Date Appliance Placed on Claims

Help Guide for NextGen® Enterprise PM 8

Add or Modify Dental Appliance Dates

When a dental payer is linked to an encounter, you can enter Date Appliance Placed and Date Appliance Removed dates for orthodontia from the Patient Insurance - Encounter window in NextGen® Enterprise PM. The Date Appliance Placed date is then included on paper ADA and electronic 837D claims. Note: These date fields appear only when the primary payer on the encounter has the Dental payer check box enabled in File Maintenance on the Defaults-2 tab of the Payer Information window. To enter appliance dates for a patient's dental insurance, do the following: Access the Patient Chart. Select the Encounters tab. From the Encounters list, select an encounter with a dental payer attached as the primary insurance. Select the Insurance sub-tab. In the Encounter Insurance section, select the primary dental payer. In the Verification section, select Open Record . The Patient Insurance - Encounter window opens. Patient Insurance - Encounter In the Date Appliance Placed field, enter or select the da

Help Guide for NextGen® Enterprise PM 8

Date Appliance Placed on Claims

When you enter a Date Appliance Placed on the Patient Insurance - Encounter window in NextGen® Enterprise PM, it is included on claims as indicated below. The Date Appliance Removed is informational only and is not included on claims. On paper ADA Claims, Date Appliance Placed prints in Box 41. On electronic 837D claims, Date Appliance Placed creates and populates the 2300 DPT*452 segment on electronic 837D claims in ASC X12 Version 5010 format. The segment format is as follows: The DTP01 (date time qualifier) value is 452 (Appliance Placement). The DTP02 (date time period format qualifier) value is D8 (date expressed in format CCYYMMDD). The DTP03 (date time period) value is the date entered in the Date Appliance Placed field. Parent topic: Add or Modify Dental Appliance Dates

Help Guide for NextGen® Enterprise PM 8

Add or Modify Dental Appliance Dates

When a dental payer is linked to an encounter, you can enter Date Appliance Placed and Date Appliance Removed dates for orthodontia from the Patient Insurance - Encounter window in NextGen® Enterprise PM. The Date Appliance Placed date is then included on paper ADA and electronic 837D claims. Note: These date fields appear only when the primary payer on the encounter has the Dental payer check box enabled in File Maintenance on the Defaults-2 tab of the Payer Information window. To enter appliance dates for a patient's dental insurance, do the following: Access the Patient Chart. Select the Encounters tab. From the Encounters list, select an encounter with a dental payer attached as the primary insurance. Select the Insurance sub-tab. In the Encounter Insurance section, select the primary dental payer. In the Verification section, select Open Record . The Patient Insurance - Encounter window opens. In the Date Appliance Placed field, enter or select the date the dental appliance was pl

Help Guide for NextGen® Enterprise PM 8

Dental Billing

This section provides information on dental billing for Health Centers that perform dental services. Specific setup in File Maintenance is required so that dental charges can be entered on encounters and then billed to dental payers on either 1500, ADA or UB claim forms. The type of claim form generated is determined by the setup for each dental payer. The following claim formats are supported in NextGen® Enterprise PM: 1500: Electronic 837PPaper CMS 1500 Form (2012) ADA: Electronic 837D Paper ADA Form (2024) UB: Electronic 837IPaper UB04 Form (2004) Dental billing in NextGen® Enterprise PM involves the following setup in File Maintenance: Practice Preferences Code Tables CPT4 Codes SIM library Claim Edits library Claim Printing library Transaction Codes Payers Set Up Practice Preferences for Dental Billing View Code Tables for Dental Billing Service Items Library for Dental Billing Claim Edits for Dental Billing Claim Printing Library for ADA Claims Payers Master File for Dental Billi

Help Guide for NextGen® Enterprise PM 8

Dental Billing

This section provides information on dental billing for Health Centers that perform dental services. Specific setup in File Maintenance is required so that dental charges can be entered on encounters and then billed to dental payers on either 1500, ADA or UB claim forms. The type of claim form generated is determined by the setup for each dental payer. The following claim formats are supported in NextGen® Enterprise PM: 1500: Electronic 837PPaper CMS 1500 Form (2012) ADA: Electronic 837D Paper ADA Form (2024) UB: Electronic 837IPaper UB04 Form (2004) Dental billing in NextGen® Enterprise PM involves the following setup in File Maintenance: Practice Preferences Code Tables CPT4 Codes SIM library Claim Edits library Claim Printing library Transaction Codes Payers Set Up Practice Preferences for Dental Billing View Code Tables for Dental Billing Service Items Library for Dental Billing Claim Edits for Dental Billing Claim Printing Library for ADA Claims Payers Master File for Dental Billi

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

Date Appliance Placed on Claims

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