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Create an EDI File by Practice
Select the
EDI File
toolbar button.
The
837 Electronic File Creation
window opens.
Complete the following required fields:
Submitter Profile Library
Claim Form
Send File Name
Batch Type
Select the
Practices
tab.
You can search for claims by a single practice, multiple practices, or all practices within your enterprise.
To search for claims by single or multiple practices go to
Step 5
.
To search for claims for
All Practices
in your enterprise go to
Step 7
.
To search for pending claims associated with a single or multiple practices, select the open record
icon.
The
Practices
window opens.
Select the
Flashlight
icon to search for practices.
Move the applicable practices to the
Included
section.
Select
OK
.
To search for pending claims across all practices, enable the
All Practices
check box.
Enable any of the following check boxes to update claims, create a report, or send a test file.
Update claim requests as processed
Report results
- to display the report after it is processed.
Use test code in REF02 trans type segment
Select
Find
.
The claims that match the search criteria display in the
Pending Electronic Claims
section.
In the
Pending Electronic Claims
section, select the claims to include in the EDI file.
Select
Process
.
The
Electronic Send
report automatically displays when the
Report results
check box is enabled.
Help Guide for NextGen® Enterprise PM 8
837 Electronic File Creation - File Options and Pending Electronic Claims
The File Options and Pending Electronic Claims section of this window display on the General, Advanced, and Practices tab. File Options - you can identify the electronic file name, the batch type, create a report, create a test file, and update claim requests as they are processed. Pending Electronic Claims - This section displays the claims that match the search results entered on the General, Advanced, or Practices tab. You can select the claims to include in the electronic file. File Options Section This section of the window includes fields for identifying the file name and batch type. Also, you can run a report, update claim requests as processed, or create a test file. Use the following table to enter data in the fields in this section of the window. Menu Item Description Send Filename (required) To name the EDI file and the path to save the file, select the open folder icon . Browse to the desired location and then name the file. Batch Type (required Select the batch type. Prod
Help Guide for NextGen® Enterprise PM 8
Search for Claims to Include in an EDI File
On the Practices tab you can search for claims associated with a single practice, multiple practices, or all practices within your enterprise. Then you can select the claims that you want to include in the electronic file. Select the EDI File toolbar button. The 837 Electronic File Creation window opens. Select the Practices tab. Use the following table to complete the fields on this window. Field Description Open Record Select the Open Record icon to open the Practices window. On this window you can search for the practices in your enterprise and then add the applicable practices to the Included section of the window. All Practices Enable this check box to search for claims associated with all practices in your enterprise. Parent topic: 837 Electronic File Creation Window
Help Guide for NextGen® Enterprise PM 8
Create an EDI File by Payer, Patient Name, Rendering Physician, Financial Class, or Location
Click the EDI File toolbar button. The 837 Electronic File Creation window opens. Complete the following required fields: Submitter Profile Library Claim Form Send File Name Batch Type Click the Advanced tab. To refine your search by payer, patient name, provider, financial class, or location, complete any of the following fields: Payer Last/First Name of the patient Rendering- select or search for the rendering provider Report Transmission Code Financial Class Location To search for claims by the primary, secondary, tertiary payer, or for ERA Posted Charges, enable the following check boxes: Primary Secondary Tertiary ERA Posted Charges Only Enable any of the following check boxes to update claims, automatically create a report, or send a test file: Update claim requests as processed Report results - to display the report after it is processed. Use test code in REF02 trans type segment Click Find. In the Pending Electronic Claims section select the claims to include in the EDI file. C
Help Guide for NextGen® Enterprise PM 8
Create an EDI File by Claim Type, CPT4 Code or Date
To create an EDI file by claim form, claim type, CPT4 code, or begin and end date, use this procedure. Select the EDI File toolbar button. The 837 Electronic File Creation window opens. Complete the following required fields: Submitter Profile Library Claim Form Send File Name Batch Type To further refine your search, enter data in the applicable fields. Enable any of the following check boxes to update claims, create a report, or send a test file: Update claim requests as processed Report results - to display the report after it is processed. Use test code in REF02 trans type segment Select Find. In the Pending Electronic Claims section select the claims to include in the EDI file. Select Process. The Electronic Send report generates and automatically displays when the Report Results check box is enabled. Parent topic: 837 Electronic File Creation Window
Help Guide for NextGen® Enterprise PM 8
Search for 837 Electronic Claims
Use the Advanced tab to create a search query for encounters by payer, patient name, rendering provider, financial class, report transmission code, ERA posted charges only, or location. The query you create, will return a list of pending electronic claims that match the search criteria. Select the EDI File button on the tool bar. Use the following table to enter search criteria on the Advanced tab: Field Description Payer Select a payer to narrow the search for pending claims. When a specific payer is selected, the search returns pending claims based on the submitter profile and claim form criteria, as well as the specific payer that was selected. This search field is beneficial if you want to create an 837 file for a single payer, but the submitter profile has been attached to more than one payer. Last Enter the first few characters or the last name of the patient to narrow the search for pending claims. First Enter the first few characters or the first name of the patient to narrow t
Help Guide for NextGen® Enterprise PM 8
Create an 837 Electronic File
Use the General tab to search for claims by form type, claim type, CPT4 codes, and by date. To access this window, select the EDI File toolbar button. The 837 Electronic File Creation window opens. On the General tab use the following table to identify your search criteria. Field Description Submitter Profile Library (required) Select the applicable submitter profile library. Pending claims that were created with this submitter profile attached to the payer will be returned in the search. The 837 electronic files are created based on submitter profiles because the settings in the submitter profile are specific to the payer, which maintains HIPAA compliancy. Claim Form (required) Select one of the following claim forms: 1500 ADA (Dental) UB. You can only include one claim form type in an 837 electronic file. This corresponds to the submitter profile option, Number of functional groups per file. Claim Type Select the claim type to narrow the search for pending claims based on the claim t
