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File Maintenance Help for NextGen® Enterprise 8
Libraries are attached to the payer on the Practice tab, they are only active for the practice in which you are working. If you have multiple practices within your enterprise, you must access each practice to activate the libraries as necessary. To attach libraries to a payer: Open the File Maintenance. Open the System > Practice > Payer master file > Practice. Select the Libraries tab. Select the necessary libraries and settings. Libraries are available only when the current practice has practice access to them. Field Description Claim Edit Library Select the Claim Edits Library that you want to use for this payer. This selection overrides the default Claim Edits library selected in the Practice Preferences for Libraries. Type of Service Library Select the appropriate Type of Service Library for the payer. Place of Service Library Select the drop-down arrow and select the appropriate Place of Service Library for the payer. This enables you to attach a library with alternative place ofAdd Libraries to a Practice
Help Guide for NextGen® Enterprise PM 8
The Encounter Rate Billing library enables you to configure the billing process for payers who require a flat encounter rate. This library is used to configure the business rules applicable to a payer. The Encounter Rate Billing library provide the flexibility to set up multiple rate codes to accommodate the different billing requirements of individual payers. The appropriate library can then be attached to the payer. A SIM with the appropriate CPT4 code must be set up in the SIM library before you set up encounter rate billing. Note: When you copy an Encounter Rate Billing library, the SIM Configuration Hierarchy and the encounter rate information are also copied. To add or modify an Encounter Rate Billing library, do the following: Access File Maintenance. Select Libraries, and then Encounter Rate Billing. The Encounter Rate Billing List window opens. Do one of the following: To add a library, select Open Menu and select New. To modify a library, select the library from the list, andAdd or Modify an Encounter Rate Billing Library
File Maintenance Help for NextGen® Enterprise 8
Before you begin A SIM with the appropriate CPT4 code must be set up in the SIM Library before you set up encounter rate billing. Note: When you copy an Encounter Rate Billing Library, the SIM configuration hierarchy and the encounter rate information are also copied. Encounter Rate Billing Library provides flexibility to set up multiple rate codes to accommodate different billing requirements of individual payers. You can generate both Encounter Rate Library Listing and Encounter Rate Library with Claim Detail Rules reports from the Encounter Rate Billing Library. For more information, go to NextGen Healthcare Success Community and download the latest Reports User Guide forNextGen®Enterprise PM. To add or modify an Encounter Rate Billing Library, do the following: Open File Maintenance. Select Libraries > Encounter Rate Billing. The Encounter Rate Billing List window opens. Do one of the following: To add a library, select the open menu button and then select New. To modify a library,Add or Modify an Encounter Rate Billing Library
File Maintenance Help for NextGen® Enterprise 8
A Claim Printing library must be attached to a practice to bill an encounter and generate a claim within that practice. When a library is attached to a practice, that library becomes the default Claim Printing library for the practice. To access the Practice Preferences window, do one of the following: In NextGen® Enterprise PM, select the Admin menu > Preferences > Practices. In File Maintenance, select Master Files > System > Practices. Double-click a practice, and then select Preferences. The Practice Preferences window opens. Select the Libraries in the Preference List. Select a claim printing library from the Claim Print Library drop-down list. Select OK. Parent topic: Claim Print Options in Claim Printing LibraryAttach a Claim Printing Library to a Practice
Help Guide for NextGen® Enterprise PM 8
A Claim Printing library must be attached to a practice to bill an encounter and generate a claim within that practice. When a library is attached to a practice, that library becomes the default Claim Printing library for the practice. To access the Practice Preferences window, do one of the following: In NextGen® Enterprise PM, select Admin > Preferences > Practice. In File Maintenance, on the Master Files list select System and then Practices. Double-click a practice, and then select Preferences. The Practice Preferences window opens. Select Libraries in the Preference List. Select a claim printing library from the Claim Print Library drop-down list. Select OK. Parent topic: Claim Printing LibraryAttach a Claim Printing Library to a Practice
File Maintenance Help for NextGen® Enterprise 8
Default Libraries Select the following libraries for the practice as needed. Diagnosis Code Library: Select the Diagnosis Codes library to be used in the practice. Service Item Library: Select the Service Items library to be used in the practice. Claim Modifiers Library: Select the default Claim Modifiers library to be used for all payers in the practice, if applicable. Payer-specific libraries are linked to the payer in the Payers master file Practice tab > Libraries sub-tab. NDC Library: Select the NDC library to be used in the practice. Claim Edits Library: Select the default Claim Edits library to be used for all payers in the practice. Payer-specific libraries are linked to the payer in the Payers master file > Practice tab > Libraries sub-tab. Self Pay SIM Exception: Select the SIM Exception to be used for all self-pay patients in the practice, if applicable. Eligibility Profile Library: Select the default Eligibility Profiles library to be used for all RTS payers in the practice