Process a Claim for a Single Encounter

Help Guide for NextGen® Enterprise PM 8

Process a Claim for a Single Encounter

Open the patient chart and select the Encounters tab. To process a claim, right-click the applicable encounter and then click Claims. The Encounter Claim Requests window opens. You can generate a claim print for a claim request having electronic media type by right selecting the claim request and disabling the Electronic claim option. Note: The alternate payer name appears in the Payer-Insured column for a carve-out claim. Right-click a claim request and then select Print. The Claim Printing window opens. In the Print Format list, do one of the following: Select Actual Claim Form to generate the claim form that you want to submit to the payer. Select Claim Copy - Not for Submission to generate a copy or spare claim form that you do not intend to submit to a payer. Select Preview to preview the claims. Select the Update 'Pending' to 'Archived' status on paper claim check box to automatically archive the claims after claim printing. Select Options to configure the claim print settings. F

Help Guide for NextGen® Enterprise PM 8

Process Claim Requests for Multiple Encounters

To process claim requests for more than one encounter, use the Claim Request Lookup feature to locate claim requests that are in a Pending status. You can set the search criteria for the lookup to narrow your search to specific types of claim requests. Select Claim Lookup on the NextGen® Enterprise PM main menu. The Claim Request Lookup window appears. Select Pending in the Request Status field. Enter the additional search criteria that you want to use to locate the claim requests. Select Find. The Claim Request Lookup lists the claim requests that match your criteria in the Claim Requests section of the window. Place an x in the check boxes next to the claim requests that you want to process. To select all the claim requests in the list, place an x in the top check box on the column heading bar. Right-click on one of the claim requests that you selected and choose Print > Claims option from the short-cut menu. The Claim Printing window appears. Select the Print Format that you want to

Help Guide for NextGen® Enterprise PM 8

Process Claim Requests for Multiple Encounters

To process claim requests for more than one encounter, use the Claim Request Lookup feature to locate claim requests that are in a Pending status. You can set the search criteria for the lookup to narrow your search to specific types of claim requests. Select the Claim Lookup button on the NextGen® Enterprise PM main menu. The Claim Request Lookup window appears. Select Pending in the Request Status field. Enter the additional search criteria that you want to use to locate the claim requests. Select Find. The Claim Request Lookup lists the claim requests that match your criteria in the Claim Requests section of the window. Place an x in the check boxes next to the claim requests that you want to process. To select all the claim requests in the list, place an x in the top check box on the column heading bar. Right-click on one of the claim requests that you selected and choose Print > Claims option from the short-cut menu. The Claim Printing window appears. Select the Print Format that

Help Guide for NextGen® Enterprise PM 8

Set Up Claim Print Options

If your printer is not aligning the text on the claim forms correctly, you can adjust the text alignment by changing the print settings when you process claim requests. You can customize the print offset from the top and left borders of the claim form and experiment with different settings to achieve the ideal text alignment on the forms. You can access the print offset settings by selecting the Properties button on the Claim Printing window that displays when you print claims from the Claim Request Lookup results. You can choose to print the claims you process to a file rather than to a printer by selecting the Print to file option, output format, and file name. When you select this option, you must select the Open Record button and enter a file name and destination folder for the file you want to create. Note: The application does not support electronic paper claim output as a HIPAA-compliant electronic claim solution. Only the paper claim file format required by the payer to process

Help Guide for NextGen® Enterprise PM 8

Set Up Claim Print Options

If your printer is not aligning the text on the claim forms correctly, you can adjust the text alignment by changing the print settings when you process claim requests. You can customize the print offset from the top and left borders of the claim form and experiment with different settings to achieve the ideal text alignment on the forms. You can access the print offset settings by selecting the Properties button on the Claim Printing window that displays when you print claims from the Claim Request Lookup results. You can choose to print the claims you process to a file rather than to a printer by selecting the Print to file option, output format, and file name. When you select this option, you must select the Open Record button and enter a file name and destination folder for the file you want to create. Note: The application does not support electronic paper claim output as a HIPAA-compliant electronic claim solution. Only the paper claim file format required by the payer to process

NextGen® Background Business Processor User Guide

Print Pending Paper Claims Job

To configure the settings for the job, complete the following fields: Field Description Claim Print Action Indicates whether you want to print or export the paper claims. Claim Form Indicates the claim form you want the job to use for the pending claims. This field displays one of the following: ADA 2019 ADA 2024 CMS1500 (2005) UB04 CMS 1500 (2012) UB92 Forms or forms enhanced Note: The forms or forms enhanced are available in Claim Form list only if the forms or forms enhanced are mapped to the payer in File Maintenance. Note: When you change the practice in Run as Practice, the Claim Form list is refreshed. Claim Type Indicates one or more claim types for the job from the list. Rendering Physician Indicates the rendering physician that you want to apply to the job. Financial Class Indicates one or more financial classes that you want to apply to the job. Note: The Self Pay financial class is not available. Primary Indicate whether you want the job to include primary claims or not. Se

Process a Claim for a Single Encounter

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Process a Claim for a Single Encounter

Process Claim Requests for Multiple Encounters

Process Claim Requests for Multiple Encounters

Set Up Claim Print Options

Set Up Claim Print Options

Print Pending Paper Claims Job

Process a Claim for a Single Encounter

Process a Claim for a Single Encounter

Process Claim Requests for Multiple Encounters

Process Claim Requests for Multiple Encounters

Set Up Claim Print Options

Set Up Claim Print Options

Print Pending Paper Claims Job