Set Up Revenue Codes

Help Guide for NextGen® Enterprise PM 8

Set Up Revenue Codes for SIMs

The Service Items in the SIM library must have the proper revenue codes set up for recurring billing. In File Maintenance, select Libraries and then Service Items . Select the applicable library from the list. Enter the service item number in the Search field. The Service Item Library Maintenance window opens. Enter the Service Item number that you want to use for recurring billing in the Search field. Select the applicable revenue code in the Revenue Code field. The revenue code must be a valid code for recurring billing. Refer to Setting Up Revenue Codes in this section for a list of valid codes. Select OK. Parent topic: File Maintenance Settings Required for 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

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

Set Up Practice Preferences for Recurring UB Billing

You must set up the following three fields in Practice Preferences or the Payers master file to trigger recurring UB billing: Bill Classification Type of Facility Bill Frequency If your practice does exclusively recurring UB billing, then it is best to set up these fields in Practice Preferences. However, if you use recurring billing at a few locations, you can override the UB settings in Practice Preferences with settings in the Payers master file for the locations using recurring billing. In NextGen® Enterprise PM, select Admin > Preferences > Practice. In the Practice Preferences window, select the Claims tab. In the Type of Facility field, select 7 (Clinic). Leave the Frequency of Bill field blank. This field must be blank for the automated billing process. In the Bill Classification field, select one of the following options: 4 (Outpatient Rehab Facility) 5 (Comp Outpatient Rehab Facility) Select OK. Note: If the values in the Type of Facility, Bill Classification, and Frequency o

Help Guide for NextGen® Enterprise PM 8

File Maintenance Settings Required for Recurring UB Billing

To enable recurring UB billing, you must set up the following items in File Maintenance: Practice Preferences Payer master file Revenue Codes The SIM library Set Up Practice Preferences for Recurring UB Billing Set Up the Payer Master File for Recurring UB Billing Override Practice Preferences with the Payer Master File Set Up Revenue Codes Set Up Revenue Codes for SIMs Parent topic: Recurring UB Billing

Help Guide for NextGen® Enterprise PM 8

Recurring UB Billing

Recurring UB billing is a process that enables you to indicate a treatment plan by linking claims using onset date, discharge date, default value code, and occurrence codes. These values are then copied forward from one encounter to the next. Default value and occurrence codes, which are set up in the Revenue Codes master file, automatically post to the encounter during billing if recurring billing is enabled. For the interim and final claims in the series, the onset date, value codes, and occurrence codes can be copied forward from the initial encounter. Recurring billing is used for billing a series of visits for the following therapies: Physical therapy Speech therapy Occupational therapy Note: The application currently works only for the revenue codes that represent the above therapies. File Maintenance Settings Required for Recurring UB Billing Setting Up UB Claim Forms Encounter Settings Required for Recurring UB Billing Parent topic: UB Claims

Set Up Revenue Codes

Recommendations

Set Up Revenue Codes for SIMs

Set Up the Payer Master File for Recurring UB Billing

Override Practice Preferences with the Payer Master File

Set Up Practice Preferences for Recurring UB Billing

File Maintenance Settings Required for Recurring UB Billing

Recurring UB Billing

Set Up Revenue Codes for SIMs

Set Up the Payer Master File for Recurring UB Billing

Override Practice Preferences with the Payer Master File

Set Up Practice Preferences for Recurring UB Billing

File Maintenance Settings Required for Recurring UB Billing

Recurring UB Billing