NextGen Knowledge Center

Run Claim Edits after Entering Charges

You must run claim edits on charges immediately after you enter charges. The edits identify errors that may need to be corrected before the encounter goes through the billing process to create a claim for the payer.

  1. Open the Patient Chart for the desired patient.
  2. On the Encounters tab, select the encounter to run the claim edits.
  3. From the main toolbar, select Edits and do one of the following:
    • You can run edits from the Appointment Book using Edits on the appointment toolbar.
    • You can run edits from an open claim.
    • You can add edits to the autoflow process.
    When the claim edits run successfully, the Claim Production Status window opens displaying the following:
    • Build, Critical, Custom, Required, Error, Warning, and Informational labels under the Severity column.
    • Errors for encounters appearing in red that result in bad claims and prevent reimbursement.
    • Warnings for encounters appearing in blue do not prevent a clean claim, but might be contractual, and should be addressed.
    • Informational messages for encounters appearing in green and it requires no action.