Set up SIM Codes for Test Results

Help Guide for NextGen® Enterprise PM 8

Set Up Claim Edits for Test Results

During the billing process, when a SIM code is set up to create MEA test result segments on electronic 837P claims, but the charge does not have the test date or test result details, then you can activate the claim edits instead of creating a new claim. Open File Maintenance. Select Libraries, and then Claim Edits. The Claim Edits List window opens. Double-click the desired library. The Claim Edit Library Maintenance window opens. In the claim edit grid, do the following: Select the row with the IDs 286 and 287. In the Severity column, select either Critical or Required for the selected IDs. This severity selection prevents the claims from being created when the edit fails. Select OK. Parent topic: Setting up Charge Test Results

Help Guide for NextGen® Enterprise PM 8

View Code Tables for Test Results

A Test Results Qualifier table is pre-installed in File Maintenance > Code Tables. Each test includes a two-digit qualifier code that is sent in the MEA test result segment on electronic 837P (1500) claims. Note: You cannot add or modify the Test Results Qualifier codes. Open File Maintenance. Select Code Tables. The Code Tables List window opens. Select Test Results Qualifier from the Code Table list. The list of pre-defined tests and two-digit qualifier codes displays. Select Close. Parent topic: Setting up Charge Test Results

Help Guide for NextGen® Enterprise PM 8

Set up SIM Codes for Test Results

You can set up specific SIM codes in the Service Items Library to create MEA test result segments on electronic 837P (1500) claims. Open File Maintenance. Select Libraries, and then Service Items. The Service Items List window opens. Double-click the desired library. The Service Item Library Maintenance window opens. Select Search, and then enter the desired SIM code. Select the General tab. Select 1500 from the Form list. Select the Other tab. Select the Create Test Results MEA Segment check box. Note: Create Test Results MEA Segment check box is not available if either UB or ADA is selected in the Form field on the General tab. Select OK. Parent topic: Setting up Charge Test Results

Help Guide for NextGen® Enterprise PM 8

Setting up Charge Test Results

The setup required for sending MEA test result segments on electronic 837P (1500) claims involves the following areas in File Maintenance. Service Items Library Claim Edits Library Code Tables Set up SIM Codes for Test Results You can set up SIM Codes to create MEA test results on electronic claims. Set Up Claim Edits for Test Results You can set up claim edits to create MEA test results on electronic claims. View Code Tables for Test Results You can view code tables for test results on the Code Tables List window. Parent topic: Charge Test Results on Electronic Claims

Help Guide for NextGen® Enterprise PM 8

Setting up Charge Test Results

The setup required for sending MEA test result segments on electronic 837P (1500) claims involves the following areas in File Maintenance. Service Items Library Claim Edits Library Code Tables Set up SIM Codes for Test Results You can set up SIM Codes to create MEA test results on electronic claims. Set Up Claim Edits for Test Results You can set up claim edits to create MEA test results on electronic claims. View Code Tables for Test Results You can view code tables for test results on the Code Tables List window. Parent topic: Charge Test Results on Electronic Claims

Help Guide for NextGen® Enterprise PM 8

Set Up Claim Edits for Test Results

During the billing process, when a SIM code is set up to create MEA test result segments on electronic 837P claims, but the charge does not have the test date or test result details, then you can activate the claim edits instead of creating a new claim. Open File Maintenance. Select Libraries, and then Claim Edits. The Claim Edits List window opens. Double-click the desired library. The Claim Edit Library Maintenance window opens. In the claim edit grid, do the following: Select the row with the IDs 286 and 287. In the Severity column, select either Critical or Required for the selected IDs. This severity selection prevents the claims from being created when the edit fails. Select OK. Parent topic: Setting up Charge Test Results

Set up SIM Codes for Test Results

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Set Up Claim Edits for Test Results

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Set Up Claim Edits for Test Results