Claim Request Reports

Help Guide for NextGen® Enterprise PM 8

Claim Status Report

After submitting a request for claim status, you can generate a report showing the details of the claim attached to the encounter. The data for the report is taken from the NextGen® Eligibility Verification claim status 277 X12 transaction file. The status-wise statistics of the claims in the report help you analyze the overall status of the claim requests submitted in the practice. The statistical table displays the following information. Number of accepted claims and rejected claims Billed amount for accepted claims and rejected claims Paid amount for accepted claims and rejected claims Total number of claims Total billed amount Total paid amount The table following the statistical report shows the claims that have been requested for claim status in the practice. You can click a claim to view more details. The row expands showing the columns of the report as configured in Configuration Options. The following is an example of a claim when expanded. The claim status is color coded as f

Help Guide for NextGen® Enterprise PM 8

Claim Requests Report

The Claim Requests report generates a list of claims for specific practices, encounters, and service locations. The Claim Requests report also displays certain charge-line claim details. Note: File Maintenance settings can cause the charge-line claim details to appear differently than what is displayed in the encounter charges. You can select the Acknowledgment Status and Claim Status Category columns to include results from 997 and 277/277u transactions submitted to payers using NextGen® Eligibility Verification. You can open the Claim Requests report by selecting Claim Requests under the General option of the Reports menu in NextGen® Enterprise PM. Claim Requests Report Columns You can select the columns to appear on the Claim Requests report. Filters in Claim Requests Report Parent topic: General Reports

Help Guide for NextGen® Enterprise PM 8

Claim Requests Report

The Claim Requests report generates a list of claims for specific practices, encounters, and service locations. The Claim Requests report also displays certain charge-line claim details. Note: File Maintenance settings can cause the charge-line claim details to appear differently than what is displayed in the encounter charges. You can select the Acknowledgment Status and Claim Status Category columns to include results from 997 and 277/277u transactions submitted to payers using NextGen® Eligibility Verification. You can open the Claim Requests report by selecting Claim Requests under the General option of the Reports menu in NextGen® Enterprise PM. Claim Requests Report Columns You can select the columns to appear on the Claim Requests report. Filters in Claim Requests Report Parent topic: General Reports

Help Guide for NextGen® Enterprise PM 8

Reports

This section provides information on the reports used in NextGen® Eligibility Verification. These reports include: The Eligibility Referral Listing report Reconciliation Reports The Claims Requests report Go to NextGen Healthcare Success Community and download the Reports User Guide for NextGen® Enterprise PM for detailed information on Reporting. In addition, eligibility verification users have enhanced reports. Enhanced reports are not available for legacy reporting. These enhanced reports are: The Eligibility Verification Benefit report The Eligibility Inquiry Status report About Eligibility Referral Listing Report Reconciliation Reports The Reconciliation Report allows you to match the Eligibility Verification monthly invoice with the monthly transaction. This report is designed specifically for clients with a "per transaction" billing model. If you are currently being billed by the number of providers you have, this option is not designed for you. Modify Payer Listing Report Claim

Help Guide for NextGen® Enterprise PM 8

Open Claim Status Report from Reports Menu

Before you begin Submit a claim request for a encounter. In NextGen® Enterprise PM, select Reports > General > Claim Status. The Claim Status report opens. The Columns filter in the Configuration Options list opens by default. Select the columns that need to appear on the report and select Refresh Report. The Claim Status report opens displaying the following: Claim status response date and time. Statistical overview of the claims (accepted and rejected), billed amount, and paid amount. Collapsed view of the list of the claims whose status is requested for. Note: To view the details of the claim status, select and expand the desired claim. Parent topic: Claim Status

Help Guide for NextGen® Enterprise PM 8

Open Claim Status Report from Reports Menu

Before you begin Submit a claim request for a encounter. In NextGen® Enterprise PM, select Reports > General > Claim Status. The Claim Status report opens. The Columns filter in the Configuration Options list opens by default. Select the columns that need to appear on the report and select Refresh Report. The Claim Status report opens displaying the following: Claim status response date and time. Statistical overview of the claims (accepted and rejected), billed amount, and paid amount. Collapsed view of the list of the claims whose status is requested for. Note: To view the details of the claim status, select and expand the desired claim. Parent topic: Claim Status

Claim Request Reports

Recommendations

Claim Status Report

Claim Requests Report

Claim Requests Report

Reports

Open Claim Status Report from Reports Menu

Open Claim Status Report from Reports Menu

Claim Request Reports

Claim Status Report

Claim Requests Report

Claim Requests Report

Reports

Open Claim Status Report from Reports Menu

Open Claim Status Report from Reports Menu