UB Claims Tab on Secondary References Tab

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 the UB Claims tab.) The default for the 2010A Billing Provider references from Field Locator 51 on the UB claims from the payer master. Physician Billing ID - If the provider is attached to a billing group, the Physician Billing ID is the group number. If not, then it is the individual provider number. The Physician Billing ID is the default for the 2010A Billing Provider references on HCFA claims. Group Nbr - The group number for the rendering physician. If the rendering physician is not attached to a group, the field will be blank. Indiv Phys ID - The individual provider number for 2010A Billing Provider and 2310B Rendering Provider references. The supervising physician's individual ID for 2310E Supervising Provider references. Tax ID - The rendering provider's tax ID for 2010A Billing Provider and 2310B Rendering Provider references. The supervising physician's tax ID for 2310E Supervising Provider references. State Lic Nbr - The state license number for 2010A Billing Provider and 2310B Rendering Provider references. The supervising physician's state license number for 2310E Supervising Provider references. Opt Clm Val 1 - The optional claim value 1 from the provider master file. Opt Clm Val 2 - The optional claim value 2 from the provider master file. Submitter ID - The electronic submitter ID for the payer. Payer Opt Val - The practice/payer-specific value entered in the Practice Payer Opt Val field on the Practice Parameters tab of the payer master file. Phys Site ID - The default payer from the provider/location setup. Loc Site ID - The location master site ID. Facility ID - The facility ID, if available, from the Location master file. It can be any one of the three Claim Type Specific Codes: Medicare Facility ID, BCBS Facility ID, and Medicaid Facility ID. UPIN - The rendering provider's UPIN for 2010A Billing Provider and 2310B Rendering Provider references. The supervising physician's UPIN for 2310E Supervising Provider references. Group Opt Val - The Opt Group Val from the group master. Prov Loc Code - The Loc ID number from the Group Information section on the Practice tab of the provider master for 2010A Billing Provider and 2310B Rendering Provider references. This is a Medicaid clinic rate specific code for 2310E Supervising Provider references.

Help Guide for NextGen® Enterprise PM 8

Practice tab on UB Tab

The following conditions apply to the UB tab that appears on the Add/Modify Payer Information window and then the Practice tab: Regular UB users do not use this tab. Setup this tab for Enhanced UB users is location-specific, not practice-specific. Some of the fields on this tab are labeled Field Locator n, which identifies the corresponding field on the actual UB claim form. The following table contains the UB tab fields and their descriptions: Field Description Location The Location field displays only when the practice has multiple locations. Select a practice location. For multiple location practices, the Location field must be populated before any of the fields on the UB tab are enabled. For single location practices, the Location field does not display and all fields on the UB tab are automatically enabled. Field Locator 1 Name The Field Locator 1 Name field is a free-form text entry field. The default for this field is blank. If the field is left blank, the name that defaults to

Help Guide for NextGen® Enterprise PM 8

Provider Secondary References

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 the group number. If not, then it is the individual provider number. The Physician Billing ID is the default for the Billing Provider references on 1500 claims. Group Nbr– The group number for the rendering physician. If the rendering physician is not attached to a group, the field will be blank. Indiv Phys ID– The individual provider number for 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

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

Help Guide for NextGen® Enterprise PM 8

UB Sub-Tab

The following conditions apply to the UB tab that displays on the Practice tab of the Add/Modify Payer Information window: Regular UB users do not use this tab. Set up on this tab for Enhanced UB users is location-specific, not practice-specific. Some of the fields on this tab are labeled Field Locator n, which identifies the corresponding field on the actual UB claim form. The following table contains the UB tab fields and their descriptions: Field Description Location The Location field displays only when the practice has multiple locations. Select a practice location. For multiple location practices, the Location field must be populated before any of the fields on the UB tab are enabled. For single location practices, the Location field does not display and all of the fields on the UB tab are automatically enabled. Field Locator 1 Name The Field Locator 1 Name field is a free-form text entry field. The default for this field is blank. If the field is left blank, the name that defaul

File Maintenance Help for NextGen® Enterprise 8

UB Sub-Tab

The following conditions apply to the UB tab that displays on the Practice tab of the Add/Modify Payer Information window: Regular UB users do not use this tab. Set up on this tab for Enhanced UB users is location-specific, not practice-specific. Some of the fields on this tab are labeled Field Locator n, which identifies the corresponding field on the actual UB claim form. The following table contains the UB tab fields and their descriptions: Field Description Location The Location field displays only when the practice has multiple locations. Select a practice location. For multiple location practices, the Location field must be populated before any of the fields on the UB tab are enabled. For single location practices, the Location field does not display and all of the fields on the UB tab are automatically enabled. Field Locator 1 Name The Field Locator 1 Name field is a free-form text entry field. The default for this field is blank. If the field is left blank, the name that defaul

UB Claims Tab on Secondary References Tab

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