The
Claim Production Status report is automatically generated when one or more encounters are billed in
NextGen® Enterprise PM. After the claim edits process completes for all encounters, the report generates and appears on screen. The report identifies whether the encounters passed or failed claim edits by displaying each encounter in one of the following text colors:
- Green: Indicates the encounter passed all claim edits and a pending claim is created for the payer. Self-pay encounters also display in green if the Include Self-Pay Encounters In Claim Billing Report option is enabled in .
- Blue: Indicates the encounter failed one or more claim edits that are set up in the Claim Edits Library with Severity = Warning, and a pending claim is created for the payer.
- Red: Indicates the encounter failed one or more claim edits that are set up in the Claim Edits Library with Severity = Build, Critical or Required, and a pending claim is not created for the payer. To create a claim, the issue causing the failure must be corrected and the encounter must go through the billing and claim edits process again.
- Black: Indicates the encounter cannot be billed because there are no charges selected for billing. This happens when charges have not yet been entered on the encounter, or when the encounter is in Rebill status but no charges are selected to be rebilled in Balance Control.
The report has "drill-down" functionality that enables you to double-click on a record to access the tab directly from the report. This is useful when correcting errors for encounters on the report.
Note: Encounters that failed one or more claim edits will be included in the next billing run. If the cause of the error was corrected, the encounter will pass the claim edits on the second run and a pending claim will be created. If the cause of the error was not corrected, the encounter continues to fail the same edit and displays the same red error message until corrected.
