Process Charges that Require Test Results for Claims

Help Guide for NextGen® Enterprise PM 8

Process Charges that Require Test Results for Claims

SIM codes for specific tests, such as Creatinine, Hemoglobin and Hematocrit, can be set up to require a test qualifier, test date and test result for claims. This information is sent in an MEA test result segment on electronic 837P (1500) claims. You can identify SIM codes that require test results for claims before processing pending charges by running the EHR Manual Charge Processing Pending report. Include the column Test Result Required on the report. The EHR Manual Charge Processing History report can also be used after charges are processed, by including the same column. While processing the pending charges, if SIM codes are missing that is required test result information needed for claims, the system alerts the user. Note: For more information on setting up the SIM codes, go to NextGen Healthcare Success Community and download the latest Billing and Collections User Guide for NextGen® Enterprise PM, and then refer to the Charge Test Results on Electronic Claims section. Process

Help Guide for NextGen® Enterprise PM 8

Process Pending Charges

Open NextGen® Enterprise PM. From the File menu, select Processes, and then select Pending Charges. The Process Pending Charges window opens. Enter the appropriate Search Criteria to locate the desired pending charges, and then select Find. Charges matching with the entered search criteria appear in the Pending Charge List section. All charges are pre-selected in the column on the left. Note: Charges that require test results for claims are identified with a Y (Yes) in the TR Req (Test Results Required) column. Clear the charges that should not be processed, if needed. To accept the selected charges, select Process. A confirmation message appears to process the charges. Select OK. A message appears stating that one or more charges are flagged to create test results for MEA segment. You can open the charges from Charge Entry window and select the Test Results icon to open the Test Result window and enter these results. Select OK. Open the Charge Posting window for the desired patient an

Help Guide for NextGen® Enterprise PM 8

Process Charges from Charge Posting Window

Open NextGen® Enterprise PM. Select Charges. The Charge Posting window opens. Select the desired patient and encounter with pending charges. A message appears confirming to process the pre-loaded charges. Select Process to accept the charges. A window appears stating that one or more charges are flagged to create test results for MEA segment. You can open the charges and select the Test Results icon to fill these results. Select OK. Select a charge that requires test results, and then select the Test Results button on the charge toolbar. The Test Data for this Charge window opens. Enter the Qualifier, Test Date, and Test Results required for the claim. To save changes and close the window, select OK. Parent topic: Process Charges that Require Test Results for Claims

Help Guide for NextGen® Enterprise PM 8

Charge Test Results on Electronic Claims

Some payers require the test result details to be included on electronic 837P (1500) claims for reimbursement on specific tests, such as Creatinine, Hemoglobin and Hematocrit. The information required includes a qualifier that identifies the test, the test date, and the test result. An electronic 837P claim can create up to five separate MEA test result segments for results that you can enter manually from the Charge Posting window in NextGen® Enterprise PM or receive it through an interface. The MEA test results are included in the 2400 DTP*738 segment in the 837P electronic claim file. Note: You can use this functionality for electronic 837P (1500) claims. It does not apply to electronic 837I (UB) or 837D (ADA) claims. Setting up Charge Test Results You can set up charge test results on electronic claims for reimbursement. Enter Test Results for a Charge You can enter test results for a charge on the Charge Posting window. Significant Events for Charge Test Results You can enable sig

Help Guide for NextGen® Enterprise PM 8

Charge Test Results on Electronic Claims

Some payers require the test result details to be included on electronic 837P (1500) claims for reimbursement on specific tests, such as Creatinine, Hemoglobin and Hematocrit. The information required includes a qualifier that identifies the test, the test date, and the test result. An electronic 837P claim can create up to five separate MEA test result segments for results that you can enter manually from the Charge Posting window in NextGen® Enterprise PM or receive it through an interface. The MEA test results are included in the 2400 DTP*738 segment in the 837P electronic claim file. Note: You can use this functionality for electronic 837P (1500) claims. It does not apply to electronic 837I (UB) or 837D (ADA) claims. Setting up Charge Test Results You can set up charge test results on electronic claims for reimbursement. Enter Test Results for a Charge You can enter test results for a charge on the Charge Posting window. Significant Events for Charge Test Results You can enable sig

Help Guide for NextGen® Enterprise PM 8

Process Pending Charges

Open NextGen® Enterprise PM. From the File menu, select Processes, and then select Pending Charges. The Process Pending Charges window opens. Enter the appropriate Search Criteria to locate the desired pending charges, and then select Find. Charges matching with the entered search criteria appear in the Pending Charge List section. All charges are pre-selected in the column on the left. Note: Charges that require test results for claims are identified with a Y (Yes) in the TR Req (Test Results Required) column. Clear the charges that should not be processed, if needed. To accept the selected charges, select Process. A confirmation message appears to process the charges. Select OK. A message appears stating that one or more charges are flagged to create test results for MEA segment. You can open the charges from Charge Entry window and select the Test Results icon to open the Test Result window and enter these results. Select OK. Open the Charge Posting window for the desired patient an

Process Charges that Require Test Results for Claims

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