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Force Claims to Paper by ICD Code
You can select diagnoses that force the claim to paper for specific payers when associated with a SIM code.
To force claims to paper for specific ICD codes for a payer, perform the following steps:
From File Maintenance, access
Libraries
>
Service Items
.
The
Service Item Library Maintenance
window opens.
Enter the CPT4 code and then select
Payer
.
On the
Payer
tab, do the following:
Select a payer in the
Payer
field.
Enable the
Force to Paper
check box.
Select the
Open Record/Force to Paper ICDs
button.
The
Diagnosis Codes
window opens.
On the Diagnosis Codes window do the following:
Search for the ICD codes that you want to force to paper.
Use the blue arrow
to move the codes from the
Available
list to the
Included
list.
When a payer, with an ICD code set to force to paper, is included in a Service Item, a paper claim is generated for the charge that includes the SIM.
Force Claims to Paper by ICD Code
Help Guide for NextGen® Enterprise PM 8
Force the Secondary Claim to Bill to the Primary Claim Provider
When you are using Supervisor Billing for a provider and the patient has two payers, you can set the application to force the secondary claim to bill the payer for the same provider (the supervisor) that the primary claim bills for. You can set the option to force the secondary claim to bill the primary claim provider in the master file for the payer. In File Maintenance, select Master Files > Payers > Practice > Other. Enable the Force rendering provider from primary claim as rendering on secondary claim check box. Parent topic: Generating Secondary Electronic Claims
Help Guide for NextGen® Enterprise PM 8
Force Claims to Paper by ICD Code
You can select diagnoses that force the claim to paper for specific payers when associated with a SIM code. To force claims to paper for specific ICD codes for a payer, perform the following steps: From File Maintenance, access Libraries > Service Items. The Service Item Library Maintenance window opens. Enter the CPT4 code and then select Payer. On the Payer tab, do the following: Select a payer in the Payer field. Enable the Force to Paper check box. Select the Open Record/Force to Paper ICDs button. The Diagnosis Codes window opens. On the Diagnosis Codes window do the following: Search for the ICD codes that you want to force to paper. Use the blue arrow to move the codes from the Available list to the Included list. When a payer, with an ICD code set to force to paper, is included in a Service Item, a paper claim is generated for the charge that includes the SIM. Parent topic: Generating Secondary Electronic Claims
File Maintenance Help for NextGen® Enterprise 8
Force Service Items to Paper at the Payer Level
When you force a service item to paper at the payer level, a paper claim generates for that service item, even when the payer is set for electronic transmission. Open the Service Item library. The Service Item Library Maintenance window opens. In the Search list on the left, select the service item. The matching results are listed. Note: You can enter an asterisk (*) to see all the records. Select the applicable service item from the Search list. Select the Payer tab. In the Payer field, select the payer from the drop-down list, then select the Force to Paper check box. Parent topic: Forcing Service Items to a Paper Claim
File Maintenance Help for NextGen® Enterprise 8
Force Service Items to Paper at the Practice Level
When you force a service item to paper at the practice level, a paper claim generates for that service item, even when the payer is set for electronic transmission. Open the Service Item library. The Service Item Library Maintenance window opens. In the Search list on the left, begin typing the service item you want to search for. The matching results are listed. Note: You can enter an asterisk (*) to see all the records. Select on the applicable service item from the Search list. On the General tab, select the Force to Paper check box. Parent topic: Forcing Service Items to a Paper Claim
File Maintenance Help for NextGen® Enterprise 8
Forcing Service Items to a Paper Claim
In the Service Item Library Maintenance window, you can force specific service items to a paper claim when claims generate at the practice and payer levels. In addition, forcing specific service items to paper at either level overrides the claim Media Type set on the Add/Modify Payer Information window. Force Service Items to Paper at the Practice Level Force Service Items to Paper at the Payer Level Parent topic: General Tab
File Maintenance Help for NextGen® Enterprise
Set Up an Alternate Type of Service Codes Library
Open File Maintenance and then select Libraries > Type of Service. Select the open menu button and then select New. Enter a name for the new library in the Service Name field. Select the open menu button and then select New. The Add Type of Service Alternate window opens. Select a standard type of service from the list. Enter the applicable alternate type of service code for paper and electronic claims Note: When you enter alternate type of service codes for paper and electronic claim types, you must enter in both of these fields. For example, if a payer requires an alternate type of service code for paper claims, but they want the standard type of service code for electronic claims, then you must enter the alternate code in the ALT Paper field and the standard code in the ALT Electronic field. This is applicable if the payer requires an alternate code for electronic claims, but standard code for paper claims is required. If one of these fields is left blank, then the corresponding typ
