Set Up Claim Print Options

Help Guide for NextGen® Enterprise PM 8

Process Claim Requests for Multiple Encounters

To process claim requests for more than one encounter, use the Claim Request Lookup feature to locate claim requests that are in a Pending status. You can set the search criteria for the lookup to narrow your search to specific types of claim requests. Select the Claim Lookup button on the NextGen® Enterprise PM main menu. The Claim Request Lookup window appears. Select Pending in the Request Status field. Enter the additional search criteria that you want to use to locate the claim requests. Select Find. The Claim Request Lookup lists the claim requests that match your criteria in the Claim Requests section of the window. Place an x in the check boxes next to the claim requests that you want to process. To select all the claim requests in the list, place an x in the top check box on the column heading bar. Right-click on one of the claim requests that you selected and choose Print > Claims option from the short-cut menu. The Claim Printing window appears. Select the Print Format that

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

Claim Printing Library

The Claim Printing library enables you to specify options that define which information prints on claim forms. You must create and attach a Claim Printing library to a practice at the practice preference level before a paper claim can be generated. 1500 Claims, UB Claims, and ADA Claims are available in the Claim Printing library. The Claim Printing library attached at the practice preferences level is the default library. At the payer level, if needed, you can set up an alternate Claim Printing library for a specific payer. You can set the type of information you want to print in each claim field using the selections in the Setting and Option columns in the Claim Printing window. Set Up Claim Printing Library Security Right You can modify the access rights of a user group if you are assigned the Claim Printing Library security rights. Claim Print Options in Claim Printing Library You can select the claim print options through available paper claims and payer types. Attach a Claim Prin

NextGen® Background Business Processor Help 8

Print Pending Paper Claims Job

To configure the settings for the job, complete the following fields: Field Description Claim Print Action Indicates whether you want to print or export the paper claims. Claim Form Indicates the claim form you want the job to use for the pending claims. This field displays one of the following: ADA 2024 ADA 2019 CMS1500 (2005) UB04 CMS 1500 (2012) UB92 Forms or forms enhanced Note: The forms or forms enhanced are available in Claim Form list only if the forms or forms enhanced are mapped to the payer in File Maintenance. Note: When you change the practice in Run as Practice, the Claim Form list is refreshed. Claim Type Indicates one or more claim types for the job from the list. Rendering Physician Indicates the rendering physician that you want to apply to the job. Financial Class Indicates one or more financial classes that you want to apply to the job. Note: The Self Pay financial class is not available. Primary Indicate whether you want the job to include primary claims or not. Se

Help Guide for NextGen® Enterprise PM 8

Generate Paper Claims

When UB claims are previewed or printed, a claim status header displays at the top of the claim. The claim header indicates the status of the claim, either pending or archived, and for claims that are archived the date they were processed also prints in the header. The claim status header only displays on claims that have already been processed (archived) or when a copy (not for submission) is previewed or printed. The Claim Maintenance window allows you to customize the claim header, insurance information, and additional claim details. Select on the following tabs to populate the fields that you want to display on a claim: View Claim Claim Header Insurance On the tool bar, select the Claims icon . The Claim Request Lookup window opens. To search for the claim request, enter the applicable search criteria. To view the claim, highlight the claim request row and double-click. The Claim Maintenance window opens with a preview of the populated claim form. On the Claim Maintenance tool bar,

NextGen® Background Business Processor Help 8

Claim Status Requests Job

You can create the job to download and export the claim status report by configuring the fields as described in the following table. Field Description Claim Request Create Date From/To Indicates the date range for future appointments that you what the job to cover. Financial Class Indicates the financial class that you want to restrict the eligibility requests job to. Service Location Indicates the service location of the practice to which you want to restrict the eligibility requests job. Claim Type Indicates the claim types that you want to include with the job. Payer Indicates the payer associated with the claim. Media Type Indicates one of the following type for claims: Paper Electronic Aged Days Without Payment Enter the number of days without payment that you want the job Claim Status Report: Printer Name If you indicated that you want the claim status report sent to the printer, identify the printer you want to use. You can also apply the following settings to the printer: Orien

Set Up Claim Print Options

Recommendations

Process Claim Requests for Multiple Encounters

Process a Claim for a Single Encounter

Claim Printing Library

Print Pending Paper Claims Job

Generate Paper Claims

Claim Status Requests Job