiration dates of the default rows must not overlap. In File Maintenance, select Master Files > Practice > Groups. The Groups List window opens. Double-click a group. The Group Information window opens. Select a location in the Service Location field. Right-click the Default row and select New. The group details section opens with additional fields. Select the New Default Line check box. The Payer Name field displays the default value. Enter the values in the required fields. Select OK. Parent topic: Set Up the Groups Master File

File Maintenance Help for NextGen® Enterprise 8

Group Information Setup for a Provider

Group information is set up for the rendering provider for each service location. Each provider has a default group information record that is automatically included for generic use. However, you can set up specific information for a payer. If you have group information set up for a specific payer, then it becomes the default information for box 33 of the HCFA 1500. Note: If you do not have group information set up for the payer or the default level, then the provider information in the top half of the window is printed in box 33 of the HCFA 1500. To set up group information: On the Add/Modify Provider Information window, select the Practice tab. Under Service Location, select a location. A list of payers for that location displays in the Group Information section. If you want to copy the information for one payer to other locations in the Service Locations list, right-click the payer and then select one of the following: Copy to All Locations to copy the payer to all other locations.

Set Up the Groups Master File

Recommendations

Set Up the Groups Master File

Add Multiple Default Rows for Billing Group

Set Up a Default Location for Group Provider Numbers

Tax ID Number for Billing Group

Add Multiple Default Rows for Billing Group

Group Information Setup for a Provider

Set Up the Groups Master File

Add Multiple Default Rows for Billing Group

Set Up a Default Location for Group Provider Numbers

Tax ID Number for Billing Group

Add Multiple Default Rows for Billing Group

Group Information Setup for a Provider