Select a Default Claim Modifiers Library

Help Guide for NextGen® Enterprise PM 8

Hide a Claim Modifier

You can hide a claim modifier, if needed. A hidden modifier is no longer applied to claims in NextGen® Enterprise PM, even if the modifier is still in effect and not expired. For example, a charge meets all criteria defined for a hidden modifier, and the date of service on the charge falls within the modifier's effective date range. When the encounter is billed, the modifier change is not applied to the claim for the charge because the modifier is hidden. Access File Maintenance. Select Libraries, and then Claim Modifiers. The Claims Modifiers List window opens. Select a library from the list, and then select the open menu button . Select Open. The Claim Modifiers Library Maintenance window opens. From the Claim Modifiers list, select a modifier to hide and then do one of the following: Select Open Menu and then select Hide. Right-click and then select Hide. Double-click to open the modifier, then select the Hide check box, and then select OK. A prompt appears asking you to confirm hid

File Maintenance Help for NextGen® Enterprise 8

Select a Default Claim Modifiers Library

A Claim Modifiers library can be selected at the practice-level to be used for all payers, or at the payer-level to be used for specific payers only. A payer-level library overrides the default practice-level library for that payer. To select a default library for a practice, do the following: Access NextGen® Enterprise PM. From the Admin menu, select Preferences, and then Practice. The Practice Preferences window opens. In the Preferences List, select Libraries. In the Claim Modifiers Library field, select the default library to be used for the practice. To save changes and close the window, select OK. To select a default library for a payer, Access File Maintenance Select System Master Files, then PM, and then Payers. The Payer List window opens. From the list, double-click to open a payer. The Modify Payer Information window opens. Select the Practice tab, and then the Libraries sub-tab. In the Modifiers Library field, select the Claim Modifiers library to be used for the payer. To

Help Guide for NextGen® Enterprise PM 8

Claim Modifiers Library

The Claim Modifiers library can be used by practices when the modifier usage differs from payer to payer. During charge posting, add units to a charge when a specific modifier is entered on the charge for specific SIM types. During the billing process, add a modifier to the claim if the modifier was not entered on the charge. During the billing process, remove a modifier from the claim if the modifier was entered on the charge. Note: For a claim modifier to be applied, the charge service date must fall within the effective date and expiration date defined for the modifier, and the charge must meet all Modifier Change for Claims criteria defined for the modifier. The practice-level default Claim Modifiers library selected in Practice Preferences > Libraries is used for all payers. A payer-level library selected in the Libraries sub-tab under the Practice tab in the Payers master file overrides the practice-level library for that payer. You can generate Claim Modifiers report from the Cl

Help Guide for NextGen® Enterprise PM 8

Select a Default Library for a Payer

A library selected at the payer-level overrides the default library selected at the practice-level. Access File Maintenance. Select System Master Files, then PM, and then Payers. The Payer List window opens. Double-click to open the desired payer. The Modify Payer Information window opens. Select the Practice tab, and then the Libraries sub-tab. Modify Payer Information window; Practice tab; Libraries sub-tab In the Behavioral Health Billing Library field, select the library to be used for the payer. In the Modifiers Library field, select the library to be used for the payer. In the Claim Edit Library field, select the library to be used for the payer. To save changes and close the window, select OK. Parent topic: Default Library Selection

Help Guide for NextGen® Enterprise PM 8

Select a Default Library for a Practice

A default library selected at the practice-level is used for all payers in the practice. Access NextGen® Enterprise PM. From the Admin menu, select Preferences, and then Practice. The Practice Preferences window opens. In the Preference List on the left, select Libraries. Practice Preferences window > Libraries tab In the Behavioral Health Billing Library field, select the default library to be used for the practice. In the Non-Coordinated SIM Library field, select the default library to be used for the practice. Note: To utilize the Non-Coordinated SIM functionality, a library must be selected for the practice. In the Claim Modifiers Library field, select the default library to be used for the practice. In the Claim Edits Library field, select the default library to be used for the practice. To save changes and close the window, select OK. Parent topic: Default Library Selection

Help Guide for NextGen® Enterprise PM 8

Libraries tab on the Practice tab

You can override the default Claim Edits Library selected on the Practice Preferences Libraries window in the Payers file. In File Maintenance, access the Payers master file. On the Payers List window, double-click the applicable payer. Select Practice and then Libraries. In the Claim Edits Library field, select the applicable library. Select OK. Parent topic: Assign a Default Claim Edits Library

Select a Default Claim Modifiers Library

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Hide a Claim Modifier

Select a Default Claim Modifiers Library

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Libraries tab on the Practice tab

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Select a Default Library for a Practice

Libraries tab on the Practice tab