Default Library Selection

Help Guide for NextGen® Enterprise PM 8

Claim Modifiers Library

The Claim Modifiers library can be used by practices when the modifier usage differs from payer to payer. During charge posting, add units to a charge when a specific modifier is entered on the charge for specific SIM types. During the billing process, add a modifier to the claim if the modifier was not entered on the charge. During the billing process, remove a modifier from the claim if the modifier was entered on the charge. Note: For a claim modifier to be applied, the charge service date must fall within the effective date and expiration date defined for the modifier, and the charge must meet all Modifier Change for Claims criteria defined for the modifier. The practice-level default Claim Modifiers library selected in Practice Preferences > Libraries is used for all payers. A payer-level library selected in the Libraries sub-tab under the Practice tab in the Payers master file overrides the practice-level library for that payer. You can generate Claim Modifiers report from the Cl

Help Guide for NextGen® Enterprise PM 8

Behavioral Health Billing Library

The Behavioral Health Billing library defines parameters for “variance” charges which can be calculated and added to encounters during the billing process for specific payers. The library also defines other claim and billing parameters that may be needed when billing Behavioral Health services to specific payers. A single library can be created and linked to the practice to be used for all payers. Or payer-specific libraries can be created and linked only to those payers. You can generate the Behavioral Health Billing report from the Behavioral Health Billing library , go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM. Add or Modify a Behavioral Health Billing Library The Behavioral Health Billing library defines parameters for variance charges and other claim and billing parameters which can be calculated and added to encounters during the billing process for specific payers. Parent topic: Behavioral Health Billing

Help Guide for NextGen® Enterprise PM 8

Default Library Selection

A Behavioral Health Billing Library, Claim Modifiers Library, and Claim Edits Library can be selected at the practice-level to be used for all payers, or at the payer-level to be used for specific payers only. A Non-Coordinated SIM Library can be selected at the practice-level only. Note: A payer-level library overrides the practice-level default library. Select a Default Library for a Practice Select a Default Library for a Payer Parent topic: Behavioral Health Billing

Help Guide for NextGen® Enterprise PM 8

Select a Default Library for a Practice

A default library selected at the practice-level is used for all payers in the practice. Access NextGen® Enterprise PM. From the Admin menu, select Preferences, and then Practice. The Practice Preferences window opens. In the Preference List on the left, select Libraries. In the Behavioral Health Billing Library field, select the default library to be used for the practice. In the Non-Coordinated SIM Library field, select the default library to be used for the practice. Note: To utilize the Non-Coordinated SIM functionality, a library must be selected for the practice. In the Claim Modifiers Library field, select the default library to be used for the practice. In the Claim Edits Library field, select the default library to be used for the practice. To save changes and close the window, select OK. Parent topic: Default Library Selection

Help Guide for NextGen® Enterprise PM 8

Select a Default Library for a Payer

A library selected at the payer-level overrides the default library selected at the practice-level. Access File Maintenance. Select System Master Files, then PM, and then Payers. The Payer List window opens. Select to open the desired payer. The Modify Payer Information window opens. Select the Practice tab, and then the Libraries sub-tab. In the Behavioral Health Billing Library field, select the library to be used for the payer. In the Modifiers Library field, select the library to be used for the payer. In the Claim Edit Library field, select the library to be used for the payer. To save changes and close the window, select OK. Parent topic: Default Library Selection

Help Guide for NextGen® Enterprise PM 8

Select a Default Library for a Practice

A default library selected at the practice-level is used for all payers in the practice. Access NextGen® Enterprise PM. From the Admin menu, select Preferences, and then Practice. The Practice Preferences window opens. In the Preference List on the left, select Libraries. Practice Preferences window > Libraries tab In the Behavioral Health Billing Library field, select the default library to be used for the practice. In the Non-Coordinated SIM Library field, select the default library to be used for the practice. Note: To utilize the Non-Coordinated SIM functionality, a library must be selected for the practice. In the Claim Modifiers Library field, select the default library to be used for the practice. In the Claim Edits Library field, select the default library to be used for the practice. To save changes and close the window, select OK. Parent topic: Default Library Selection

Default Library Selection

Recommendations

Claim Modifiers Library

Behavioral Health Billing Library

Default Library Selection

Select a Default Library for a Practice

Select a Default Library for a Payer

Select a Default Library for a Practice

Default Library Selection

Claim Modifiers Library

Behavioral Health Billing Library

Default Library Selection

Select a Default Library for a Practice

Select a Default Library for a Payer

Select a Default Library for a Practice