Generating and Submitting Claims

Help Guide for NextGen® Enterprise PM 8

Open the Waystar Website from Claims Lookup

When you select the Waystar option in the External tab of the Practice Preference window, it will be available in the claims context menu. Open NextGen® Enterprise PM. Select Claims Lookup. The Claim Request Lookup window opens. In the Claim Requests section, right-click on a claim, and then select Waystar. The Waystar option is available only for electronic claims. If the claim form type is 1500 for the selected claim, the professional claims search page of the Waystar® Clearinghouse opens. If the claim form type is UB for the selected claim, the institutional claims page of the Waystar® Clearinghouse opens. Parent topic: Generating and Submitting Claims

Help Guide for NextGen® Enterprise PM 8

Search for Claim Requests

The Claim Request Lookup window enables you to search through the system for claims that match the search criteria. In NextGen® Enterprise PM, select Tasks > Lookup > Claims or select the Claims icon. The Claim Request Lookup window opens. To search for claims by request status, media type, claim type, or rendering physician, use the General tab. For more information about the fields in General tab, refer to General Search Criteria. To search for claims by supervising physician, claim number, or acknowledgment status, select the Advanced tab. For more information about the fields in Advanced tab, refer to Advanced Search Criteria. Select Find. The search results appear in the Claim Requests list. Double-click the claim in the Claim Requests list to access a claim request. Note: There is a green check mark in the Consolidated Service Claims (CSC) column for all the CSC candidate claims. CSC cannot be deleted. General Search Criteria You can search a claim by its status, media type, clai

Help Guide for NextGen® Enterprise PM 8

Preview and Print Paper Claims

The Claim Printing window enables you to bulk preview and print the paper claim forms. In NextGen® Enterprise PM, select File > Print Forms > Claims. The Claim Printing window opens. Select the preferred Print Format. Select the type of Form. Do one of the following: Select Preview to view the claim forms. Select OK to print the claim forms. Parent topic: Generating and Submitting Claims

Help Guide for NextGen® Enterprise PM 8

Generate Paper Claims

When UB claims are previewed or printed, a claim status header displays at the top of the claim. The claim header indicates the status of the claim, either pending or archived, and for claims that are archived the date they were processed also prints in the header. The claim status header only displays on claims that have already been processed (archived) or when a copy (not for submission) is previewed or printed. The Claim Maintenance window allows you to customize the claim header, insurance information, and additional claim details. Select on the following tabs to populate the fields that you want to display on a claim: View Claim Claim Header Insurance On the tool bar, select the Claims icon. The Claim Request Lookup window opens. To search for the claim request, enter the applicable search criteria. To view the claim, highlight the claim request row and double-click. The Claim Maintenance window opens with a preview of the populated claim form. On the Claim Maintenance tool bar,

Help Guide for NextGen® Enterprise PM 8

Generating Courtesy Claims

A courtesy claim is a claim that you, the provider, does not submit to a payer (because you are non-par with the patient’s contract) for charges related to services you have rendered on the patient. It is a claim that you generate, but do not send. Instead, you give it to the patient so they can submit it. The example in this section shows how a courtesy claim can be generated. This example assumes that some providers in your office are par with the contract and the services are to be billed. Set Up the Payer Master Set Up the Contract Library for Courtesy Claims Set Up Contract Exceptions for Courtesy Claims Entering a Courtesy Charge for a Claim Parent topic: Generating and Submitting Claims

Help Guide for NextGen® Enterprise PM 8

Generating and Submitting Claims

This section explains generating and submitting claims in general and under certain conditions. Search for Claim Requests You can search a claim request by the claim's status, type, physician, and service location, or by the first or last name of the patient through the Claim Request Lookup window. Generate Paper Claims Preview and Print Paper Claims You can bulk preview and print paper claims. Open the Waystar Website from Claims Lookup You can open the Waystar website through the claims lookup to submit a claim. Generating Courtesy Claims Parent topic: Claims

Generating and Submitting Claims

Recommendations

Open the Waystar Website from Claims Lookup

Search for Claim Requests

Preview and Print Paper Claims

Generate Paper Claims

Generating Courtesy Claims

Generating and Submitting Claims

Generating and Submitting Claims

Open the Waystar Website from Claims Lookup

Search for Claim Requests

Preview and Print Paper Claims

Generate Paper Claims

Generating Courtesy Claims

Generating and Submitting Claims