Charge Test Results on Electronic Claims

Help Guide for NextGen® Enterprise PM 8

Setting up Charge Test Results

The setup required for sending MEA test result segments on electronic 837P (1500) claims involves the following areas in File Maintenance. Service Items Library Claim Edits Library Code Tables Set up SIM Codes for Test Results You can set up SIM Codes to create MEA test results on electronic claims. Set Up Claim Edits for Test Results You can set up claim edits to create MEA test results on electronic claims. View Code Tables for Test Results You can view code tables for test results on the Code Tables List window. Parent topic: Charge Test Results on Electronic Claims

Help Guide for NextGen® Enterprise PM 8

Enter Test Results for a Charge

When you enter a charge on the Charge Posting window for a SIM code that is set up in the Service Items library to create MEA test result segments, the system allows you to enter a test Qualifier, Date, and Result. A confirmation message appears stating that the charge is saved. Note: If test results are received from an HL7 interface, all the fields for charge test results fill automatically. Open NextGen® Enterprise PM. Select Charges. The Charge Posting window opens. Select the desired patient and encounter. Do the following for the SIM code that is set up to create MEA test result segments. Enter a new charge, and then select Save or Next. Select an existing charge, and then select the Test Results button on the charge toolbar. The Test Data for this Charge window opens. Note: You can enter up to five test qualifiers and results. In the Qualifier field, select one of the following: HT(Height) R1(Hemoglobin) R2(Hematocrit) R3(Epoetin Starting Dosage) R4(Creatinine) A qualifier canno

Help Guide for NextGen® Enterprise PM 8

Charge Test Results on Electronic Claims

Some payers require the test result details to be included on electronic 837P (1500) claims for reimbursement on specific tests, such as Creatinine, Hemoglobin and Hematocrit. The information required includes a qualifier that identifies the test, the test date, and the test result. An electronic 837P claim can create up to five separate MEA test result segments for results that you can enter manually from the Charge Posting window in NextGen® Enterprise PM or receive it through an interface. The MEA test results are included in the 2400 DTP*738 segment in the 837P electronic claim file. Note: You can use this functionality for electronic 837P (1500) claims. It does not apply to electronic 837I (UB) or 837D (ADA) claims. Setting up Charge Test Results You can set up charge test results on electronic claims for reimbursement. Enter Test Results for a Charge You can enter test results for a charge on the Charge Posting window. Significant Events for Charge Test Results You can enable sig

Help Guide for NextGen® Enterprise PM 8

Process Charges that Require Test Results for Claims

SIM codes for specific tests, such as Creatinine, Hemoglobin and Hematocrit, can be set up to require a test qualifier, test date and test result for claims. This information is sent in an MEA test result segment on electronic 837P (1500) claims. You can identify SIM codes that require test results for claims before processing pending charges by running the EHR Manual Charge Processing Pending report. Include the column Test Result Required on the report. The EHR Manual Charge Processing History report can also be used after charges are processed, by including the same column. While processing the pending charges, if SIM codes are missing that is required test result information needed for claims, the system alerts the user. Note: For more information on setting up the SIM codes, go to NextGen Healthcare Success Community and download the latest Billing and Collections User Guide for NextGen® Enterprise PM, and then refer to the Charge Test Results on Electronic Claims section. Process

Help Guide for NextGen® Enterprise PM 8

Process Charges that Require Test Results for Claims

SIM codes for specific tests, such as Creatinine, Hemoglobin and Hematocrit, can be set up to require a test qualifier, test date and test result for claims. This information is sent in an MEA test result segment on electronic 837P (1500) claims. You can identify SIM codes that require test results for claims before processing pending charges by running the EHR Manual Charge Processing Pending report. Include the column Test Result Required on the report. The EHR Manual Charge Processing History report can also be used after charges are processed, by including the same column. While processing the pending charges, if SIM codes are missing that is required test result information needed for claims, the system alerts the user. Note: For more information on setting up the SIM codes, go to NextGen Healthcare Success Community and download the latest Billing and Collections User Guide for NextGen® Enterprise PM, and then refer to the Charge Test Results on Electronic Claims section. Process

Help Guide for NextGen® Enterprise PM 8

Setting up Charge Test Results

The setup required for sending MEA test result segments on electronic 837P (1500) claims involves the following areas in File Maintenance. Service Items Library Claim Edits Library Code Tables Set up SIM Codes for Test Results You can set up SIM Codes to create MEA test results on electronic claims. Set Up Claim Edits for Test Results You can set up claim edits to create MEA test results on electronic claims. View Code Tables for Test Results You can view code tables for test results on the Code Tables List window. Parent topic: Charge Test Results on Electronic Claims

Charge Test Results on Electronic Claims

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Setting up Charge Test Results

Enter Test Results for a Charge

Charge Test Results on Electronic Claims

Process Charges that Require Test Results for Claims

Process Charges that Require Test Results for Claims

Setting up Charge Test Results

Charge Test Results on Electronic Claims

Setting up Charge Test Results

Enter Test Results for a Charge

Charge Test Results on Electronic Claims

Process Charges that Require Test Results for Claims

Process Charges that Require Test Results for Claims

Setting up Charge Test Results