Populate the Populate 2400 PS1 Purchase Service Segment

Help Guide for NextGen® Enterprise PM 8

Co-Pays Tab

Because co-payments can vary among different departments and services, you can create multiple co-payments. When you enable multiple co-pays, co-pay settings display in the Payers master file in File Maintenance and in Insurance Maintenance in NextGen® Enterprise PM. The co-pay information created in the payers master file becomes the default for all insurance. However, you can change the co-pay settings when you modify insurance in NextGen® Enterprise PM. To enable multiple co-pays: On the General tab of the Enterprise Preferences window, select the Enable Multiple Co-Pays check box. Note: If you enable this option but no co-pays exist in the Payers master file, users can still add specialty co-pays in Insurance Maintenance. To create multiple co-pay information: Select Co-Pays tab on Modify Payer Information window in the Payers master file . Note: The tab displays only when multiple co-pays is enabled in Enterprise Preferences. The tab displays co-pay information that is used in Ins

Help Guide for NextGen® Enterprise PM 8

Populate the Populate 2400 PS1 Purchase Service Segment

The Enable PS1 Segment for Electronic Claims option on the Payer Defaults 2 tab of the Modify Payer Information window enables you to populate the Purchase Service Amount in the 2400 loop/PS1 segment for electronic claims. Open File Maintenance, select Master Files > Payers, and select the applicable payer. On the Modify Payer Information window, select the System > Claims-2. Enable the Populate 2400 PS1 purchase service segment check box. Select OK. Parent topic: Payers Master File

Help Guide for NextGen® Enterprise PM 8

Add or Modify a Payer

From the Master Files - System list, select Payers. The Payers List window opens. To add a payer, select open menu , and then select New. The Add Payer Information window opens. Enter all the required information under the following tabs: Payer Defaults - 1 Defaults - 2 System Practice Alt Payer External Co-Pays Select OK to save the changes. To modify a payer, select the payer from the list, select open menu , and then select Open. The Modify Payer Information window opens. Do the required changes and then select OK. Parent topic: Payers Master File

Help Guide for NextGen® Enterprise PM 8

Enable Segments for Claim-level Approved Amounts and Adjustments

The Submitter Profile library and the Payer master file both have settings that add the claim-level allowed amount segment and the claim-level adjustment segment to the electronic claim file. Because the settings work independently of each other, you can enable them at either level. However, if the same option is enabled at both levels, the Payer master file setting always overrides the Submitter Profile library setting. The following table shows the various results according to how the submitter profile and payer-level options are set: If the Submitter Profile setting is... And the payer-level setting is set to... Then the segment will... Enabled <none> (blank) Create Enabled Create Disabled Not create Disabled <none> (blank) Not create Enabled Create Disabled Not create Do one of the following: To set the options at the Submitter Profile level: In File Maintenance, select Libraries > Submitter Profiles. Open a submitter profile, and then select the Exception Options tab. Select in th

Help Guide for NextGen® Enterprise PM 8

Enable Segments for Claim-level Approved Amounts and Adjustments

The Submitter Profile library and the Payer master file both have settings that add the claim-level allowed amount segment and the claim-level adjustment segment to the electronic claim file. Because the settings work independently of each other, you can enable them at either level. However, if the same option is enabled at both levels, the Payer master file setting always overrides the Submitter Profile library setting. The following table shows the various results according to how the submitter profile and payer-level options are set: If the Submitter Profile setting is... And the payer-level setting is set to... Then the segment will... Enabled <none> (blank) Create Enabled Create Disabled Not create Disabled <none> (blank) Not create Enabled Create Disabled Not create Do one of the following: To set the options at the Submitter Profile level: In File Maintenance, select Libraries > Submitter Profiles. Open a submitter profile, and then select the Exception Options tab. Select in th

Help Guide for NextGen® Enterprise PM 8

Set Up NDC Information for Electronic Claims

You must set up NDC options in the Payers master file to include the NDC information on the electronic claim. In File Maintenance, select Master Files - System > Payers and then select the applicable payer from the list.The Modify Payer Information window opens. Select the Claims-2 tab under the System tab. Select the following check boxes: Enable NDC coding for electronic claims- Select this option to include NDC information on the electronic claim. When checked, this option populates the 2410 LIN segment. Populate 2410 CTP segment- Select this option to populate the 2410 CTP segment. Select OK. Parent topic: NDC Setup for Paper and Electronic Claims

Populate the Populate 2400 PS1 Purchase Service Segment

Recommendations

Co-Pays Tab

Populate the Populate 2400 PS1 Purchase Service Segment

Add or Modify a Payer

Enable Segments for Claim-level Approved Amounts and Adjustments

Enable Segments for Claim-level Approved Amounts and Adjustments

Set Up NDC Information for Electronic Claims

Populate the Populate 2400 PS1 Purchase Service Segment

Co-Pays Tab

Populate the Populate 2400 PS1 Purchase Service Segment

Add or Modify a Payer

Enable Segments for Claim-level Approved Amounts and Adjustments

Enable Segments for Claim-level Approved Amounts and Adjustments

Set Up NDC Information for Electronic Claims