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Set Up CCI Edits
In File Maintenance, select
Libraries
>
Claim Edits
>
Claim Edits Libraries
.
Select the applicable claim edit library.
The
Claim Edit Library Maintenance
window appears.
Check
the appropriate CCI bundling edits as needed. You can set the CCI bundling edits with a severity level based on business practices.
Select
System
>
Payers
, and then select the applicable payer.
The
Modify Payer Information
window appears.
Select the
Practice
tab, and then the
Libraries
tab on the bottom of the window.
Attach the claim edit library to the payer by selecting a library in the
Claim Edit Library
field.
Select
OK
.
Bundling CCI Edits
CCI Bundling Anesthesia Edits
CCI Bundling Lab Edits
Set Up CCI Edits
Help Guide for NextGen® Enterprise PM 8
Select Mutually Exclusive Edits in the Claim Edit Library
Check √ the appropriate CCI Mutually Exclusive edits as needed. You can set the CCI Mutually Exclusive edits with a Severity level based on business practices. Mutually Exclusive Edit Example Parent topic: CCI Edits
Help Guide for NextGen® Enterprise PM 8
Set Up CCI Edits
In File Maintenance, select Libraries > Claim Edits > Claim Edits Libraries. Select the applicable claim edit library. The Claim Edit Library Maintenance window appears. Check the appropriate CCI bundling edits as needed. You can set the CCI bundling edits with a severity level based on business practices. Select System > Payers, and then select the applicable payer. The Modify Payer Information window appears. Select the Practice tab, and then the Libraries tab on the bottom of the window. Attach the claim edit library to the payer by selecting a library in the Claim Edit Library field. Select OK. Bundling CCI Edits CCI Bundling Anesthesia Edits CCI Bundling Lab Edits Parent topic: CCI Edits
File Maintenance Help for NextGen® Enterprise
Set Up the Claim Edits Library
In File Maintenance, select Libraries, and then select Claim Edits. The Claim Edits List window opens. Select Open Menu, and then select New. The Claim Edit Library Maintenance window opens. In Claim Edit Library, enter the name of the library. In Default Severity, select a severity level to be used as the default value for new claim edits. The severity of the new claim edit matches your selection in the Default Severity field. The severity level can be manually changed for the edit. The new field does not apply to edits that are already enabled. Note: Do not use the Quick Start field on the Claim Edit Library Maintenance window to avoid incorrect results. Parent topic: Claim Edits Library
Help Guide for NextGen® Enterprise PM 8
Set Up the Claim Edits Library
In File Maintenance, select Libraries, and then select Claim Edits. The Claim Edits List window opens. Select Open Menu, and then select New. The Claim Edit Library Maintenance window opens. In Claim Edit Library, enter the name of the library. In Default Severity, select a severity level to be used as the default value for new claim edits. The severity of the new claim edit matches your selection in the Default Severity field. The severity level can be manually changed for the edit. The new field does not apply to edits that are already enabled. Note: Do not use the Quick Start field on the Claim Edit Library Maintenance window to avoid incorrect results. Parent topic: Claim Edits Library
Help Guide for NextGen® Enterprise PM 8
Claim Edits Library
Claim edits are a set of conditions that must be (or are suggested to be) met when you generate a claim. For example, is the patient's zip code required in the claim? Must the referring physician's first name appear on the claim? These are the kinds of requirements you can set up to control the information that appears in the claims you generate. The Claim Edits Libraries enable you to select the claim edits to run when billing encounters and generating claims. A default Claim Edits Library must be created and attached at the Practice Preferences level before you can bill encounters and generate claims. After, a default library is created and attached at the Practice Preferences level, you can then create payer-specific Claim Edits Libraries and attach them at the Payer Master level. These payer-specific claim edits libraries override the default Claim Edits Library. The application maintains a list of available claim edits in the Claim Edits Library, which you can access within File M
File Maintenance Help for NextGen® Enterprise 8
Claim Edits Library
Claim edits are a set of conditions that must be (or are suggested to be) met when you generate a claim. For example, is the patient's zip code required in the claim? Must the referring physician's first name appear on the claim? These are the kinds of requirements you can set up to control the information that appears in the claims you generate. The Claim Edits Libraries enable you to select the claim edits to run when billing encounters and generating claims. A default Claim Edits Library must be created and attached at the Practice Preferences level before you can bill encounters and generate claims. After, a default library is created and attached at the Practice Preferences level, you can then create payer-specific Claim Edits Libraries and attach them at the Payer Master level. These payer-specific claim edits libraries override the default Claim Edits Library. The application maintains a list of available claim edits in the Claim Edits Library, which you can access within File M
