Generating and Submitting Claims

Help Guide for NextGen® Enterprise PM 8

Claim Printing Options

Claim Printing options enable you to control what information prints in each box of a paper claim. Claim Print Options in Common Rules Tab This section contains the claim prints options in common rules tab. Claim Print Options When the Payer is Primary This section contains the claim prints options when the payer is primary. Claim Print Options When the Payer is Secondary This section contains the claim print options when the payer is secondary. Claim Print Options When the Payer is Tertiary This section contains the claim prints options when the payer is tertiary. Parent topic: Claims

Help Guide for NextGen® Enterprise PM 8

Search for Claim Requests

The Claim Request Lookup window enables you to search through the system for claims that match the search criteria. In NextGen® Enterprise PM, select Tasks > Lookup > Claims or select the Claims icon. The Claim Request Lookup window opens. To search for claims by request status, media type, claim type, or rendering physician, use the General tab. To search for claims by supervising physician, claim number, or acknowledgment status, select the Advanced tab. Select Find. The search results appear in the Claim Requests list. Double-click the claim in the Claim Requests list to access a claim request. Note: There is a green check mark in the Consolidated Service Claims (CSC) column for all the CSC candidate claims. CSC cannot be deleted. General Search Criteria You can search a claim by its status, media type, claim type, or rendering physician through the General tab of the Claim Request Lookup window. Advanced Search Criteria Parent topic: Generating and Submitting Claims

Help Guide for NextGen® Enterprise PM 8

Open the Waystar Website from Claims Lookup

When you select the Waystar option in the External tab of the Practice Preference window, it will be available in the claims context menu. Open NextGen® Enterprise PM. Select Claims Lookup. The Claim Request Lookup window opens. In the Claim Requests section, right-click on a claim, and then select Waystar. The Waystar option is available only for electronic claims. If the claim form type is 1500 for the selected claim, the professional claims search page of the Waystar® Clearinghouse opens. If the claim form type is UB for the selected claim, the institutional claims page of the Waystar® Clearinghouse opens. Parent topic: Generating and Submitting Claims

Help Guide for NextGen® Enterprise PM 8

Preview and Print Paper Claims

The Claim Printing window enables you to bulk preview and print the paper claim forms. In NextGen® Enterprise PM, select File > Print Forms > Claims. The Claim Printing window opens. Select the preferred Print Format. Select the type of Form. Do one of the following: Select Preview to view the claim forms. Select OK to print the claim forms. Parent topic: Generating and Submitting Claims

Help Guide for NextGen® Enterprise PM 8

Generate Paper Claims

When UB claims are previewed or printed, a claim status header displays at the top of the claim. The claim header indicates the status of the claim, either pending or archived, and for claims that are archived the date they were processed also prints in the header. The claim status header only displays on claims that have already been processed (archived) or when a copy (not for submission) is previewed or printed. The Claim Maintenance window allows you to customize the claim header, insurance information, and additional claim details. Select on the following tabs to populate the fields that you want to display on a claim: View Claim Claim Header Insurance On the tool bar, select the Claims icon . The Claim Request Lookup window opens. To search for the claim request, enter the applicable search criteria. To view the claim, highlight the claim request row and double-click. The Claim Maintenance window opens with a preview of the populated claim form. On the Claim Maintenance tool bar,

Help Guide for NextGen® Enterprise PM 8

Claims

A claim is a request by the insurance holder to their insurance company for payment towards services rendered in a practice for the patient. Setting Up Claims You must configure valid claims to meet regulatory and commercial insurance requirements. Transaction Flow Claims Processing Generating and Submitting Claims UB Claims Consolidated Service Claims Claim Status Claim Status shows you the status of claim requests submitted in batch mode or real time for electronic claims that are archived. Parent topic: Billing, Statements, Claims, and ERA

Generating and Submitting Claims

Recommendations

Claim Printing Options

Search for Claim Requests

Open the Waystar Website from Claims Lookup

Preview and Print Paper Claims

Generate Paper Claims

Claims

Claim Printing Options

Search for Claim Requests

Open the Waystar Website from Claims Lookup

Preview and Print Paper Claims

Generate Paper Claims

Claims