System Tab

Provider Secondary Reference	Qualifier / Data Element
Billing Tab	Employer ID Number (EI) / Tax ID
Referring Tab	<none> / <none>
Rendering Tab	<none> / <none>
Service Facility Tab	<none> / <none>
Payer Billing Tab	<none> / <none>

Help Guide for NextGen® Enterprise PM 8

Practice Tab

To set up electronic dental claims, use the ADA Claims tab on the Practice tab on the Claims tab of the Modify Payer Information window. Field Description Submitter Profile Select the submitter profile that you want to apply to ADA claims. Electronic Transmitter ID Enter the payer-assigned electronic transmitter ID to generate a claim with an electronic transmitter ID. Note: This field only displays when you select a submitter profile. Practice Payer Opt Val Enter the practice/payer-specific value. Payer Alias Enter an alternative payer name when a name that differs from the name that appears in the payer's Payer master file is required. Primary, Secondary, and Tertiary Media Types Enter the primary media type accepted by the clearinghouse as being electronic or paper. If you set it as electronic, then you can also set how the secondary and tertiary claims should be submitted. When Primary, force Secondary claims to paper Select this check box if you want the claim being sent to the se

Help Guide for NextGen® Enterprise PM 8

System Tab

To set up provider secondary references, use the ADA Claims tab on the Claims sub-tab on the System tab of the Modify Payer Information window. Use the following table to set up your Provider Secondary References for dental payers. Provider Secondary Reference Qualifier / Data Element Billing Tab Employer ID Number (EI) / Tax ID Referring Tab <none> / <none> Rendering Tab <none> / <none> Service Facility Tab <none> / <none> Payer Billing Tab <none> / <none> Note: For more information on provider secondary references, go to NextGen Healthcare Success Community and download the latest File Maintenance Master Files Guide for NextGen® Enterprise, and then refer to the Provider Secondary References: 1500 Claims, UB Claims, and ADA Claims Tabs section. Parent topic: Payers Master File for Dental Billing

Help Guide for NextGen® Enterprise PM 8

Secondary References Sub-Tab

The Secondary References tab contains additional tabs for 1500 Claims, UB Claims, and ADA Claims qualifiers and data elements. The sub-tab names, and the qualifier and data element options vary depending on whether you have selected the 1500 Claims, UB Claims, or ADA Claims tab. Provider Secondary References: 1500 Claims, UB Claims, and ADA Claims Tabs Note: TheUB Claimstab only displays when you have set up theUB Claim Formoptions in theEncountersPractice Preferences. Field Description Qualifier Select the Reference Qualifier, according to the payer, to use in REF01 of the 837 electronic file. Data Element Select the provider ID Data Type to use in REF02 of the 837 electronic file. Options for this field include the following: FL51– This option only displays on theUB Claimstab. The default for the Billing Provider references from Field Locator 51 on the UB claims from the Payers master file. Phys Billing ID– If the provider is attached to a billing group, the Physician Billing ID is t

Help Guide for NextGen® Enterprise PM 8

Secondary References Sub-Tab

The Secondary References tab contains additional tabs for 1500 Claims, UB Claims, and ADA Claims qualifiers and data elements. The sub-tab names, and the qualifier and data element options vary depending on whether you have selected the 1500 Claims, UB Claims, or ADA Claims tab. Provider Secondary References: 1500 Claims, UB Claims, and ADA Claims Tabs Note: TheUB Claimstab only displays when you have set up theUB Claim Formoptions in theEncountersPractice Preferences. Field Description Qualifier Select the Reference Qualifier, according to the payer, to use in REF01 of the 837 electronic file. Data Element Select the provider ID Data Type to use in REF02 of the 837 electronic file. Options for this field include the following: FL51– This option only displays on theUB Claimstab. The default for the Billing Provider references from Field Locator 51 on the UB claims from the Payers master file. Phys Billing ID– If the provider is attached to a billing group, the Physician Billing ID is t

File Maintenance Help for NextGen® Enterprise

Secondary References Sub-Tab

The Secondary References tab contains additional tabs for 1500 Claims, UB Claims, and ADA Claims qualifiers and data elements. The sub-tab names, and the qualifier and data element options vary depending on whether you have selected the 1500 Claims, UB Claims, or ADA Claims tab. Provider Secondary References: 1500 Claims, UB Claims, and ADA Claims Tabs Note: TheUB Claimstab only displays when you have set up theUB Claim Formoptions in theEncountersPractice Preferences. Field Description Qualifier Select the Reference Qualifier, according to the payer, to use in REF01 of the 837 electronic file. Data Element Select the provider ID Data Type to use in REF02 of the 837 electronic file. Options for this field include the following: FL51– This option only displays on theUB Claimstab. The default for the Billing Provider references from Field Locator 51 on the UB claims from the Payers master file. Phys Billing ID– If the provider is attached to a billing group, the Physician Billing ID is t

File Maintenance Help for NextGen® Enterprise 8

Secondary References Sub-Tab

The Secondary References tab contains additional tabs for 1500 Claims, UB Claims, and ADA Claims qualifiers and data elements. The sub-tab names, and the qualifier and data element options vary depending on whether you have selected the 1500 Claims, UB Claims, or ADA Claims tab. Provider Secondary References: 1500 Claims, UB Claims, and ADA Claims Tabs Note: TheUB Claimstab only displays when you have set up theUB Claim Formoptions in theEncountersPractice Preferences. Field Description Qualifier Select the Reference Qualifier, according to the payer, to use in REF01 of the 837 electronic file. Data Element Select the provider ID Data Type to use in REF02 of the 837 electronic file. Options for this field include the following: FL51– This option only displays on theUB Claimstab. The default for the Billing Provider references from Field Locator 51 on the UB claims from the Payers master file. Phys Billing ID– If the provider is attached to a billing group, the Physician Billing ID is t

System Tab

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Secondary References Sub-Tab