Set Up NDC Information for Electronic Claims

Help Guide for NextGen® Enterprise PM 8

Set Up NDC Information for Paper Claims

You must set up NDC options in the Claim Printing library to include the NDC information on a paper claim. The claim printing options for NDC are only available for CMS 1500. If selected, in the Claim Printing library, the CMS 1500 claim will print in the Times New Roman font. In File Maintenance, select Libraries > Claim Printing and then select the applicable library from the list. The Claim Printing Library window opens. In the 1500 Claims field, select CMS 1500 (2005) or CMS 1500 (2012) as applicable. Select the Common Rules tab. To print the National Drug Code in Box 19 of the 1500 claim form, select NDC Code, else Narrative for box [19] Reserved for Local Use. When this option is selected, the National Drug Code prints only in Box 19 of the 1500 claim form followed by the line number it is referencing. Note: If this option is enabled and the NDC information is not in the NDC library, then any existing charge narrative prints in Box 19. To print supplemental charge-related data fo

Help Guide for NextGen® Enterprise PM 8

NDC Setup for Paper and Electronic Claims

Some payers require NDC information on claims. The following options are available for including NDC information on a claim: Electronic or Paper Claims - You can add or update the National Drug Code, Basis of Measure, or Drug Unit Count data. Electronic Claims - You can add NDC information. To include the NDC information on a claim, you must: Complete all of the appropriate fields in the NDC library. Enable the NDC functionality in the Payers master file for electronic claims. Enable the NDC functionality in the Claim Printing library for paper claims. Set Up NDC Information for Paper Claims Set Up NDC Information for Electronic Claims Parent topic: NDC Library

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

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

File Maintenance Help for NextGen® Enterprise

Search for Payers Using Payer Number or NEIC Number

The Payers List window enables you to search for a payer. In File Maintenance, select Master Files > System > Payers. The Payers List window opens. Select the NEIC/Payer Number column header, and enter the payer number or NEIC number in the Payers List Search field. To view a payer, select the payer and select Enter. The Modify Payer Information window for the selected payer opens. Parent topic: Payers Master File

File Maintenance Help for NextGen® Enterprise 8

Search for Payers Using Payer Number or NEIC Number

The Payers List window enables you to search for a payer. In File Maintenance, select Master Files > System > Payers. The Payers List window opens. Select the NEIC/Payer Number column header, and enter the payer number or NEIC number in the Payers List Search field. To view a payer, select the payer and select Enter. The Modify Payer Information window for the selected payer opens. Parent topic: Payers Master File

Set Up NDC Information for Electronic Claims

Recommendations

Set Up NDC Information for Paper Claims

NDC Setup for Paper and Electronic Claims

Populate the Populate 2400 PS1 Purchase Service Segment

Populate the Populate 2400 PS1 Purchase Service Segment

Search for Payers Using Payer Number or NEIC Number

Search for Payers Using Payer Number or NEIC Number

Set Up NDC Information for Paper Claims

NDC Setup for Paper and Electronic Claims

Populate the Populate 2400 PS1 Purchase Service Segment

Populate the Populate 2400 PS1 Purchase Service Segment

Search for Payers Using Payer Number or NEIC Number

Search for Payers Using Payer Number or NEIC Number