Groups Master File

Help Guide for NextGen® Enterprise PM 8

Providers Master File

In the Provider master file, you can: Set up supervisor billing. Set up a facility to bill as a nonperson. Attach taxonomy codes. Supervisor Billing Facility Billing as a Non-Person CLIA Numbers Parent topic: Setting Up Claims

Help Guide for NextGen® Enterprise PM 8

Set Up the Groups Master File

Set up the Groups master file if a group needs to have specific information printed in box 33 of the HCFA 1500. The group must be selected in the Provider master file to be used. For more information on how the group works with the Provider master file to be displayed in the HCFA 1500, refer to Providers. Access the list of Practice master files. In the Master Files field, select Groups. The Groups List window opens. Select the open menu button, and then select New. The Group Information window opens. Enter information in the Group Information window as applicable. Select OK. Fields in the Group Information Window The following table describes the fields available in the Group Information window: Set Up a Default Location for Group Provider Numbers Add Multiple Default Rows for Billing Group You can add multiple default rows for a location and default payer of the billing group. Tax ID Number for Billing Group You can enter multiple tax IDs for a location and default or non-default pay

File Maintenance Help for NextGen® Enterprise 8

Attach Formats to a Payer

From the Master Files - System list, select Payers, and then double-click the appropriate payer. The Modify Payer Information window opens. Select the Payer Defaults - 2 tab. Select the Require Policy Number check box if you want to require a policy number. Select the drop-down arrow in the Policy Number Format field and select one from the list if you want to use a specific format for the policy number. Select the Require Group Number check box if you want to require a group number. Select the drop-down arrow in the Group Number Format field and select one from the list if you want to use a specific format for the group number. Note: The Group Number field on the Insurance Maintenance window has a maximum field length of 19 characters. The Format Name for any format that exceeds this limit does not display in the Group Number Format list. Select OK. Note: You can require a policy number and a group number with or without using a format. You can also enter a format with or without requ

Help Guide for NextGen® Enterprise PM 8

Set Up Medicare and Medicaid Claim Types

These options enable you to run claims processing for Medicare and Medicaid claim types without receiving edits due to the format requirements of these claim types. In File Maintenance, access the Payers Master file. Select Payers. From the Payers List File Maintenance window, double-click the appropriate payer. Select the System tab and then the Claims sub-tab. Set up medicare claim or medicaid claim. Set Up Medicare Claims Set Up Medicaid Claims Parent topic: Claims Sub-Tab

File Maintenance Help for NextGen® Enterprise 8

Set Up Medicare and Medicaid Claim Types

These options enable you to run claims processing for Medicare and Medicaid claim types without receiving edits due to the format requirements of these claim types. In File Maintenance, access the Payers Master file. Select Payers. From the Payers List File Maintenance window, double-click the appropriate payer. Select the System tab and then the Claims sub-tab. Set up medicare claim or medicaid claim. Set Up Medicare Claims Set Up Medicaid Claims Parent topic: Claims Sub-Tab

File Maintenance Help for NextGen® Enterprise 8

Formats

You define specific formats used for payers with the Formats master file. This master file defines specific formats of character types that can be entered for group and policy numbers on patient records. Only entries that correspond to the specified format are acceptable or valid for the Group and Policy Numbers fields. You can attach a format to a payer and also require policy and group numbers on the Insurance Maintenance window in NextGen® Enterprise PM. When a group or policy number format is selected on the Payer Defaults - 2 tab, only character types defined in that format from the Formats List can be entered in the Health Insurance Claim (HIC)/Policy Number and Group Number fields for that payer on the Insurance Maintenance window. Access the Formats Master File Add or Modify Format Sets Delete Formats Attach Formats to a Payer Parent topic: Master Files - System

Groups Master File

Recommendations

Providers Master File

Set Up the Groups Master File

Attach Formats to a Payer

Set Up Medicare and Medicaid Claim Types

Set Up Medicare and Medicaid Claim Types

Formats

Providers Master File

Set Up the Groups Master File

Attach Formats to a Payer

Set Up Medicare and Medicaid Claim Types

Set Up Medicare and Medicaid Claim Types

Formats