837 Electronic File Creation Window

Help Guide for NextGen® Enterprise PM 8

Electronic Send Report

When pending claims are processed and the 837 electronic file is created, the Electronic Send report automatically displays if the Report results check box on the 837 Electronic File Creation window is enabled. The report separates claims that were accepted from those that were rejected. In addition, you can use the drill-down arrow to double-click on information in the report, and the editable claim view displays. After the Electronic Send report displays you can click the filter button and further filter the report. Electronic Send Report Columns The claims related data is available on the Electronic Send report. Electronic Send Report - Filter 2 Parent topic: Processing Electronic Claims - 837 Files

Help Guide for NextGen® Enterprise PM 8

Application Setup for the 837 File

The structure of the 837 electronic file is important to understand because much of the information that is required in the 837 file must be set up in File Maintenance. The following areas of the application must be set up to support the creation of 837 electronic files: In File Maintenance Access... For more information refer to... Libraries Submitter Profiles File Maintenance Libraries Guide for NextGen® Enterprise PM Master Files Locations Payers Providers File Maintenance Master Files Guide for NextGen® Enterprise PM Practice Preferences File Maintenance Preferences Guide for NextGen® Enterprise PM Parent topic: Processing Electronic Claims - 837 Files

Help Guide for NextGen® Enterprise PM 8

Create an EDI File by Claim Type, CPT4 Code or Date

To create an EDI file by claim form, claim type, CPT4 code, or begin and end date, use this procedure. Select the EDI File toolbar button. The 837 Electronic File Creation window opens. Complete the following required fields: Submitter Profile Library Claim Form Send File Name Batch Type To further refine your search, enter data in the applicable fields. Enable any of the following check boxes to update claims, create a report, or send a test file: Update claim requests as processed Report results - to display the report after it is processed. Use test code in REF02 trans type segment Select Find. In the Pending Electronic Claims section select the claims to include in the EDI file. Select Process. The Electronic Send report generates and automatically displays when the Report Results check box is enabled. Parent topic: 837 Electronic File Creation Window

Help Guide for NextGen® Enterprise PM 8

Create an EDI File by Payer, Patient Name, Rendering Physician, Financial Class, or Location

Click the EDI File toolbar button. The 837 Electronic File Creation window opens. Complete the following required fields: Submitter Profile Library Claim Form Send File Name Batch Type Click the Advanced tab. To refine your search by payer, patient name, provider, financial class, or location, complete any of the following fields: Payer Last/First Name of the patient Rendering- select or search for the rendering provider Report Transmission Code Financial Class Location To search for claims by the primary, secondary, tertiary payer, or for ERA Posted Charges, enable the following check boxes: Primary Secondary Tertiary ERA Posted Charges Only Enable any of the following check boxes to update claims, automatically create a report, or send a test file: Update claim requests as processed Report results - to display the report after it is processed. Use test code in REF02 trans type segment Click Find. In the Pending Electronic Claims section select the claims to include in the EDI file. C

Help Guide for NextGen® Enterprise PM 8

Create an EDI File by Practice

Select the EDI File toolbar button. The 837 Electronic File Creation window opens. Complete the following required fields: Submitter Profile Library Claim Form Send File Name Batch Type Select the Practices tab. You can search for claims by a single practice, multiple practices, or all practices within your enterprise. To search for claims by single or multiple practices go to Step 5. To search for claims for All Practices in your enterprise go to Step 7. To search for pending claims associated with a single or multiple practices, select the open record icon. The Practices window opens. Select the Flashlight icon to search for practices. Move the applicable practices to the Included section. Select OK. To search for pending claims across all practices, enable the All Practices check box. Enable any of the following check boxes to update claims, create a report, or send a test file. Update claim requests as processed Report results - to display the report after it is processed. Use test

Help Guide for NextGen® Enterprise PM 8

837 Electronic File Creation - File Options and Pending Electronic Claims

The File Options and Pending Electronic Claims section of this window display on the General, Advanced, and Practices tab. File Options - you can identify the electronic file name, the batch type, create a report, create a test file, and update claim requests as they are processed. Pending Electronic Claims - This section displays the claims that match the search results entered on the General, Advanced, or Practices tab. You can select the claims to include in the electronic file. File Options Section This section of the window includes fields for identifying the file name and batch type. Also, you can run a report, update claim requests as processed, or create a test file. Use the following table to enter data in the fields in this section of the window. Menu Item Description Send Filename (required) To name the EDI file and the path to save the file, select the open folder icon . Browse to the desired location and then name the file. Batch Type (required Select the batch type. Prod

837 Electronic File Creation Window

File Options and Pending Electronic Claims Sections

General, Advanced, Practices, File Options, and Pending Electronic Claims

Recommendations

Electronic Send Report

Application Setup for the 837 File

Create an EDI File by Claim Type, CPT4 Code or Date

Create an EDI File by Payer, Patient Name, Rendering Physician, Financial Class, or Location

Create an EDI File by Practice

837 Electronic File Creation - File Options and Pending Electronic Claims

Electronic Send Report

Application Setup for the 837 File

Create an EDI File by Claim Type, CPT4 Code or Date

Create an EDI File by Payer, Patient Name, Rendering Physician, Financial Class, or Location

Create an EDI File by Practice

837 Electronic File Creation - File Options and Pending Electronic Claims