Setting Up ERA

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

Help Guide for NextGen® Enterprise PM 8

Setting Up Payers for ERA

All payers from whom ERA 835 files will be received must be configured prior to importing the electronic files in NextGen® Enterprise PM. If there are multiple master files for the same payer (e.g. Aetna, Aetna HMO, Aetna PPO, etc.), the setup should be done to all master files for that payer. ERA Payer Number Cross-over Indicator Select All Lines for Bill to Next Insurance Create Zero Balance Claims to Subsequent Payers Set Up Default Transaction Codes for a Payer Set Up Default Transaction Codes for an Alternate Payer You can set up default transaction codes for an alternate payer in File Maintenance. Reason Code Library Remittance Profile Library Parent topic: Setting Up ERA

Help Guide for NextGen® Enterprise PM 8

Setting Up ERA

The ERA posting process requires the following set up in File Maintenance: Remittance Profile Library Reason Code Library Payers: Enter an ERA Payer Number Select a Remittance Profile Library for specific ERA payers, if applicable Select a Reason Codes Library for specific payers, if applicable Practice Preferences: Select a default Remittance Profile Library for all ERA payers Select a default Reason Codes Library for all payers Configure Patient Pay Import options, if applicable Set Up a Remittance Profile Library Setting Up Reason Codes for ERA You can use the Reason Codes Library to configure business rules to automate ERA transaction posting. Setting Up Payers for ERA You can define the various parameters in Payers Master File related to ERA. Setting Up Enterprise Preferences for ERA Setting Up Practice Preferences for ERA You can set preferences for all payers in the practice. Parent topic: Electronic Remittance Advice

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 - 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 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

Setting Up ERA

Recommendations

Set Up a Remittance Profile Library

Setting Up Payers for ERA

Setting Up ERA

Set Up the Remittance Profile - Default Tab

Set Up the Remittance Profile - Default Tab

Set Up a Remittance Profile Library

Set Up a Remittance Profile Library

Setting Up Payers for ERA

Setting Up ERA

Set Up the Remittance Profile - Default Tab

Set Up the Remittance Profile - Default Tab

Set Up a Remittance Profile Library