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
Recommendations
Help Guide for NextGen® Enterprise PM 8
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 BillingEncounter Settings Required for Recurring UB Billing
Help Guide for NextGen® Enterprise PM 8
You can set up the claim form for UB billing in any one of the following areas of the application: The Service Items library on the General tab. The Service Items library on the Payer tab. The Payer master file on the UB sub-tab of the Practice tab. Set Up a UB Claim Form in the General tab of Service Items Library Set Up a UB Claim Form in the Payer tab of the Service Item Library Set Up a UB Claim Form in the Payer Master File Parent topic: Recurring UB BillingSetting Up UB Claim Forms
Help Guide for NextGen® Enterprise PM 8
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 RecurringSet Up the Payer Master File for Recurring UB Billing
Help Guide for NextGen® Enterprise PM 8
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 BillingSet Up Revenue Codes for SIMs
Help Guide for NextGen® Enterprise PM 8
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 FOverride Practice Preferences with the Payer Master File
Help Guide for NextGen® Enterprise PM 8
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