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Processing Electronic Claims - 837 Files
This section explains how electronic claims (837 files) are processed.
The basic steps include:
Select the
EDI
file icon.
The
837 Electronic File Creation
window opens.
Select a
Submitter Profile
library.
Select options applicable to the types of claims that you want to send electronically.
Select the
Process
button.
Electronic Claims File Structure
Control Segments
Application Setup for the 837 File
837 Electronic File Creation Window
Electronic Send Report
Set Up Automatic Task Completion for Clean Claims
Processing Electronic Claims - 837 Files
Help Guide for NextGen® Enterprise PM 8
Processing Electronic Claims - 837 Files
This section explains how electronic claims (837 files) are processed. The basic steps include: Select the EDI file button. The 837 Electronic File Creation window opens. Select a Submitter Profile library. Select options applicable to the types of claims that you want to send electronically. Select the Process button. Electronic Claims File Structure Control Segments Application Setup for the 837 File 837 Electronic File Creation Window Electronic Send Report Set Up Automatic Task Completion for Clean Claims Submitting Electronic Claims Archiving and Retrieving 837 Electronic Files Tracking Records of Reprinted Archived Claims Parent topic: Claims Processing
Help Guide for NextGen® Enterprise PM 8
837 Electronic File Creation Window
Use the 837 Electronic File Creation window to identify search criteria for claims that you want to send in an electronic file. This window has the following tabs: General, Advanced, and Practices. Each tab contains the File Options and Electronic Claims sections. File Options and Pending Electronic Claims Sections These sections display on each of the tabs for the 837 Electronic File Creation window. File Options - you can select the file for data transfer, identify the batch type, create a report, update claim requests, and send a test file. Pending Electronic Claims - displays the claims that match the search criteria on the active tab. General, Advanced, Practices, File Options, and Pending Electronic Claims Refer to the following topics for information about the fields on this window: 837 Electronic File Creation - General Tab 837 Electronic File Creation - Advanced Tab 837 Electronic File Creation Window Practices Tab 837 Electronic File Creation - File Options and Pending Electr
Help Guide for NextGen® Enterprise PM 8
Electronic Send Report
When pending claims are processed and the 837 electronic file is created, the Electronic Send report automatically displays if the Report results check box on the 837 Electronic File Creation window is enabled. The report separates claims that were accepted from those that were rejected. In addition, you can use the drill-down arrow to double-click on information in the report, and the editable claim view displays. After the Electronic Send report displays you can click the filter button and further filter the report. Electronic Send Report Columns The claims related data is available on the Electronic Send report. Electronic Send Report - Filter 2 Parent topic: Processing Electronic Claims - 837 Files
Help Guide for NextGen® Enterprise PM 8
837 Electronic File Creation Window
Use the 837 Electronic File Creation window to identify search criteria for claims that you want to send in an electronic file. This window has the following tabs: General, Advanced, and Practices. Each tab contains the File Options and Electronic Claims sections. File Options and Pending Electronic Claims Sections These sections display on each of the tabs for the 837 Electronic File Creation window. File Options - you can select the file for data transfer, identify the batch type, create a report, update claim requests, and send a test file. Pending Electronic Claims - displays the claims that match the search criteria on the active tab. General, Advanced, Practices, File Options, and Pending Electronic Claims Refer to the following topics for information about the fields on this window: 837 Electronic File Creation - General Tab 837 Electronic File Creation - Advanced Tab 837 Electronic File Creation Window Practices Tab 837 Electronic File Creation - File Options and Pending Electr
Help Guide for NextGen® Enterprise PM 8
Create an EDI File by Claim Type, CPT4 Code or Date
To create an EDI file by claim form, claim type, CPT4 code, or begin and end date, use this procedure. Select the EDI File toolbar button. The 837 Electronic File Creation window opens. Complete the following required fields: Submitter Profile Library Claim Form Send File Name Batch Type To further refine your search, enter data in the applicable fields. Enable any of the following check boxes to update claims, create a report, or send a test file: Update claim requests as processed Report results - to display the report after it is processed. Use test code in REF02 trans type segment Select Find. In the Pending Electronic Claims section select the claims to include in the EDI file. Select Process. The Electronic Send report generates and automatically displays when the Report Results check box is enabled. Parent topic: 837 Electronic File Creation Window
Help Guide for NextGen® Enterprise PM 8
Create an EDI File by Claim Type, CPT4 Code or Date
To create an EDI file by claim form, claim type, CPT4 code, or begin and end date, use this procedure. Select the EDI File toolbar button. The 837 Electronic File Creation window opens. Complete the following required fields: Submitter Profile Library Claim Form Send File Name Batch Type To further refine your search, enter data in the applicable fields. Enable any of the following check boxes to update claims, create a report, or send a test file: Update claim requests as processed Report results - to display the report after it is processed. Use test code in REF02 trans type segment Select Find. In the Pending Electronic Claims section select the claims to include in the EDI file. Select Process. The Electronic Send report generates and automatically displays when the Report Results check box is enabled. Parent topic: 837 Electronic File Creation Window
