Batch NextGen® Eligibility Verification When NPI is Missing

The following are examples of how NextGen® Eligibility Verification manages eligibility when specific information is missing or not defined:

• If the resources physician link does not contain an NPI, NextGen® Eligibility Verification batch eligibility sends the appointment rendering physician NPI as the provider if the resources physician link record does not contain an NPI.
• If the appointment resources physician link is fille but an NPI does not exist, the appointment rendering physician NPI is used.
• If the appointment rendering physician is not filled, then the Eligibility Profile Library (2100B Loop NM1 Segments Identification Code (NM109) is used.
• If the appointment rendering physician is filled but an NPI does not exist, then the Eligibility Profile Library (2100B Loop NM1 Segments Identification Code (NM109) is used.

The following two images are in sequence and provide an example of editing a response from scheduling administration. The first image shows an open edit resource accessed through the Admin menu in NextGen® Enterprise PM. When the resource is opened, the physician link is blank.

The image below provides an example from the Edit Appointment window. When the physician link is missing, the rendering physician is used and the rendering physician appears.