Override Practice Preferences with the Payer Master File

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 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

Help Guide for NextGen® Enterprise PM 8

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 Parent topic: Recurring UB Billing

Help Guide for NextGen® Enterprise PM 8

Set Up Payers for Enhanced UB Users

In File Maintenance, select Master Files - System > Payers. Right-click the applicable payer and then select Open. The Modify Payer Information window appears. Select the Practice tab and then the UB tab. Modify Payer Information In the Location field, select the practice location, if applicable. This enables all the fields and check boxes on the tab. The location that you select must be the same as the location that is selected on the Create Encounter or Encounter Maintenance window. Enter the applicable information in the Field Locator fields and enable the check boxes to display the information on the UB claim. The following conditions must be met for Enhanced UB users that want to use the automated UB billing process: Field Locator 51 must be populated. The Type of Facility field must be equal to 7 (Clinic). The Bill Classification field must be equal to 4 (Outpatient Rehab Facility). The Bill Frequency field must be blank. Select OK. Parent topic: Setting Up UB Claims for Enhanced

Help Guide for NextGen® Enterprise PM 8

UB/General Tab

All the fields on the UB > General sub-tab can be automatically populated. The information on this tab can be overridden, but it is not recommended, especially if you are an Enhanced UB user and you want to use the automated UB claims process. Regular UB users should not use the fields on this window, except to change the Source of Admission field. Regular UB users should continue to use the Billing & Collections tab on the Encounter Maintenance window to review or change the values that display on the UB claim form. Encounter Maintenance Field Description Type of Bill This field is divided into three positions. The values for each position are described separately. First Position After the UB claim is billed, this position is populated automatically with the value that is in the Type of Facility field located on Modify Payer Information > Practice > UB sub-tab. If this field does not contain a value, this position is populated from the Type of Facility field in Practice Preferences >

Override Practice Preferences with the Payer Master File

Recommendations

Set Up the Payer Master File for Recurring UB Billing

Set Up Practice Preferences for Recurring UB Billing

Set Up Revenue Codes

File Maintenance Settings Required for Recurring UB Billing

Set Up Payers for Enhanced UB Users

UB/General Tab

Set Up the Payer Master File for Recurring UB Billing

Set Up Practice Preferences for Recurring UB Billing

Set Up Revenue Codes

File Maintenance Settings Required for Recurring UB Billing

Set Up Payers for Enhanced UB Users

UB/General Tab