Consolidated Service Claims are sent in an EDI file in the X12 837 standard format and includes the following criteria:
- The header data is populated from the header claim.
- A header claim can be automatically or manually identified to consolidate all claim details by doing the following:
- Manually identify a header claim - In NextGen® Enterprise PM access the Encounter Maintenance window, and then click tab. In the Primary Responsible Attending field select Responsible Attending.
- Automatically identify a header claim - In File Maintenance access the Consolidated Services Claim library. On the Attending Specialty Hierarchy window, you can identify the Attending Specialty Hierarchy.
- Claims in the status of Copy of, Hold, and Consolidated are viewable.
- Charges are in the same order as in the original claim.
- Non-covered services are not included in the claim data.
