Set Up Claim Options

Help Guide for NextGen® Enterprise PM 8

Set Up Billing Options

Open File Maintenance. Select Libraries, and then select Behavioral Health Billing. The Behavioral Health Billing List window opens. From the list, double-click to open the library. The Behavioral Health Billing Library Maintenance window opens. Select Billing Options. Enter theBilling Options fields to set up the billing options for behavioral health billing. Select OK. Billing Options Field Descriptions The Billing Options is used to specify which Place of Service code and ICD codes should be used on claims when multiple Behavioral Health charges on an encounter have different codes. Parent topic: Add or Modify a Behavioral Health Billing Library

File Maintenance Help for NextGen® Enterprise

Set Up Claim Options

The Claim Options tab is used to configure specific parameters that affect claims for Behavioral Health charges. Options to always send unit count as 1 on claim charge lines, and to always send one line item per claim are available. On secondary and tertiary claims, charges can bill as the total sum of the roll-up charges, or as the total sum minus transactions posted from the prior payer. Also, secondary and tertiary claims can be billed as a primary claim depending on the prior payer. Open File Maintenance. Select Libraries, and then select Behavioral Health Billing. The Behavioral Health Billing List window opens. Double-click to open the library. The Behavioral Health Billing Library Maintenance window opens. Select Claim Options. Enter the Claim Options fields to set up the claim options for behavioral health billing. Select OK. Claim Options Field Descriptions You can set up claim options for behavioral health charges. Parent topic: Add or Modify a Behavioral Health Billing Libra

File Maintenance Help for NextGen® Enterprise 8

Set Up Claim Options

The Claim Options tab is used to configure specific parameters that affect claims for Behavioral Health charges. Options to always send unit count as 1 on claim charge lines, and to always send one line item per claim are available. On secondary and tertiary claims, charges can bill as the total sum of the roll-up charges, or as the total sum minus transactions posted from the prior payer. Also, secondary and tertiary claims can be billed as a primary claim depending on the prior payer. Open File Maintenance. Select Libraries, and then Behavioral Health Billing. The Behavioral Health Billing List window opens. Double-click to open the desired library. The Behavioral Health Billing Library Maintenance window opens. Select the Claim Options tab. Complete the fields to set up Claim Options. For more information on each field, see Claim Options Field Descriptions. To save changes and close the window, select OK. Claim Options Field Descriptions Parent topic: Behavioral Health Billing Libra

Help Guide for NextGen® Enterprise PM 8

Set Up Claim Options

The Claim Options tab is used to configure specific parameters that affect claims for Behavioral Health charges. Options to always send unit count as 1 on claim charge lines, and to always send one line item per claim are available. On secondary and tertiary claims, charges can bill as the total sum of the roll-up charges, or as the total sum minus transactions posted from the prior payer. Also, secondary and tertiary claims can be billed as a primary claim depending on the prior payer. Open File Maintenance. Select Libraries, and then Behavioral Health Billing. The Behavioral Health Billing List window opens. Double-click to open the desired library. The Behavioral Health Billing Library Maintenance window opens. Select the Claim Options tab. Behavioral Health Billing Library Maintenance window; Claim Options tab Complete the fields to set up Claim Options. For more information on each field, see Claim Options Field Descriptions. To save changes and close the window, select OK. Claim

Help Guide for NextGen® Enterprise PM 8

Add or Modify a Behavioral Health Billing Library

A single library can be created and linked to the practice to be used for all payers or a payer-specific libraries can be created and linked only to those payers. Open File Maintenance. Select Libraries, and then select Behavioral Health Billing. The Behavioral Health Billing List window opens. Do one of the following: To create a library, select Open Menu , and then select New. To modify a library, select the library from the list, and then select Open Menu and select Open. The Behavioral Health Billing Library Maintenance window opens. In Behavioral Health Billing Library, enter a name for the library. Enter the Charge Options, Claim Options, and Biling Options parameters. Select OK. You can generate the Behavioral Health Billing report from the Behavioral Health Billing library , go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM. Set Up Charge Options You can set up charge options to configure a variance SIM code to be u

Help Guide for NextGen® Enterprise PM 8

Claim Options Field Descriptions

Use the following table to setup claim options. Field Description Force Claim Break when Place of Service is Selects one or more Place of Service codes that cause charges with the selected POS to break for a separate claim. Always send unit count as 1 on claim charge lines If this field is enabled, claim edit #273 CPT4(s) cannot be in excess of a particular number of units should be disabled in File Maintenance > Libraries > Claim Edits. Always send one line item per claim You can select this option if claims should only include 1 line item. If an encounter has three charges. Two of the charges roll-up and the third charge is not part of the roll-up. If you select this option, two claims will be created for the encounter, each with 1 line item. Secondary Claims Roll-up lines view Manages the billing options for the roll-up charge amount on secondary claims. Sum of roll-up less prior payer transactions: Sends the charge amount on claims for the secondary payer as the sum of the roll-up

Set Up Claim Options

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Set Up Billing Options

Set Up Claim Options

Set Up Claim Options

Set Up Claim Options

Add or Modify a Behavioral Health Billing Library

Claim Options Field Descriptions

Set Up Billing Options

Set Up Claim Options

Set Up Claim Options

Set Up Claim Options

Add or Modify a Behavioral Health Billing Library

Claim Options Field Descriptions