Set Up Revenue Codes for SIMs

Help Guide for NextGen® Enterprise PM 8

Set Up Revenue Codes

Revenue Codes used for physical therapy, occupational therapy, and speech therapy must be set up in the Revenue Codes master file for recurring billing. In File Maintenance, select Master Files - System and then Revenue Codes. Select the open menu button and then select New or select a revenue code from the list. The Modify Revenue Code Information window opens. Enter the revenue code, in the Code field. Valid codes and descriptions for recurring billing are: 420-429 - Physical Therapy 430-439 - Occupational Therapy 440-449 - Speech Therapy Enter the description that corresponds with the revenue code, in the Description field. Select your default occurrence code in the Occurrence Code field. Valid codes are: 35, 44, and 45. Select your default value code in the Value Code field. Valid codes are: 50, 51, and 52. Select OK. Parent topic: File Maintenance Settings Required for Recurring UB Billing

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

Set Up SIM Codes for Roll-Up Billing by Revenue Code

To set up a SIM code for roll-up billing by revenue code, do the following: Access File Maintenance. Select Libraries, and then Service Items. The Service Items List window opens. From the list, select a library and then select Open Menu and select Open. The Service Item Library Maintenance window opens. Do one of the following: To add a SIM code, select Open Menu and select New. To modify a SIM code, search for the code and then select the code from the list on the left. Select the General tab. Each SIM code that is to roll-up to a single line item on the claim must have the following parameters defined. Revenue Code: Select the appropriate Revenue Code for UB/837I claims. This is the default revenue code for all UB payers. If the roll-up payer requires a different revenue code, the Alt Rev code must be defined on the Payer tab for the roll-up payer. Form: Select 1500. This is the default type of form for all payers. If the roll-up payer requires a different form (e.g. UB), additional

Help Guide for NextGen® Enterprise PM 8

Set Up SIM Codes for Roll-Up Billing by CPT4 Code

To set up a SIM code for roll-up billing by CPT4 code, do the following: Access File Maintenance. Select Libraries, and then Service Items. The Service Items List window opens. From the list, select a library and then select Open Menu and select Open. The Service Item Library Maintenance window opens. Do one of the following: To add a SIM code, select Open Menu and select New. To modify a SIM code, search for the code and then select the code from the list on the left. Select the General tab. Each SIM code that is to roll-up to a single line item on the claim must have the following parameters defined. Revenue Code: Select the appropriate revenue code for UB/837I claims. This is the default revenue code for all UB payers. If the roll-up payer requires a different revenue code, the Alt Rev code must be defined on the Payer tab for the roll-up payer. Form: Select 1500. This is the default type of form for all payers. If the roll-up payer requires a different form (e.g. UB), additional se

File Maintenance Help for NextGen® Enterprise 8

Suppress Billing for All SIMs In a Library

From the File Maintenance desktop, select Libraries > Service Items. The Service Items Libraries window opens. Right-click a service item library, and then select Select Suppress Billing for this Library. The Suppress Billing check box on the Service Item Library Maintenance window > General tab automatically becomes selected for all SIMs in the library. You can also turn off suppress billing for all SIMs in a library: Right-click the library, and then select the Deselect Suppress Billing for this Library. The Suppress Billing check box on the Service Item Library Maintenance window > General tab automatically becomes cleared for all SIMs in the library. Parent topic: General Tab

Help Guide for NextGen® Enterprise PM 8

Set Up a Service Item for Regular UB Users

Access the service item from the Service Item Library to attach a payer and set the Form field to UB. Access File Maintenance. Select Libraries > Service Items. Right-click a Service Item library, and then select Open. To create a new SIM, select an existing SIM or select the open menu button. Select the Payer tab and select the applicable payer. Enter an effective date in the Eff field and an expiration date in the Exp field. Select the General tab, and then select UB from the Form field. Select the Add button, and then select OK. Parent topic: Set Up UB Claims for Regular UB Users

Set Up Revenue Codes for SIMs

Recommendations

Set Up Revenue Codes

File Maintenance Settings Required for Recurring UB Billing

Set Up SIM Codes for Roll-Up Billing by Revenue Code

Set Up SIM Codes for Roll-Up Billing by CPT4 Code

Suppress Billing for All SIMs In a Library

Set Up a Service Item for Regular UB Users

Set Up Revenue Codes

File Maintenance Settings Required for Recurring UB Billing

Set Up SIM Codes for Roll-Up Billing by Revenue Code

Set Up SIM Codes for Roll-Up Billing by CPT4 Code

Suppress Billing for All SIMs In a Library

Set Up a Service Item for Regular UB Users