Set Up a UB Claim Form in the Payer Master File

Help Guide for NextGen® Enterprise PM 8

Setting Up UB Claim Forms

You can set up the claim form for UB billing in any one of the following areas of the application: The Service Items library on the General tab. The Service Items library on the Payer tab. The Payer master file on the UB sub-tab of the Practice tab. Set Up a UB Claim Form in the General tab of Service Items Library Set Up a UB Claim Form in the Payer tab of the Service Item Library Set Up a UB Claim Form in the Payer Master File Parent topic: Recurring UB Billing

Help Guide for NextGen® Enterprise PM 8

Set Up the Payer Master File for Recurring UB Billing

The Frequency of Bill field must be set up in the Payer Master file to trigger recurring UB billing. In File Maintenance, select Master Files - System > Payers. Select the applicable payer from the list, and then select the UB tab on the Practice tab. In the Modify Payer Information window, select the location in the Location field if your practice has multiple locations. When the location is entered, the remaining fields in the window display the data you have set up for the payer. Note: The location that you select must be the same location as shown on the encounter. Select the rendering providers in the Rendering Provider field. Leave the Frequency of Bill field blank or set to <none>. This field must be blank for recurring billing. Enter data in other fields, as applicable for the payer for enhanced UB billing. For setup information on enhanced UB billing, refer to Setting Up UB Claims for Enhanced UB Users. Select OK. Parent topic: File Maintenance Settings Required for Recurring

Help Guide for NextGen® Enterprise PM 8

Set Up Payers for Enhanced UB Users

In File Maintenance, select Master Files - System > Payers. Right-click the applicable payer and then select Open. The Modify Payer Information window appears. Select the Practice tab and then the UB tab. Modify Payer Information In the Location field, select the practice location, if applicable. This enables all the fields and check boxes on the tab. The location that you select must be the same as the location that is selected on the Create Encounter or Encounter Maintenance window. Enter the applicable information in the Field Locator fields and enable the check boxes to display the information on the UB claim. The following conditions must be met for Enhanced UB users that want to use the automated UB billing process: Field Locator 51 must be populated. The Type of Facility field must be equal to 7 (Clinic). The Bill Classification field must be equal to 4 (Outpatient Rehab Facility). The Bill Frequency field must be blank. Select OK. Parent topic: Setting Up UB Claims for Enhanced

Help Guide for NextGen® Enterprise PM 8

Setting Up a Payer for UB Claims

After you set up Practice Preferences, the following UB tabs display on the Modify Payer Information window of the Payers master file: On the System > Claims sub-tab, UB Claims tab displays in the Provider Secondary References section and the Provider Paper Qualifiers section. On Practice > Claims sub-tab, the UB Claims tab displays. On Practice > Secondary References sub-tab, the UB Claims tab displays. System Tab/Claims Tab/UB Claims Tab UB Claims Tab on Claims Tab UB Claims Tab on Secondary References Tab Practice tab on UB Tab Parent topic: UB Claims

Help Guide for NextGen® Enterprise PM 8

Override Practice Preferences with the Payer Master File

If you use recurring billing at a few locations, you can maintain the UB settings in Practice Preferences and override the settings in the Payer master file for the locations using recurring billing. In File Maintenance, select Master Files - System > Payers. Select the applicable payer from the list, and then select the UB tab on the Practice tab. In the Modify Payer Information window, select the location in the Location field if your practice has multiple locations. When the location is entered, the remaining fields in the window display the data you have set up for the payer. Note: The location that you select must be the same location as shown on the encounter. In the Bill Classification field, select one of the following options: 4 (Outpatient Rehab Facility) 5 (Comp Outpatient Rehab Facility) In the Type of Facility field, select 7 (Clinic). Enter data in other fields, as applicable for the payer. Select OK. Note: If the values in the Type of Facility, Bill Classification, and F

Help Guide for NextGen® Enterprise PM 8

Practice tab on UB Tab

The following conditions apply to the UB tab that appears on the Add/Modify Payer Information window and then the Practice tab: Regular UB users do not use this tab. Setup this tab for Enhanced UB users is location-specific, not practice-specific. Some of the fields on this tab are labeled Field Locator n, which identifies the corresponding field on the actual UB claim form. The following table contains the UB tab fields and their descriptions: Field Description Location The Location field displays only when the practice has multiple locations. Select a practice location. For multiple location practices, the Location field must be populated before any of the fields on the UB tab are enabled. For single location practices, the Location field does not display and all fields on the UB tab are automatically enabled. Field Locator 1 Name The Field Locator 1 Name field is a free-form text entry field. The default for this field is blank. If the field is left blank, the name that defaults to

Set Up a UB Claim Form in the Payer Master File

Recommendations

Setting Up UB Claim Forms

Set Up the Payer Master File for Recurring UB Billing

Set Up Payers for Enhanced UB Users

Setting Up a Payer for UB Claims

Override Practice Preferences with the Payer Master File

Practice tab on UB Tab

Setting Up UB Claim Forms

Set Up the Payer Master File for Recurring UB Billing

Set Up Payers for Enhanced UB Users

Setting Up a Payer for UB Claims

Override Practice Preferences with the Payer Master File

Practice tab on UB Tab