Process Claim Requests for Multiple Encounters

Print Format	Description
Actual Claim Form	Select this format to generate the claim form that you want to submit to the payer.
Claim Copy - Not for Submission	Select this format to generate a copy or spare claim form that you do not intend to submit to a payer.

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

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. S

Help Guide for NextGen® Enterprise PM 8

Resubmit Claim Status Request from Encounter Claim Request

Before you begin Submit a claim request for an encounter. The Encounter Claim Request window enables you to resubmit a claim status request. In NextGen® Enterprise PM, do one of the following to open the Encounter Lookup window. On the main toolbar, select Encounter. From the Tasks menu, select Lookup > Encounters. The Encounter Lookup window opens. Enter the search criteria to find the desired encounter and select Find. The Encounter List section displays the encounters matching the search criteria. Double-click the desired encounter. The Patient Chart opens displaying the encounter details on the Encounter tab. Do one of the following. In the Encounters list, right-click the desired encounter and select Claims. Select Claims on the taskbar. On the Tasks menu, select Lookup > Claims. The Encounter Claims Request window opens displaying the claim request for the selected encounter. Right-click the claim request and select Claim Status Request. A message appears stating that the applica

Help Guide for NextGen® Enterprise PM 8

Open Claim Status Report from Encounter Lookup

Before you begin Submit a claim request for the encounter. In NextGen® Enterprise PM, do one of the following to open the Encounter Lookup window: On the main toolbar, select Encounter. From the Tasks menu, select Lookup > Encounters. The Encounter Lookup window opens. Enter the search criteria to find the desired encounter and select Find. The Encounter List section displays the encounters matching the search criteria. Right-click the desired encounter and select Claims. Note: Alternatively, you can open the Encounter Claims Request window using one of the following methods. From the Patient Chart, on the Encounters tab, in the Encounters list, right-select the desired encounter and select Claims. Select Claims on the taskbar. From the Tasks menu, select Lookup > Claims The Encounter Claims Request window opens displaying the claim requests for the selected encounter. Right-click the desired claim request and select View Claim Status. The Claim Status report opens displaying the follo

Help Guide for NextGen® Enterprise PM 8

Search for Claim Requests

The Claim Request Lookup window enables you to search through the system for claims that match the search criteria. In NextGen® Enterprise PM, select Tasks > Lookup > Claims or select the Claims icon. The Claim Request Lookup window opens. To search for claims by request status, media type, claim type, or rendering physician, use the General tab. To search for claims by supervising physician, claim number, or acknowledgment status, select the Advanced tab. Select Find. The search results appear in the Claim Requests list. Double-click the claim in the Claim Requests list to access a claim request. Note: There is a green check mark in the Consolidated Service Claims (CSC) column for all the CSC candidate claims. CSC cannot be deleted. General Search Criteria You can search a claim by its status, media type, claim type, or rendering physician through the General tab of the Claim Request Lookup window. Advanced Search Criteria Parent topic: Generating and Submitting Claims

Help Guide for NextGen® Enterprise PM 8

Print or Export an Account Statement from Account Lookup

Open NextGen® Enterprise PM. Select Account. The Account Lookup window opens. Select the desired account in the Search Criteria section. Select Find. In the Account List section, right-click on the account, and then select Print > Statements. The Guarantor Statement window opens. The default settings on the Guarantor Statement > General tab are pre-defined settings in Practice Preferences > Statements. Review the default Statement Options settings and make modifications, if needed. Note: The Enterprise, Practice, Location and Provider filter tabs are not available when printing an individual demand account statement. Do one of the following: To print the statement, select Print. To create an ASCII export file and to be sent to a third-party vendor for processing (printing and mailing), select Export. If the Update Last Statement Dates check box is selected, a message appears asking if the statements printed or exported correctly. Do one of the following: If the statement prints or expo

Process Claim Requests for Multiple Encounters

Recommendations

Set Up Claim Print Options

Process a Claim for a Single Encounter

Resubmit Claim Status Request from Encounter Claim Request

Open Claim Status Report from Encounter Lookup

Search for Claim Requests

Print or Export an Account Statement from Account Lookup

Set Up Claim Print Options

Process a Claim for a Single Encounter

Resubmit Claim Status Request from Encounter Claim Request

Open Claim Status Report from Encounter Lookup

Search for Claim Requests

Print or Export an Account Statement from Account Lookup