Set Up the CSC (Consolidated Service Claim) Parameters in Remittance Profile
Note:
The
CSC Options
tab is available when a
Consolidate Services Claim
library is attached in
Practice Preferences
>
Libraries
.
Open
File Maintenance
.
Select
Libraries
>
Remittance Profiles
.
The
Remittance Profiles List
window opens.
Select and open a profile library.
The
Remittance Profile
window opens.
Select the
CSC Options
tab.
Make the desired settings for
CSC Options
.
For more information, see
Settings in CSC Options of Remittance Profile
.
Settings in CSC Options of Remittance Profile
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Set Up the CSC (Consolidated Service Claim) Parameters in Remittance Profile
Help Guide for NextGen® Enterprise PM 8
Settings in CSC Options of Remittance Profile
You can use the following list of options and descriptions to make settings on the CSC Options tab in your Remittance Profile. CSC Tab Options Option Description Consolidated Services Claim payment Posting Enable Posting to CSC Claims Enables matching logic for the following 835 segments during the ERA Posting process: REF*EA Segment REF01 (2100 level)-EA - Medical Record Identification Number identifies the CSC Claim from the superclaim_encounters table. REF*EA - the REF*6R line item control number is used to match to the service line(s) for ERA posting. REF*6R - is used for UB/837I posting of CSC and Non-CSC Claim payments. On the Default tab, in the Charge Matching Options, you must select Use Bundled Payment Processing for UB Claim to this segment. REF*EA - If not returned , the 2100 Service Lines REF6R is used to look for a match. REF6R - identifies a match to a CSC Claim, each payment’s line item is posted to the matching REF*6R. REF*EA and REF*6R - are missing, the normal Remitt
Help Guide for NextGen® Enterprise PM 8
Set Up the Remittance Profile - Default Tab
To set up the Default tab in a Remittance Profile library, do the following: Open File Maintenance. Select Libraries and then select Remittance Profiles. The Remittance Profiles List window opens. Open the profile library. The Remittance Profile window opens. Select the Default tab. Select settings for default options. For more information, see Default Tab - Options and Settings. When you're done setting options, select OK to save changes and close the window. Default Settings in Remittance Profile You can define the parameters in the Remittance Profile Library Default tab settings that are used for processing the ERA 835 file. Parent topic: Set Up a Remittance Profile Library
Help Guide for NextGen® Enterprise PM 8
Set Up the Remittance Profile - Reversals and Corrections Tab
The Reversals and Corrections tab in the Remittance Profile library is used to set options for handling the following types of ERA transactions: Reversals and Corrections Writing Off Balances resulting from Overpayments or Underpayments To set up the Reversals and Corrections tab in a Remittance Profile library, do the following: Open File Maintenance. Select Libraries, and then select Remittance Profiles. The Remittance Profiles List window opens. Open the profile library. The Remittance Profile window opens. Select the Reversals and Corrections tab. Select settings for reversal and correction options. For more information, see Reversals and Corrections Tab - Options and Settings. When you're done setting options, select OK to save changes and close the window. Settings for Reversals and Corrections in Remittance Profile Parent topic: Set Up a Remittance Profile Library
Help Guide for NextGen® Enterprise PM 8
Set Up the Remittance Profile - CSC Options Tab
The CSC Options tab in the Remittance Profile library is used to set options for handling ERA transactions for services that were combined for the same patient on the same day through the Consolidated Services Claim process. Note: The CSC Options tab is available when a Consolidate Services Claim library is attached in Practice Preferences > Libraries. To set up the CSC Options tab in a Remittance Profile library, do the following: Open File Maintenance. Select Libraries, and then select Remittance Profiles. The Remittance Profiles List window opens. Open the profile library. The Remittance Profile window opens. Select the CSC Options tab. Select settings for CSC options. When you're done setting options, select OK to save changes and close the window. CSC Options Tab - Options and Settings Parent topic: Set Up a Remittance Profile Library
File Maintenance Help for NextGen® Enterprise 8
Set Up the Remittance Profile - CSC Options Tab
The CSC Options tab in the Remittance Profile library is used to set options for handling ERA transactions for services that were combined for the same patient on the same day through the Consolidated Services Claim process. Note: The CSC Options tab is available when a Consolidate Services Claim library is attached in Practice Preferences > Libraries. To set up the CSC Options tab in a Remittance Profile library, do the following: Open File Maintenance. Select Libraries, and then select Remittance Profiles. The Remittance Profiles List window opens. Open the profile library. The Remittance Profile window opens. Select the CSC Options tab. Select settings for CSC options. When you're done setting options, select OK to save changes and close the window. CSC Options Tab - Options and Settings Parent topic: Remittance Profiles Library
Help Guide for NextGen® Enterprise PM 8
Set Up a Remittance Profile Library
The Remittance Profile Library defines various parameters and rules that are used when importing and processing ERA 835 files downloaded from payers into NextGen® Enterprise PM. The Default Remittance Profile library in File Maintenance is pre-installed in the application and includes a few recommended pre-set options. All remaining options are set based on your organizational preferences or in response to the payer’s ERA 835 file configuration. Practice Level vs. Payer Level Libraries A default Remittance Profile Library must be selected in Practice Preferences > Libraries. The default library is used for all ERA payers in the practice that do not have a specific library linked. A different Remittance Profile Library to be used for a specific payer/financial class can be linked on the Payer > Practice > Libraries sub-tab. This library overrides the default library in Practice Preferences for the payer/financial class. Any payers that do not have a Remittance Profile Library attached u
