Loading...
Recommendations
Explore
Claim Edits Library
This section contains a listing of all of the available claim edits in the application.
Claim Edit Columns
Claim Edit Descriptions
This section describes the various claim edits available.
System-Level Claim Edit Descriptions
Claim Edits Library
Help Guide for NextGen® Enterprise PM 8
837 File Structure
This section provides a detailed description of the 837 file structure. 837 File Structure Parent topic: Claims
Help Guide for NextGen® Enterprise PM 8
Claim Edits Library
This section contains a listing of all of the available claim edits in the application. Claim Edit Columns You can use the claim edit columns to configure claim edits. Claim Edit Descriptions Claim edits fields lists the corresponding ID, and the specific claim field on the 837 electronic claim file impacted by the edit. System-Level Claim Edit Descriptions
Help Guide for NextGen® Enterprise PM 8
Claim Edits
This chapter includes information about the Claim Edits library and the various types of edits that can be applied to a claim during claim processing. This section includes: Claim Edits Library PQRI Edits CCI Edits Local Medical Review Policy ICD Diagnosis Edits Claim Edits Library PQRI Edits CCI Edits Local Medical Review Policy Parent topic: Setting Up Claims
Help Guide for NextGen® Enterprise PM 8
Claim Edit Columns
The columns in the Claim Edit Library Maintenance window have the following flexibility: You can sort columns alphabetically or numerically in ascending or descending order. You can adjust most column widths to display more or less information. The following columns appear on the Claim Edit Library Maintenance window: Active – The fields in this column can be checked or unchecked at your discretion. When the field is checked, the claim edit that it corresponds to is considered Activated, which means that the claim edit will run when an encounter is billed and a claim is created using this Claim Edits Library. ID – The fields in this column display a unique ID number that corresponds to each claim edit in the library. These ID numbers cannot be changed. If you sort by the ID number, it makes it easier to reference when new claim edits are added to the library. Claim Edit – The fields in this column display the claim edits that are available in the Claim Edits Library. Help Text – The fi
Help Guide for NextGen® Enterprise PM 8
Claim Edits
This chapter includes information about the Claim Edits library and the various types of edits that can be applied to a claim during claim processing. This section includes: Claim Edits Library PQRI Edits CCI Edits Local Medical Review Policy ICD Diagnosis Edits Claim Edits Library Claim edits are a set of conditions that must be met when you generate a claim. PQRI Edits CCI Edits Local Medical Review Policy Parent topic: Setting Up Claims
Help Guide for NextGen® Enterprise PM 8
Claim Edits for Dental Billing
Claim edits that are specific to dental can be selected through the Claim Edits library or automatically when sending diagnoses using the 5010 format. Claim Edits Library for Dental Billing System Claim Edits for the 5010 Format Parent topic: Dental Billing
