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Entering Reason Codes during Payment Entry
During the payment entry process, you have the ability to apply reason codes at the:
Add a Transaction Level Reason Code During Payment Entry
Add a Line-item Reason Code during Payment Entry
Add a Transaction Level Reason Code during Payment Entry
You can use the Payment Entry window to enter transaction level reasons code during the payment entry.
Add a Line-item Reason Code during Payment Entry
You can use the Payment Entry window to add a line-item reason code during payment entry.
Entering Reason Codes during Payment Entry
Help Guide for NextGen® Enterprise PM 8
Add a Line-item Reason Code during Payment Entry
You can enter multiple reason codes at the line-item level, and each line-item can have a different reason code. Line-item reason codes are selected from the Line Item Reasons column at the bottom of the Payment Entry window. Open NextGen® Enterprise PM. On the main toolbar, select Posting . The Batch Posting window opens. Double-click the desired batch header record. The Payment Entry window opens. Type the encounter number in Enc/Clm#, and select Enter. The account guarantor, patient, medical record number, and the billed account displays in the Payment Entry window. In Line Item Reasons, select the codes that match the payer's reason code on the remittance advice. Enter the required fields and select Recalc. Select Save. Parent topic: Entering Reason Codes during Payment Entry
Help Guide for NextGen® Enterprise PM 8
Add a Transaction Level Reason Code during Payment Entry
Transaction level reason codes are selected in the Payment Entry window in the Clm Reasons field. You can enter multiple reason codes at the transaction level. Transaction codes are set up for the practice in the Reason Code Maintenance window in File Maintenance. Open NextGen® Enterprise PM. On the main toolbar, select Posting . The Batch Posting window opens. Double-click the desired batch header record. The Payment Entry window opens. Type the encounter number in Enc/Clm#, and press Enter. The account guarantor, patient, medical record number, and the billed account displays in the Payment Entry window. In the Clm Reasons list, select the codes that match the payer's reason code on the remittance advice. Select Save. Parent topic: Entering Reason Codes during Payment Entry
Help Guide for NextGen® Enterprise PM 8
Posting Encounter and Account Level Payments
You can print on-demand encounter and account level receipts from the following windows after a payment is entered and saved: Payment Entry Account Summary Enter an Encounter Payment Enter a Transaction for an Account You can use the Payment Entry window to enter transactions details for an account. Enter an Invoice Payment You can enter an invoice payment in to the system using the Payment Entry window. Receive a Secondary Payer Payment before the Primary Payer You can use the Use Settled up status option for posting the payment to a secondary payer. Parent topic: Posting Transactions
Help Guide for NextGen® Enterprise PM 8
Add a Line-item Reason Code During Payment Entry
You can enter multiple reason codes at the line-item level, and each line-item can have a different reason code. Line-item reason codes are selected from the Line Item Reasons column at the bottom of the Payment Entry window. Open NextGen® Enterprise PM. On the main toolbar, select Posting . The Batch Posting window opens. Double-click the desired batch header record. The Payment Entry window opens. Enter the encounter number in Enc/Clm# and select Enter. The account guarantor, patient, medical record number, and the billed account appear in the Payment Entry window. In Line Item Reasons, select the codes that match the payer's reason code on the remittance advice. Enter the required fields and select Recalc. Select Save. Parent topic: Posting Transactions Overview
Help Guide for NextGen® Enterprise PM 8
Add a Transaction Level Reason Code During Payment Entry
Transaction level reason codes are selected in the Clm Reasons field on the Payment Entry window. You can enter multiple reason codes at the transaction level. Transaction codes are set up for the practice in the Reason Code Maintenance window in File Maintenance. Open NextGen® Enterprise PM. On the main toolbar, select Posting . The Batch Posting window opens. Double-click the desired batch header record. The Payment Entry window opens. Enter the encounter number in Enc/Clm# and select Enter. The account guarantor, patient, medical record number, and the billed account appear in the Payment Entry window. In the Clm Reasons list, select the codes that match the payer's reason code on the remittance advice. Select Save. Parent topic: Posting Transactions Overview
Help Guide for NextGen® Enterprise PM 8
Reason Code Types
There are four types of reason codes as described below. The type of code that is used is determined by the payer. Different payers may return the same code as either a Line Item code or a Claim Level code. If this occurs, it is possible to have the same code in the Reason Code Library with two different code types to ensure that the ERA 835 file processes correctly. Adjudication codes are always claim level codes. Remark codes are always line item level codes. Reason codes that are imported “on-the-fly” are automatically flagged as either Line Item or Claim Level, depending on how they are returned by the payer in the ERA file. Line Item: Line Item reason codes are returned by the payer at the charge, or CPT® 4 code, level. They are available for selection in the Line Item Reasons column at the bottom of the Payment Entry window. They display in the Reason column in the Patient Chart > Encounters > Transactions sub-tab. Claim Level: Claim Level reason codes are returned by the payer a
