Lock Box Posting

Help Guide for NextGen® Enterprise PM 8

Reading the ERA Import Posting Report

After you have completed the ERA Posting process, the ERA Import Posting report generates. Overall, the report is a complete audit of the ERA 835 file and is grouped by unsuccessful and successful entries. NextGen® Enterprise PM does not, however, report provider level adjustments. The report is sorted by practice with the ERA payments that did not post successfully listed first, followed by all the ERA payments that posted successfully. An ERA message displays in the Description column of the report next to each line item as an indicator for why the ERA claim payment did or did not post against the encounter information. Each of these messages applies to ANSI file formats. The transaction level Reason Codes that are distributed to service lines display on the report, along with their descriptions. Note: The ERA Import Posting report detects and rejects an ERA transaction with a denial reason code and total transaction amount that is not $0.00. Resolving Encounter-Related ERA Errors On

Help Guide for NextGen® Enterprise PM 8

Posting an Electronic Remittance

This section provides information about the process of posting an electronic remittance. When posting the ERA, the system compares the ERA payment information for each claim in the file against the encounter information in your system that the claim was originally created for. In order for the ERA payments for each claim to post successfully, the ERA payment information for a claim must match the encounter information the ERA is posting against. If there is a discrepancy between the ERA information and the encounter information, the ERA payment for that claim does not post and an error message displays on the ERA Import Posting report. In addition, if an ERA payment is posting against multiple line items in an encounter, all the line items must be error-free for the ERA payment to post successfully. The ERA process only calculates and posts adjustments for encounter primary and secondary payers. If the primary ERA pays a charge off, it is settled to the secondary and is included on the

Help Guide for NextGen® Enterprise PM 8

Posting Transactions

In NextGen® Enterprise PM, a payment is considered posted only if has gone through the posting process. You can add or modify payments for an encounter only until it is posted. The posting process is a way of telling the application that everything has been done correctly and is ready to be committed to the system. Payment posting could be manual in paper format as Explanation of Benefits (EOB) or electronically as Electronic Remittance Advice (ERA). In NextGen® Enterprise PM, there are two sources for transactions, patients or payers. Payments may come from primary, secondary or tertiary payers. Transaction Posting Process You can create a batch to enter relevant information for payments and posting the payments. Viewing Transaction Dates You can view different dates associated with all transactions in the Batch Maintenance window. Recording Transactions to a Batch You can create a transaction batch header to enter payments or transactions. Posting Encounter and Account Level Payments

Help Guide for NextGen® Enterprise PM 8

Electronic Remittance Advice

Electronic Remittance Advice (ERA) 835 files can be imported from the File > Processes > ERA Posting menu. This process compares transactions in the ERA 835 file for each claim against the charge information in NextGen® Enterprise PM. When ERA transactions match to charges, a transaction batch is automatically created, and the ERA transactions are added to the batch ledger. Transactions in the ERA file that do not match to charges, or do not post for other reasons, display on the ERA Import Posting report as “Not Posted” and are not added to the transaction batch. The ERA Posting process is designed to increase efficiency. Once the original set up for the process is complete, there is minimal effort required to set up additional payers. It is estimated to take about 15 minutes to post an electronic ERA 835 file for a 30-page Explanation of Benefits (EOB) electronically, compared to approximately two hours to post the same 30-page EOB manually. ERA Automatic Adjustments and Library Sett

Help Guide for NextGen® Enterprise PM 8

Start the ERA Posting Process

The Electronic Remittance Advice (ERA) Posting process is not automatic. You must start it from the Import Remittance window. Note: The ERA Import function uses the CLP02 element to determine which COB to use if both primary and secondary payers have the same ERA Payer Number. The Default for Contract <> Payment Allowed Amount and Default for Contract <> ERA Payment Amount options are applicable only for the primary payer (CLP02=1). Note: You must create and assign an automated Encounter task in Task Types master file in File Maintenance along with the custom user-defined reason code to track the discrepancy in ERA payment amount and contractual reimbursed amount when 835/ERA file is posted in NextGen® Enterprise PM. For more information about creating and assigning the automated task, go to NextGen Healthcare Success Community and download the latest File Maintenance Master Files Guide for NextGen® Enterprise From the File menu, select Processes, and then ERA Posting. The Import Remit

Help Guide for NextGen® Enterprise PM 8

Patient Pay Practice Preferences

The Patient Pay Practice Preferences provides options related to patient payments that are processed electronically in NextGen® Enterprise PM, similar to an ERA 835 file. The electronic file comes from a bank instead of a payer. A practice would set this up with their financial institution. Patients that owe balances would send their payments to the bank instead of sending it to the practice. The bank would then deposit the money into the practice's account and send the practice a file that can be imported into NextGen® Enterprise PM, just as an ERA file is imported. A transaction batch is automatically created when the file is imported, and a report is generated similar to the ERA Import Posting report. Patient Pay Practice Preferences Descriptions Patient Pay Practice Preferences enable you to set your preferences related to patient payments that are processed electronically in NextGen® Enterprise PM. Parent topic: Setting Up Practice Preferences for ERA

Lock Box Posting

Recommendations

Reading the ERA Import Posting Report

Posting an Electronic Remittance

Posting Transactions

Electronic Remittance Advice

Start the ERA Posting Process

Patient Pay Practice Preferences

Reading the ERA Import Posting Report

Posting an Electronic Remittance

Posting Transactions

Electronic Remittance Advice

Start the ERA Posting Process

Patient Pay Practice Preferences