Search for Claim Requests

Help Guide for NextGen® Enterprise PM 8

General Search Criteria

Search Criteria Description Request Status Searches a claim by the status of a claim when you select one of the following options: Archived A displays all archived claims. Consolidated C displays all Consolidated Services Claims (CSC). Note: You cannot delete a CSC. Hold H displays all CSC Candidate Encounter Claims. Pending displays all pending claims. Media Type Searches a claim by claim media types when you select one of the following options: Electronic Paper Claim Form Searches a claim by claim form media types when you select either Electronic or Paper in the Media Type. When you select Electronic the following options appear in the Claim Form column: 1500 ADA UB Form 1 Template Pediatrics Form When you select Paper the following options appear in the Claim Form column: CMS 1500 ADA 2019 ADA 2024 CMS 1500 (2005) CMS 1500 (2012) UB04 UB92 Form 1 Template Pediatrics Form Claim Type Searches claim by one or more claim types from the list. Rendering Physician Searches claim by one or

Help Guide for NextGen® Enterprise PM 8

Advanced Search Criteria

Search Criteria Description Supervising Physician Search by supervising physician. Select the flashlight button to display the Provider Lookup window. Last Name, First Name Search by last name, first name, or both names of the patient associated with the claim. Service Location Search by the service location where the claim was originated. Claim Nbr Search by claim number. Claim Status Category Description Search by the Claim Status Category description. Acknowledgment Status Select the acknowledgment status you want to search by when you perform a claim request lookup. You can search for one of the following statuses: Accepted Accepted w/Errors Awaiting Ack N/A Rejected You can search by acknowledgment status only when the Request Status is set to Archived. Send Filename You can use this field to include an individual EDI file as additional search criteria when you search for archived claims. Select the open record button to locate the EDI file that you want to search on. Fully Capita

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. To search for claims by supervising physician, claim number, or acknowledgment status, select the Advanced tab. 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, claim type, or rendering physician through the General tab of the Claim Request Lookup window. Advanced Search Criteria 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 preview paper claims in bulk preview and print them. Open the Waystar Website from Claims Lookup You can open the Waystar website through the claims lookup to submit a claim. Generating Courtesy Claims

Help Guide for NextGen® Enterprise PM 8

Open Claim Status Report from Encounter Lookup

Before you begin Submit a claim request for the encounter. In NextGen® Enterprise PM, do one of the following to open the Encounter Lookup window: On the main toolbar, select Encounter. From the Tasks menu, select Lookup > Encounters. The Encounter Lookup window opens. Enter the search criteria to find the desired encounter and select Find. The Encounter List section displays the encounters matching the search criteria. Right-click the desired encounter and select Claims. Note: Alternatively, you can open the Encounter Claims Request window using one of the following methods. From the Patient Chart, on the Encounters tab, in the Encounters list, right-select the desired encounter and select Claims. Select Claims on the taskbar. From the Tasks menu, select Lookup > Claims The Encounter Claims Request window opens displaying the claim requests for the selected encounter. Right-click the desired claim request and select View Claim Status. The Claim Status report opens displaying the follo

Help Guide for NextGen® Enterprise PM 8

Open Claim Status Report from Encounter Lookup

Before you begin Submit a claim request for the encounter. In NextGen® Enterprise PM, do one of the following to open the Encounter Lookup window: On the main toolbar, select Encounter. From the Tasks menu, select Lookup > Encounters. The Encounter Lookup window opens. Enter the search criteria to find the desired encounter and select Find. The Encounter List section displays the encounters matching the search criteria. Right-click the desired encounter and select Claims. Note: Alternatively, you can open the Encounter Claims Request window using one of the following methods. From the Patient Chart, on the Encounters tab, in the Encounters list, right-select the desired encounter and select Claims. Select Claims on the taskbar. From the Tasks menu, select Lookup > Claims The Encounter Claims Request window opens displaying the claim requests for the selected encounter. Right-click the desired claim request and select View Claim Status. The Claim Status report opens displaying the follo

Search for Claim Requests

Recommendations

General Search Criteria

Advanced Search Criteria

Search for Claim Requests

Generating and Submitting Claims

Open Claim Status Report from Encounter Lookup

Open Claim Status Report from Encounter Lookup

General Search Criteria

Advanced Search Criteria

Search for Claim Requests

Generating and Submitting Claims

Open Claim Status Report from Encounter Lookup

Open Claim Status Report from Encounter Lookup