UB General Sub-Tab

Field	Description
Type of Bill	This field contains three fields; one for each character of a three-digit code on UB claims. The default digits for all encounter are defined on the Claims tab in Practice Preferences. You can modify them if different digits are needed on the UB claim for the encounter.
Hold Date	This option puts a hold on the claim. It is used by Medicare but can be used by other providers as well. It stops the creation of a claim until the hold date ends, currently not used.
Source of Admission	Select from the list the actual source of the admission. For example, a clinical referral or a law enforcement. It prints in Field Locator #15 on UB claims. You can select from: 1 - Clinic Referral 8 - Court/Law Enforcement 7 - Emergency Room 3 - HMO Referral 9 - Information Not Available 1 - Physician Referral 6 - Transfer from Another Facility 4 - Transfer from Hospital A - Transfer from RPCH 5 - Transfer from SNF
Type of Admission	Type of Admission is a single digit that prints in Field Locator #14 on UB claims and reflects the type of hospital admission for the patient. The default type of admission for all encounters at a specific location for a specific Payer is defined for the Location on the encounter in the Payers table in the UB sub-tab in the Practice tab. It can be modified if a different type is needed on the UB claim for the encounter. Available options include: 3 – Elective 1 – Emergency 9 – Information Not Available 4 – Newborn 2 – Urgent

Help Guide for NextGen® Enterprise PM 8

UB Value Codes Sub-Tab

Value codes indicate the code and related dollar amounts that identify monetary data required for processing claims. This information is required for benefit determination. Value codes are two character alpha-numeric codes that print in Field Locators 39-41 on UB claims. You can modify the code and the dollar amount when specific codes and amounts are needed on the UB claim for the encounter. You can select one Value Code and associated Dollar Amount in rows 39a - 41d, or up to 12 codes and amounts per encounter. Example: When you select 21 (Catastrophic) in row 31a and enter a dollar amount, the condition code 21 and the amount display in field locator 39a on UB claim forms for the encounter. Note: A default Value Code may have been linked to the Revenue Code that prints in Field Locator #42 on UB claims for the service. The default is defined in File Maintenance > PM System Master Files > Revenue Codes. Parent topic: Encounter Maintenance - UB Tab

Help Guide for NextGen® Enterprise PM 8

UB Occurrence Codes Sub-Tab

Occurrence Codes define specific events relating to a bill that may affect payer processing. This is a two character alpha-numeric code that prints in Field Locators 31 - 34 on the UB claims form. You can select one Occurrence Code and Date for field locators 31a - 34b, or up to eight (8) codes and dates per encounter. Example: When you select 01 (Auto Accident) in row 31a and enter a date, the condition code 01 and the date display in field locator 31 on UB claim forms for the encounter. If the 01 (Auto Accident) occurrence code is linked to revenue code 369 Auto Accident Catastrophic, then 369 prints in the field locator box. Note: When an Occurrence Code is linked to a Revenue Code, the default Revenue Code prints on the UB form in the field locator box. The default is defined in File Maintenance > System Master Files > PM > Revenue Codes. Parent topic: Encounter Maintenance - UB Tab

Help Guide for NextGen® Enterprise PM 8

Encounter Maintenance - UB Tab

The UB tab includes information about the patient’s encounter that may be needed on electronic 837I or paper UB claims for the encounter. Note: This tab displays only if the default Type of Facility and Bill Classification options have been enabled in the Claims preferences under Practice Preferences. The UB tab has the following sub-tabs: General Condition Codes Occurrence Codes Value Codes UB General Sub-Tab UB Condition Codes Sub-Tab UB Occurrence Codes Sub-Tab Occurrence Codes define specific events relating to a bill that may affect payer processing. You can select one Occurrence Code and Date for field locators 31a - 34b, or up to eight (8) codes and dates per encounter. UB Value Codes Sub-Tab Value codes indicate the code and related dollar amounts that identify monetary data required for processing claims. You can modify the code and the dollar amount when specific codes and amounts are needed on the UB claim for the encounter. Parent topic: Encounter Maintenance

Help Guide for NextGen® Enterprise PM 8

UB/General Tab

All the fields on the UB > General sub-tab can be automatically populated. The information on this tab can be overridden, but it is not recommended, especially if you are an Enhanced UB user and you want to use the automated UB claims process. Regular UB users should not use the fields on this window, except to change the Source of Admission field. Regular UB users should continue to use the Billing & Collections tab on the Encounter Maintenance window to review or change the values that display on the UB claim form. Encounter Maintenance Field Description Type of Bill This field is divided into three positions. The values for each position are described separately. First Position After the UB claim is billed, this position is populated automatically with the value that is in the Type of Facility field located on Modify Payer Information > Practice > UB sub-tab. If this field does not contain a value, this position is populated from the Type of Facility field in Practice Preferences >

Help Guide for NextGen® Enterprise PM 8

Set Up UB Claims for Regular UB Users

In NextGen® Enterprise PM, select the Admin menu and then select Preferences > Practice. The Practice Preferences window opens. In the Preference List on the left, select Claims. To select the default facility code to display on all UB claims for the practice, select a code in the Type of Facility field. The code selected here is the first digit of the three-digit Type of Bill code that displays in Field Locator 4 on UB claims. Note: The Type of Facility field must be populated to enable UB claims for the practice. This also enables UB Claims tabs on the Add/Modify Payer Information window that are used to setup UB claims for specific payers. Type of Facility codes are maintained in Code Tables in the File Maintenance. The codes cannot be changed, but the descriptions can be modified if needed. Only the code displays on UB claims. The Type of Facility code table includes the following: Type of Facility Description 5 Christian Science (Ext Care) 4 Christian Science (Hospital) 7 Clinic 3

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

UB General Sub-Tab

Recommendations

UB Value Codes Sub-Tab

UB Occurrence Codes Sub-Tab

Encounter Maintenance - UB Tab

UB/General Tab

Set Up UB Claims for Regular UB Users

UB Sub-Tab

UB Value Codes Sub-Tab

UB Occurrence Codes Sub-Tab

Encounter Maintenance - UB Tab

UB/General Tab

Set Up UB Claims for Regular UB Users

UB Sub-Tab