NextGen Knowledge Center

Setup the Define TOB by Rev Code

The TOB by Rev Code tab on the Institutional Billing Maintenance window allows the Type of Bill (TOB) for claims to be defined by revenue code for the selected payers. The system creates a claim break based on TOB. Therefore, all SIM codes that have a revenue code with the same TOB are grouped together on one claim.

  1. From the Institutional Billing Maintenance window, select the Define TOB by Rev Code tab.
  2. In the Type of Bill by Revenue Code section, do one of the following:
    • To add a new TOB by revenue code rule, select open menu button and select New.
    • To modify an existing TOB by revenue code rule, select the row for the rule in the list, select open menu button and select Open.
    The Define Type of Bill by Revenue Code Category window opens.

  3. In the Effective Date and Expiration Date fields, enter an effective date and an expiration date for the rule. These fields are required. Dates cannot overlap between rules for the same revenue code category. If dates overlap, the following prompt displays when the OK button is selected. Effective/Expiration dates overlap with [TOB by Rev Code Name].
  4. In the Description field, enter a descriptive name for the rule. This field is required.
  5. In the Type of Facility field, select the type of facility code for the rule. This field is required. Type of Facility is the first digit in the TOB code on claims.
  6. In the Bill Classification field, select the bill classification code for the rule. This field is required. Bill Classification is the second digit in the TOB code on claims.
  7. In the Revenue Code Category field, select one or more revenue code categories for the rule. This field is required.
  8. To save changes and close the window, select OK.