UB/Occurrence Codes Tab

Help Guide for NextGen® Enterprise PM 8

UB/Value Codes Tab

UB Each field on the UB / Value Codes tab is labeled with a number (39, 40, or 41) followed by a letter (a, b, c, or d). The value codes that are entered in these fields will have an associated dollar amount or unit value associated with it that is entered in the field to the right of the numbered fields. When a value code is entered in one of the numbered fields and you tab to the associated field to the right, the application automatically converts the field to accept a dollar value or a unit value. If a dollar value is the required entry, the field displays with $0.00. If a unit value is the required entry, the field displays blank. All the fields on this tab correspond to the Field Locators on the UB claim form. For example, the value code and associated dollar amount or unit value that is entered in the 39a field will populate the first line, which is considered line a, of Field Locator 39 on the UB04 claim form. Field 39b would correspond with the second line, which is line b, of

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

Setting Up Encounters for UB Claims

The following list outlines the areas of the Encounter Maintenance window that are important to the setup of UB claims: On the General tab, complete the Service Location field. On the UB tab, access the following sub-tabs: Condition Codes, Occurrence Codes, and Value Codes. Encounter Maintenance Note: For Enhanced UB users, the automated UB claims process only applies to payers who are considered primary. The automating of the Type of Bill field, the Occurrence codes, and the Value codes, which are explained in the following sections, only occurs for primary payers who have the required criteria. UB/General Tab UB/Condition Codes Tab UB/Occurrence Codes Tab UB/Value Codes Tab Setting Up Practice Preferences for UB Claims Parent topic: UB Claims

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

Set Up an Encounter for Regular UB Users

Access the Encounter Maintenance window for the patient and encounter the UB claim is being created for if you want occurrence and value codes to display on the UB claim. In NextGen® Enterprise PM, select the Chart icon on the main toolbar. The Patient Lookup window appears. Enter the search criteria and then select Find. To open the chart, right-click the chart and then select Open. On the Encounters tab, right-click the encounter and then select open menu icon . The Encounter Maintenance window appears. Select the UB tab, then the Occurrence Codes sub-tab. Enter the occurrence codes and dates in the field locator fields, if applicable. To enter the value codes and associated dollar value or unit value, select the Value Codes tab and enter the data in the Field Locator fields. Select OK. To enter the charges for the patient and the encounter, open the Charge Posting window. Bill the encounter and create the UB claim. Parent topic: Set Up UB Claims for Regular UB Users

Help Guide for NextGen® Enterprise PM 8

Set Up Encounters for Enhanced UB Claims (After Billing)

Access the Encounter Maintenance window for the patient and encounter the UB claim was created for. In NextGen® Enterprise PM, select the Chart button on the main toolbar. The Patient Lookup window opens. Enter Search Criteria to locate the desired patient and then select Find. From the Matching Records section, double-click to open the desired patient. The Patient Chart window opens. Select the Encounters tab. Right-click the encounter, and then select Open. The Service Location field is no longer accessible once an encounter has been billed. Select the UB tab. Encounter Maintenance The fields on this window automatically default the applicable information once the encounter has been billed. Do not change any of the information on this window. Select the Occurrence Codes tab. UB The fields on this window automatically default the occurrence code information once the encounter has been billed. These occurrence codes are attached to the revenue codes, which are attached to the service i

UB/Occurrence Codes Tab

Recommendations

UB/Value Codes Tab

UB/General Tab

Setting Up Encounters for UB Claims

UB Occurrence Codes Sub-Tab

Set Up an Encounter for Regular UB Users

Set Up Encounters for Enhanced UB Claims (After Billing)

UB/Occurrence Codes Tab

UB/Value Codes Tab

UB/General Tab

Setting Up Encounters for UB Claims

UB Occurrence Codes Sub-Tab

Set Up an Encounter for Regular UB Users

Set Up Encounters for Enhanced UB Claims (After Billing)