Advanced Search Criteria

Search Criteria	Description
Supervising Physician	Search by supervising physician. Select the flashlight button to display the Provider Lookup window.
Last Name, First Name	Search by last name, first name, or both names of the patient associated with the claim.
Service Location	Search by the service location where the claim was originated.
Claim Nbr	Search by claim number.
Claim Status Category Description	Search by the Claim Status Category description.
Acknowledgment Status	Select the acknowledgment status you want to search by when you perform a claim request lookup. You can search for one of the following statuses: Accepted Accepted w/Errors Awaiting Ack N/A Rejected You can search by acknowledgment status only when the Request Status is set to Archived.
Send Filename	You can use this field to include an individual EDI file as additional search criteria when you search for archived claims. Select the open record button to locate the EDI file that you want to search on.
Fully Capitated Archived Claims Only	Restrict the search to fully capitated archived claims.

Help Guide for NextGen® Enterprise PM 8

General Search Criteria

Search Criteria Description Request Status Searches a claim by the status of a claim when you select one of the following options: Archived A displays all archived claims. Consolidated C displays all Consolidated Services Claims (CSC). Note: You cannot delete a CSC. Hold H displays all CSC Candidate Encounter Claims. Pending displays all pending claims. Media Type Searches a claim by claim media types when you select one of the following options: Electronic Paper Claim Form Searches a claim by claim form media types when you select either Electronic or Paper in the Media Type. When you select Electronic the following options appear in the Claim Form column: 1500 ADA UB Form 1 Template Pediatrics Form When you select Paper the following options appear in the Claim Form column: CMS 1500 ADA 2019 ADA 2024 CMS 1500 (2005) CMS 1500 (2012) UB04 UB92 Form 1 Template Pediatrics Form Claim Type Searches claim by one or more claim types from the list. Rendering Physician Searches claim by one or

Help Guide for NextGen® Enterprise PM 8

Search for Claim Requests

The Claim Request Lookup window enables you to search through the system for claims that match the search criteria. In NextGen® Enterprise PM, select Tasks > Lookup > Claims or select the Claims icon. The Claim Request Lookup window opens. To search for claims by request status, media type, claim type, or rendering physician, use the General tab. To search for claims by supervising physician, claim number, or acknowledgment status, select the Advanced tab. Select Find. The search results appear in the Claim Requests list. Double-click the claim in the Claim Requests list to access a claim request. Note: There is a green check mark in the Consolidated Service Claims (CSC) column for all the CSC candidate claims. CSC cannot be deleted. General Search Criteria You can search a claim by its status, media type, claim type, or rendering physician through the General tab of the Claim Request Lookup window. Advanced Search Criteria Parent topic: Generating and Submitting Claims

Help Guide for NextGen® Enterprise PM 8

Filters in Claim Requests Report

The following table lists the filters available on the Filter 1 section. Filter Description Create Date Select a Create Date range for claims Processed Date Select a Process Date range for claims Request Status Select one or more of the following to be included on the report: Pending Archived HOLD Consolidated Payer Seq Select one or more of the following to be included on the report: Primary Secondary Tertiary Media Type Select one or both of the following to be included on the report: Paper Electronic Name Used to narrow the focus of the report to Patient Names that fall within the beginning and ending name range you enter. You can enter: whole names partial names first initials only Status Cat Code Select a 997 acknowledgement transaction Status Category Code to be included on the report Status Code Select a 277/277u claim Status Code to be included on the report You can use the following operators on columns in theFilter 2section to filter the data in the report: Between Equals Not

Help Guide for NextGen® Enterprise PM 8

Claim Status Report Filters

The following table lists the filters available in the Filter 1 section. Filter Description Claim Status Request Date The date range of the claim status request. Claim Status Response Date The date range of the claim status response. Claim Status Includes one or more of the following statuses selected in the report for the claims: Accepted Mixed Rejected Not Reported Pending You can use the following operators on columns in theFilter 2section to filter the data in the report: Between Equals Not Equals Greater Than Less Than Like You can use the Payer section to filter data on the report by payer name. You can use the Provider section to filter data on the report by Provider name. You can use the COLUMN filter in the Sorting section to sort and group data on the report. The column sorting options include the following: Ascending Descending Group By Page Break Note: The columns that are not available for Group By or Page Break are indicated by 'n/a'. You can use the column total options

Help Guide for NextGen® Enterprise PM 8

Patient Search Criteria Information

Field Description Last Patient's last name or part of last name. First / Preferred Patient's first name or preferred name. Middle Patient's last name or part of middle name. Suffix Patient's last name or part of last name. Note: This field appears only if the Include suffix on lookup screens option is configured in Practice Preferences. Previous Last Patient's previous last name or part of previous last name. City Patient's city. Address Line 1 Patient's street address. Zip Patient's zip code. Mother's Maiden Name Patient's mother's maiden name. Social Security Patient's social security number. Note: This field cannot be used with other search criteria. Birth Date Patient's birth date in MM/DD/YYYY format. Sex Patient's birth sex. The following options are available: Female Male Undifferentiated Unknown Phone Patient's 10-digit home phone number. Note: This field cannot be used with other search criteria. Search By Is based on Person Lookup Search By selected in Practice Preferences. T

Help Guide for NextGen® Enterprise PM 8

Appointment Lookup Search Criteria

The following table describes the fields that are available in the Search Criteria section of the Appointment Lookup window: Field Description Last You must enter the patient's last name. First/Preferred You must enter the patient's first name or preferred name. Middle You must enter the patient's middle name. Suffix You must select the patient's last name suffix. Note: This field appears when you select the Include suffix on lookup screens option in the General tab of the Practice Preferences window. Date of Birth You must enter the patient's birth date in MM/DD/YYYY format. Social Security You must enter the patient's social security number. Description You must enter all or part of the text in the Description field on the Edit Appointment window. Status You can select one or more appointment statuses from the following: Canceled Expected Kept No Show Pending Note: The default appointment status that you select in the Default appointment lookup status option in the General tab of the

Advanced Search Criteria

Recommendations

General Search Criteria

Search for Claim Requests

Filters in Claim Requests Report

Claim Status Report Filters

Patient Search Criteria Information

Appointment Lookup Search Criteria

General Search Criteria

Search for Claim Requests

Filters in Claim Requests Report

Claim Status Report Filters

Patient Search Criteria Information

Appointment Lookup Search Criteria