Setting Up DMERC Billing
The following areas in the application must be set up to use DMERC billing:
Service Items libraries
DME Regions master files
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File Maintenance Help for NextGen® Enterprise 8
DMERC Billing
Support for DMERC (Durable Medical Equipment Regional Carriers) billing for Medicare payers enables you to bill one of the four standard DME Regional Carriers for DME service items. The four standard DMERCs are: HealthNow New York® Inc. Adminastar Federal, Inc. Palmetto Government Benefits Administration CIGNA Setting Up DMERC Billing Set Up DMERC at System Level Real-Time Address Validation for DME Regions Set Up Practice-Specific Information for DME Claims Parent topic: Master Files - System
Help Guide for NextGen® Enterprise PM 8
Setting Up UB Claim Forms
You can set up the claim form for UB billing in any one of the following areas of the application: The Service Items library on the General tab. The Service Items library on the Payer tab. The Payer master file on the UB sub-tab of the Practice tab. Set Up a UB Claim Form in the General tab of Service Items Library Set Up a UB Claim Form in the Payer tab of the Service Item Library Set Up a UB Claim Form in the Payer Master File Parent topic: Recurring UB Billing
Help Guide for NextGen® Enterprise PM 8
Payers Master File for Dental Billing
Three areas in the Payers master file must be set up for dental claims. These setup requirements are on the following tabs of the Payers master file: Payer Defaults - 2: Used to set up a payer for dental billing and ADA claims. System: Used to set up provider secondary references. Practice: Used to set up electronic claims. Defaults-2 Tab System Tab Practice Tab Parent topic: Dental Billing
Help Guide for NextGen® Enterprise PM 8
Set Up Modifier Reimbursement
In File Maintenance, open Libraries > Contract Parent topic: Modifier Reimbursement in Cost Estimation
File Maintenance Help for NextGen® Enterprise 8
Set Up Medical Direction for Anesthesia Billing
On the Anesthesia Library Payer Maintenance window, select the Medical Direction tab. Complete the Medical Direction settings as needed. To save changes and close the window, select OK. Medical Direction Field Descriptions Parent topic: Medical Direction for Anesthesia Billing
Help Guide for NextGen® Enterprise PM 8
File Maintenance Settings Required for Recurring UB Billing
To enable recurring UB billing, you must set up the following items in File Maintenance: Practice Preferences Payer master file Revenue Codes The SIM library Set Up Practice Preferences for Recurring UB Billing Set Up the Payer Master File for Recurring UB Billing Override Practice Preferences with the Payer Master File Set Up Revenue Codes Set Up Revenue Codes for SIMs Parent topic: Recurring UB Billing
