Create a Consolidated Services Claim

Help Guide for NextGen® Enterprise PM 8

Consolidated Services Claim

The claims services consolidation process is activated from the Claim Request Lookup window. The user will select the applicable claims to consolidate and then the application automatically consolidates the candidate claims into a Consolidated Services Claim (CSC). This process produces a Consolidated Services Claim report and alerts the user to any further actions that need to be taken before a CSC claim can be created. Note: The Consolidate Same Day Claims option is active when a CSC library is selected on the Practice Preferences Library window. Only claims with a Hold status can be consolidated by the CSC process. Parent topic: Consolidated Service Claims

Help Guide for NextGen® Enterprise PM 8

Consolidate Claims by Time Span

The CSC process is initiated on the Claims Request Lookup window. You can search for claims on a time-span of daily, weekly, monthly, or case. This process provides a clear visual of all of the HOLD claims that can be processed when the CSC process is initiated. You can sort the encounters by clicking on the TS (time-span) column. From the menu, click Tasks > Lookup > Claims or click the Claims icon. The Claim Request Lookup window opens. In the Request Status field, select Hold H. The Consolidated Services Claim Time Span field becomes active. In the Consolidated Services Claim Time Span field select one of the following options: <none> - to display all Hold claims. Consolidate Same Day Claims - to display all encounters that occurred on the same date. Consolidate Weekly Claims - to display all encounters during the same week. The week as defined in the CSC library, either Sunday through Saturday or Monday through Sunday. Consolidate Monthly Claims - to display all encounters for the

Help Guide for NextGen® Enterprise PM 8

Create a Consolidated Services Claim

Open the Claim Request Lookup window. In the Request Status field select HOLD - H. Set any additional search criteria on the General tab. Select Find. The filtered claim data displays in the Claim Requests section of the window. Claim Request Lookup To select the claims for consolidation, enable the check box. Right-click and select Consolidate Same Day Claims. Consolidated Services Claim Report The Consolidated Services Claim report opens. Consolidated Services Claim Report The alerts may appear when you try to close the Consolidated Services Claim report. Alert Messages Parent topic: Consolidated Service Claims

Help Guide for NextGen® Enterprise PM 8

Consolidated Services Claim Library

The Consolidated Services Claim (CSC) library enables you to establish rules for consolidating multiple encounter charges into a single consolidated services claim (CSC). The purpose of this library is to configure billing and claim form type rules for payers. This section includes the following topics: Security rights for user groups Consolidated Services Claim library CSC configuration rules for the consolidation of daily, weekly, monthly, and case related claims Provider hierarchy for claim headers Bill for eligible patient days You can generate the Consolidated Services Claim Library Listing report and the CSC Library with Timespan Details report from the Consolidated Services Claim library. For more information go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM. Set Up Security Access Rights for Consolidated Services Claims The Consolidated Services Claims security rights must be assigned to a user's group for combining

Help Guide for NextGen® Enterprise PM 8

Run the Consolidation Same Day Claims Process

You activate this process from the Claims Request Lookup window. On the Claims Request Lookup window, in the Request Status field select Hold. Note: When Hold is not selected in the Request Status field, the Consolidate Same Day Claims option is not available on the right-click menu. Set the applicable search criteria on the Claim Request Lookup window and select the Find button. The Claim Requests list box displays with the claims that meet the search criteria. A green check mark in the CSC column indicates a consolidated service claim. Select the same day of service claims that you want to consolidate. Right-click and select Consolidate Same Day Claims. Parent topic: Generating Secondary Electronic Claims

Help Guide for NextGen® Enterprise PM 8

Run the Consolidation Same Day Claims Process

You activate this process from the Claims Request Lookup window. On the Claims Request Lookup window, in the Request Status field select Hold. Note: When Hold is not selected in the Request Status field, the Consolidate Same Day Claims option is not available on the right-click menu. Set the applicable search criteria on the Claim Request Lookup window and select the Find button. The Claim Requests list box displays with the claims that meet the search criteria. A green check mark in the CSC column indicates a consolidated service claim. Select the same day of service claims that you want to consolidate. Right-click and select Consolidate Same Day Claims. Parent topic: Generating Secondary Electronic Claims

Create a Consolidated Services Claim

Recommendations

Consolidated Services Claim

Consolidate Claims by Time Span

Create a Consolidated Services Claim

Consolidated Services Claim Library

Run the Consolidation Same Day Claims Process

Run the Consolidation Same Day Claims Process

Consolidated Services Claim

Consolidate Claims by Time Span

Create a Consolidated Services Claim

Consolidated Services Claim Library

Run the Consolidation Same Day Claims Process

Run the Consolidation Same Day Claims Process