Loading...
Recommendations
Explore
File Maintenance Settings Required for Recurring UB Billing
File Maintenance Settings Required for Recurring UB Billing
To enable recurring UB billing, you must set up the following items in File Maintenance:
Practice Preferences
Payer master file
Revenue Codes
The SIM library
Set Up Practice Preferences for Recurring UB Billing
Set Up the Payer Master File for Recurring UB Billing
Override Practice Preferences with the Payer Master File
Set Up Revenue Codes
Set Up Revenue Codes for SIMs
Help Guide for NextGen® Enterprise PM 8
Encounter Settings Required for Recurring UB Billing
Prior to billing, an encounter must be set up for the automated billing process. The setup information is different for: The initial encounter in a series Subsequent encounters in a series The final encounter in a series Initial Encounter in a Series Creating Subsequent Encounters in a Series Final Encounter in a Series Single Encounter in a Series Parent topic: Recurring UB Billing
Help Guide for NextGen® Enterprise PM 8
Set Up the Payer Master File for Recurring UB Billing
The Frequency of Bill field must be set up in the Payer Master file to trigger recurring UB billing. In File Maintenance, select Master Files - System > Payers. Select the applicable payer from the list, and then select the UB tab on the Practice tab. In the Modify Payer Information window, select the location in the Location field if your practice has multiple locations. When the location is entered, the remaining fields in the window display the data you have set up for the payer. Note: The location that you select must be the same location as shown on the encounter. Select the rendering providers in the Rendering Provider field. Leave the Frequency of Bill field blank or set to <none>. This field must be blank for recurring billing. Enter data in other fields, as applicable for the payer for enhanced UB billing. For setup information on enhanced UB billing, refer to Setting Up UB Claims for Enhanced UB Users. Select OK. Parent topic: File Maintenance Settings Required for Recurring
Help Guide for NextGen® Enterprise PM 8
Set Up Revenue Codes for SIMs
The Service Items in the SIM library must have the proper revenue codes set up for recurring billing. In File Maintenance, select Libraries and then Service Items . Select the applicable library from the list. Enter the service item number in the Search field. The Service Item Library Maintenance window opens. Enter the Service Item number that you want to use for recurring billing in the Search field. Select the applicable revenue code in the Revenue Code field. The revenue code must be a valid code for recurring billing. Refer to Setting Up Revenue Codes in this section for a list of valid codes. Select OK. Parent topic: File Maintenance Settings Required for Recurring UB Billing
Help Guide for NextGen® Enterprise PM 8
Override Practice Preferences with the Payer Master File
If you use recurring billing at a few locations, you can maintain the UB settings in Practice Preferences and override the settings in the Payer master file for the locations using recurring billing. In File Maintenance, select Master Files - System > Payers. Select the applicable payer from the list, and then select the UB tab on the Practice tab. In the Modify Payer Information window, select the location in the Location field if your practice has multiple locations. When the location is entered, the remaining fields in the window display the data you have set up for the payer. Note: The location that you select must be the same location as shown on the encounter. In the Bill Classification field, select one of the following options: 4 (Outpatient Rehab Facility) 5 (Comp Outpatient Rehab Facility) In the Type of Facility field, select 7 (Clinic). Enter data in other fields, as applicable for the payer. Select OK. Note: If the values in the Type of Facility, Bill Classification, and F
Help Guide for NextGen® Enterprise PM 8
Set Up Practice Preferences for Recurring UB Billing
You must set up the following three fields in Practice Preferences or the Payers master file to trigger recurring UB billing: Bill Classification Type of Facility Bill Frequency If your practice does exclusively recurring UB billing, then it is best to set up these fields in Practice Preferences. However, if you use recurring billing at a few locations, you can override the UB settings in Practice Preferences with settings in the Payers master file for the locations using recurring billing. In NextGen® Enterprise PM, select Admin > Preferences > Practice. In the Practice Preferences window, select the Claims tab. In the Type of Facility field, select 7 (Clinic). Leave the Frequency of Bill field blank. This field must be blank for the automated billing process. In the Bill Classification field, select one of the following options: 4 (Outpatient Rehab Facility) 5 (Comp Outpatient Rehab Facility) Select OK. Note: If the values in the Type of Facility, Bill Classification, and Frequency o
Help Guide for NextGen® Enterprise PM 8
Set Up Revenue Codes
Revenue Codes used for physical therapy, occupational therapy, and speech therapy must be set up in the Revenue Codes master file for recurring billing. In File Maintenance, select Master Files - System and then Revenue Codes. Select the open menu button and then select New or select a revenue code from the list. The Modify Revenue Code Information window opens. Enter the revenue code, in the Code field. Valid codes and descriptions for recurring billing are: 420-429 - Physical Therapy 430-439 - Occupational Therapy 440-449 - Speech Therapy Enter the description that corresponds with the revenue code, in the Description field. Select your default occurrence code in the Occurrence Code field. Valid codes are: 35, 44, and 45. Select your default value code in the Value Code field. Valid codes are: 50, 51, and 52. Select OK. Parent topic: File Maintenance Settings Required for Recurring UB Billing
