NextGen Knowledge Center

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:

  1. Access File Maintenance.
  2. Select Libraries, and then Service Items.
    The Service Items List window opens.
  3. From the list, select a library and then select Open Menu and select Open.
    The Service Item Library Maintenance window opens.
  4. 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.
  5. 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 setup must be done in the Payers master file on the UB sub-tab, on the Practice tab of the Modify Payer Information window for the roll-up payer.
      Service Item Library Maintenance

  6. Select the Payer tab.
    Each SIM code that is to roll-up to a single revenue code line on the claim must have the following option selected for the roll-up payer. This does not include carve-out SIM codes that should not roll-up on the claim.
    • Payer: Select the roll-up payer.
    • Single Unit Revenue Code Roll Up: Select this check box.
    The following parameters need to be defined only if an alternate revenue code is needed on UB claims for the roll-up payer that is different from the revenue code defined on the General tab for all other UB payers:
    • Effective/Expiration Dates: Enter the appropriate date range.
    • Form: Select UB.
    • Alt Rev: Enter the alternate revenue code to which the SIM should roll-up to on claims.
    Service Item Library Maintenance

  7. To save changes and close the window, select OK.