Types of Service Library

File Maintenance Help for NextGen® Enterprise 8

Set Up an Alternate Type of Service Codes Library

From the File Maintenance window, select Libraries > Type of Service. Select open menu button , and then select New. Enter the name of the new library in the Service Name field. Select open menu button , and then select New. The Add Type of Service Alternate window opens. In the Type of Service list, select the applicable standard Type of Service. The Code field is automatically populated with the standard code and the field is disabled and cannot be changed. Enter the applicable Alternate Type of Service code for: paper claims in the Alt Paper field. electronic claims in the Alt Electronic field. Note: When entering alternate type of service codes for paper or electronic claim types, you must fill in both of these fields. For example, if a payer requires an alternate type of service code for paper claims, but they want the standard type of service code for electronic claims, then you must enter the alternate code in the ALT Paper field and the standard code in the ALT Electronic field

File Maintenance Help for NextGen® Enterprise 8

Attach an Alternate Type of Service Library to a Payer

From the File Maintenance window, select Master Files - System > Payers. Double-click on the applicable payer. The Add/Modify Payer Information window opens. Select the Practice tab > Libraries tab. Select the applicable Alternate Type of Service Library from the Type of Service Library field. Select OK. Parent topic: Types of Service Library

File Maintenance Help for NextGen® Enterprise 8

Appendix A: Alternate Type of Service Codes

You can create a library of Alternate Type of Service codes for each payer and attach the library to the payer at the payer level. The tables that follow outline certain payers and their Alternate Type of Service code values for paper claims. If you submit claims to these payers, you must create an Alternate Type of Service code library for those payers that use these values. Alternate Type of Service codes for electronic claims types are not explained here. Type of Service Code Table The standard Type of Service codes are part of the application's Type of Service code table. Alternate Type of Service Codes You can use alternate type of service codes on paper claims for each payer.

File Maintenance Help for NextGen® Enterprise 8

Alternate Type of Service Codes

You can use alternate type of service codes in the place of standard type of service codes for each payer by creating a library of alternate type of service codes, and then attaching the library to the payer. State Payer If the Standard Code is... Then the Alternate Code is... CT, AR, NY, PA, MD, OR, WI, SC All Types of Service codes Blank WA Medicare All Types of Service codes Blank SC Medicaid All Types of Service codes Blank PA Blue Cross Blue Shield All Types of Service codes Blank MD Blue Cross Blue Shield All Types of Service codes Blank TX WorkComp All Types of Service codes Blank WA Medicaid and WorkComp All Types of Service codes 3 AL Medicare when there is no Secondary or Tertiary Payer All Types of Service codes Blank Note: The table outlines the alternate type of service codes for paper claims. The alternate type of service codes for electronic claims are not mentioned here. Parent topic: Appendix A: Alternate Type of Service Codes

File Maintenance Help for NextGen® Enterprise 8

Alternate CPT4 Code

You can set up Alternate Payer Alternate CPT4 codes in the Service Item Library for the main payer that the alternate payer is attached to. If these codes are set up, they only populate the alternate payer claim when the following conditions are met: The location and service items on the encounter match the location and service items set up in Location field and Valid Alternate Payer Service Items on the Alternate Payer tab of the Add/Modify Payer Information window for the main payer. There are Alternate Payer Alternate CPT4 ( Alt Payer CPT4) codes set up for the main payer on the Payer tab of the Service Item Library Maintenance window. Set Up an Alternate CPT4 Code Parent topic: Payer Tab - SIM Library

File Maintenance Help for NextGen® Enterprise 8

Set Up an Alternate CPT4 Code

Open a Service Item library. From the Search list on the left, select a service item and then select the Payer tab. Select the applicable main payer from the drop-down list. Enter the Alternate Payer Alternate CPT4 code in the Alt Payer CPT4 column. Note: If there is an alternate payer attached to a main payer in the Payer Master and there are Alternate Payer Alternate CPT4 codes that need to be used on the alternate payer claim, then enter the Alternate Payer Alternate CPT4 code in the Alt Payer CPT4 field for the selected service item and payer that the alternate payer is attached to. Only when the location and service items on the encounter match the location and services set up on the Alternate Payer tab of the Add/Modify Payer Information window for the main payer will Alternate Payer Alternate CPT4 codes populate to the alternate payer claim. Parent topic: Alternate CPT4 Code

Types of Service Library

Recommendations

Set Up an Alternate Type of Service Codes Library

Attach an Alternate Type of Service Library to a Payer

Appendix A: Alternate Type of Service Codes

Alternate Type of Service Codes

Alternate CPT4 Code

Set Up an Alternate CPT4 Code

Set Up an Alternate Type of Service Codes Library

Attach an Alternate Type of Service Library to a Payer

Appendix A: Alternate Type of Service Codes

Alternate Type of Service Codes

Alternate CPT4 Code

Set Up an Alternate CPT4 Code