Setting Up a Payer for UB Claims

Help Guide for NextGen® Enterprise PM 8

Setting Up Practice Preferences for UB Claims

To set up a payer for UB claims, two fields must be set up in Practice Preferences > Claims in the UB Claim > Form section: Type of Facility Bill Classification When the above fields are populated, a UB tab displays in the following areas on the Modify Payer Information window: System > Claims > Provider Secondary References > UB Claims Practice > Claims > UB Claims Practice > Secondary References > UB Claims Practice > UB Parent topic: UB Claims Parent topic: Setting Up Encounters for UB Claims

Help Guide for NextGen® Enterprise PM 8

System Tab/Claims Tab/UB Claims Tab

The System Parameters tab has two UB Claims tabs used in the following sections of the window: Provider Secondary References Provider Paper Qualifiers Modify Payer Information Provider Secondary References Provider Paper Qualifiers Parent topic: Setting Up a Payer for UB Claims

Help Guide for NextGen® Enterprise PM 8

Practice Tab

In the File Maintenance > Master Files > System > Payers, the Practice tab of the Add/Modify Payer Information window contains several tabs. The following topics provide information about the sub-tabs on the Practice tab. Claims Tab Secondary References Sub-Tab Other Sub-Tab UB Sub-Tab Setting Up Claims to Print NextGen Document Management Images Transactions Sub-Tab Add Libraries to a Practice Post Multiple Transactions Parent topic: Payers Master File

Help Guide for NextGen® Enterprise PM 8

Set Up a UB Claim Form in the Payer Master File

When you set up a practice location as an enhanced UB user, the application generates a UB claim for the payer after billing. In File Maintenance, select Master Files - System > Payers. Select the applicable payer from the list and then select the UB tab of the Practice tab. In the Modify Payer Information window, select the location in the Location field if your practice has multiple locations. Note: The location that you select must be the same location as shown on the encounter. Enter the number provided by the payer in the Field Locator 51 field. Select the rendering providers in the Rendering Provider field. Enter data in other fields, as applicable for the payer. Select OK. Parent topic: Setting Up UB Claim Forms

File Maintenance Help for NextGen® Enterprise 8

Practice Tab

In the File Maintenance > Master Files > System > Payers, the Practice tab of the Add/Modify Payer Information window contains several tabs. The following topics provide information about the sub-tabs on the Practice tab. Claims Tab Secondary References Sub-Tab Other Sub-Tab UB Sub-Tab Transactions Sub-Tab Add Libraries to a Practice Parent topic: Payers Master File

Help Guide for NextGen® Enterprise PM 8

UB Claims

This section provides information about the process of setting up UB claims for a regular UB user and an enhanced UB user. The rules for setting up and billing UB claims are different for the two types of users. Therefore, as a user, you should fit into one of the following two categories, if your practice processes UB claims: A Regular UB user is a practice that does some, but not exclusive UB claims billing. For example, if your practice primarily does 1500 claims processing and a small percentage of UB claims, then you would be considered a Regular UB user. An Enhanced UB user is a doctor or multiple doctors at a specific practice location that exclusively does UB claims billing. For example, a clinical rehabilitation practice with specific doctors at separate locations for Physical Therapy, Occupational Therapy, and Speech Therapy that exclusively process UB claims at one location would be considered an Enhanced UB user. UB claims must be set up by entering configuration informatio

Setting Up a Payer for UB Claims

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Setting Up Practice Preferences for UB Claims

System Tab/Claims Tab/UB Claims Tab

Practice Tab

Set Up a UB Claim Form in the Payer Master File

Practice Tab

UB Claims

Setting Up Practice Preferences for UB Claims

System Tab/Claims Tab/UB Claims Tab

Practice Tab

Set Up a UB Claim Form in the Payer Master File

Practice Tab

UB Claims