Set Up Payer-Specific Requirements

Help Guide for NextGen® Enterprise PM 8

Service Items Library for Dental Billing

When setting up SIM codes for dental, set the Form field on the Service Item Library Maintenance window to ADA. Service Library Maintenance Set Up Payer-Specific Requirements Parent topic: Dental Billing

Help Guide for NextGen® Enterprise PM 8

Set Up Payer-Specific Requirements

Not all payers require an ADA claim form. Some payers may require a 1500 form. To set up a SIM code to use 1500 forms for a payer, do the following: From the Service Item Library Maintenance window, select the applicable service item. Select the Payer tab. Payer In the Payer field, select the payer. In the Eff and Exp columns, enter the effective and expiration dates for the SIM code/payer. In the Form column, select 1500. To save changes and close the window, select OK. Parent topic: Service Items Library for Dental Billing

File Maintenance Help for NextGen® Enterprise 8

Set Up a Dental and Medical SIM

Service Items can be set up and billed as dental or medical SIMs. They must be set up at the Payer level in the Service Item Library. Open a SIM in a Service Item Library. Select the General tab. Ensure that 1500 or UB is selected in the Form drop-down list. Select the Payer tab. Select the applicable dental payer from the Payer drop-down list. You must designate this payer as a dental payer on the Payer tab of the Service Item Library Maintenance window. See Payer tab for more information. In the table, enter the applicable effective and expiration dates in the Eff and Exp fields. Select ADA from the Form drop-down list. Enter any additional information that is applicable. Select OK. Parent topic: Dental SIMs

File Maintenance Help for NextGen® Enterprise 8

Set Up a SIM Used as an Anesthesia and a Dental SIM

Service items can be set up and billed as anesthesia or dental SIM. They must be set up at the Payer level in the Service Item Library. Open a SIM in a Service Item Library. Select the General tab. Ensure that 1500 or UB is selected in the Form drop-down list. Enter the applicable base units, up to four digits, in the Base Unit field. Note: One base unit is equal to either 10 or 15 minutes depending on the Anesthesia Minutes Per Unit setting on the Payer Defaults - 2 tab of the Payer master file. Check the Anesthesia SIM check box and then select the Payer tab. Select the applicable dental payer from the Payer drop-down list. You must designate this payer as a dental payer on the Payer tab of the Service Item Library Maintenance window. See Payer tab for more information. Enter the applicable effective and expiration dates in the Eff and Exp fields. Select ADA from the Form drop-down list. Enter any additional information that is applicable. Select OK. Parent topic: Dental SIMs

Help Guide for NextGen® Enterprise PM 8

Service Items Library for Dental Billing

When setting up SIM codes for dental, set the Form field on the Service Item Library Maintenance window to ADA. Service Library Maintenance Set Up Payer-Specific Requirements Parent topic: Dental Billing

File Maintenance Help for NextGen® Enterprise 8

Set Up ADA SIMs

Service items that are only used as Dental SIMs are designated as a Dental SIM by selecting ADA from the Form drop-down list on the General tab of the Service Item Library Maintenance window for that SIM. Service items designated as Dental SIMs can only be billed on an ADA Dental claim or as patient responsibility; they do not populate an 1500/837 Professional or UB/837 Institutional form. Open a SIM in a Service Item Library. In the File Maintenance window, select the General tab. Select ADA from the Form drop-down list. Select OK. Parent topic: Dental SIMs

Set Up Payer-Specific Requirements

Recommendations

Service Items Library for Dental Billing

Set Up Payer-Specific Requirements

Set Up a Dental and Medical SIM

Set Up a SIM Used as an Anesthesia and a Dental SIM

Service Items Library for Dental Billing

Set Up ADA SIMs

Set Up Payer-Specific Requirements

Service Items Library for Dental Billing

Set Up Payer-Specific Requirements

Set Up a Dental and Medical SIM

Set Up a SIM Used as an Anesthesia and a Dental SIM

Service Items Library for Dental Billing

Set Up ADA SIMs