Search for 837 Electronic Claims

Field	Description
Payer	Select a payer to narrow the search for pending claims. When a specific payer is selected, the search returns pending claims based on the submitter profile and claim form criteria, as well as the specific payer that was selected. This search field is beneficial if you want to create an 837 file for a single payer, but the submitter profile has been attached to more than one payer.
Last	Enter the first few characters or the last name of the patient to narrow the search for pending claims.
First	Enter the first few characters or the first name of the patient to narrow the search for pending claims.
Rendering	Select a rendering physician to narrow the search for pending claims. When a specific rendering physician is selected, the search returns pending claims based on the submitter profile and claim form criteria, as well as the specific rendering physician that was selected. Select the flashlight to display the Provider Lookup window. Then search for the rendering providers to include in the query.
Report Transmission Code	Select the methods for transferring pending or archived claim data: AA - Available on Request from Provider BM - By Mail EL - Electronic Only EM - Email FT - File Transfer Fx - By Fax Note: The RTC column in the Pending Electronic Claims list displays the data transfer methods. For example: EL, Fax, FT.
Primary	Enable this check box to search for primary claims.
Secondary	Enable this check box to search for secondary claims.
Tertiary	Enable this check box to search for tertiary claims.
ERA Posted Charges Only	Enable this check box to search for only ERA posted charges.
Financial Class	Select the financial class or classes to include in the query. Blue Cross Capitation Commercial HMO Medicare Medicaid PPO Workers Comp
Location	Select the locations to include in the query.

Help Guide for NextGen® Enterprise PM 8

Create an EDI File by Payer, Patient Name, Rendering Physician, Financial Class, or Location

Click the EDI File toolbar button. The 837 Electronic File Creation window opens. Complete the following required fields: Submitter Profile Library Claim Form Send File Name Batch Type Click the Advanced tab. To refine your search by payer, patient name, provider, financial class, or location, complete any of the following fields: Payer Last/First Name of the patient Rendering- select or search for the rendering provider Report Transmission Code Financial Class Location To search for claims by the primary, secondary, tertiary payer, or for ERA Posted Charges, enable the following check boxes: Primary Secondary Tertiary ERA Posted Charges Only Enable any of the following check boxes to update claims, automatically create a report, or send a test file: Update claim requests as processed Report results - to display the report after it is processed. Use test code in REF02 trans type segment Click Find. In the Pending Electronic Claims section select the claims to include in the EDI file. C

Help Guide for NextGen® Enterprise PM 8

Create an 837 Electronic File

Use the General tab to search for claims by form type, claim type, CPT4 codes, and by date. To access this window, select the EDI File toolbar button. The 837 Electronic File Creation window opens. On the General tab use the following table to identify your search criteria. Field Description Submitter Profile Library (required) Select the applicable submitter profile library. Pending claims that were created with this submitter profile attached to the payer will be returned in the search. The 837 electronic files are created based on submitter profiles because the settings in the submitter profile are specific to the payer, which maintains HIPAA compliancy. Claim Form (required) Select one of the following claim forms: 1500 ADA (Dental) UB. You can only include one claim form type in an 837 electronic file. This corresponds to the submitter profile option, Number of functional groups per file. Claim Type Select the claim type to narrow the search for pending claims based on the claim t

Help Guide for NextGen® Enterprise PM 8

837 Electronic File Creation - File Options and Pending Electronic Claims

The File Options and Pending Electronic Claims section of this window display on the General, Advanced, and Practices tab. File Options - you can identify the electronic file name, the batch type, create a report, create a test file, and update claim requests as they are processed. Pending Electronic Claims - This section displays the claims that match the search results entered on the General, Advanced, or Practices tab. You can select the claims to include in the electronic file. File Options Section This section of the window includes fields for identifying the file name and batch type. Also, you can run a report, update claim requests as processed, or create a test file. Use the following table to enter data in the fields in this section of the window. Menu Item Description Send Filename (required) To name the EDI file and the path to save the file, select the open folder icon . Browse to the desired location and then name the file. Batch Type (required Select the batch type. Prod

Help Guide for NextGen® Enterprise PM 8

Create an EDI File by Practice

Select the EDI File toolbar button. The 837 Electronic File Creation window opens. Complete the following required fields: Submitter Profile Library Claim Form Send File Name Batch Type Select the Practices tab. You can search for claims by a single practice, multiple practices, or all practices within your enterprise. To search for claims by single or multiple practices go to Step 5. To search for claims for All Practices in your enterprise go to Step 7. To search for pending claims associated with a single or multiple practices, select the open record icon. The Practices window opens. Select the Flashlight icon to search for practices. Move the applicable practices to the Included section. Select OK. To search for pending claims across all practices, enable the All Practices check box. Enable any of the following check boxes to update claims, create a report, or send a test file. Update claim requests as processed Report results - to display the report after it is processed. Use test

Help Guide for NextGen® Enterprise PM 8

Search for 837 Electronic Claims

Use the Advanced tab to create a search query for encounters by payer, patient name, rendering provider, financial class, report transmission code, ERA posted charges only, or location. The query you create, will return a list of pending electronic claims that match the search criteria. Select the EDI File button on the tool bar. The 837 Electronic File Creation window opens. Use the following table to enter search criteria on the Advanced tab: Field Description Payer Select a payer to narrow the search for pending claims. When a specific payer is selected, the search returns pending claims based on the submitter profile and claim form criteria, as well as the specific payer that was selected. This search field is beneficial if you want to create an 837 file for a single payer, but the submitter profile has been attached to more than one payer. Last Enter the first few characters or the last name of the patient to narrow the search for pending claims. First Enter the first few characte

Help Guide for NextGen® Enterprise PM 8

837 Electronic File Creation Window

Use the 837 Electronic File Creation window to identify search criteria for claims that you want to send in an electronic file. This window has the following tabs: General, Advanced, and Practices. Each tab contains the File Options and Electronic Claims sections. File Options and Pending Electronic Claims Sections These sections display on each of the tabs for the 837 Electronic File Creation window. File Options - you can select the file for data transfer, identify the batch type, create a report, update claim requests, and send a test file. Pending Electronic Claims - displays the claims that match the search criteria on the active tab. General, Advanced, Practices, File Options, and Pending Electronic Claims Refer to the following topics for information about the fields on this window: 837 Electronic File Creation - General Tab 837 Electronic File Creation - Advanced Tab 837 Electronic File Creation Window Practices Tab 837 Electronic File Creation - File Options and Pending Electr

Search for 837 Electronic Claims

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Search for 837 Electronic Claims

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837 Electronic File Creation - File Options and Pending Electronic Claims

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837 Electronic File Creation Window