Would anyone happen to know how to submit a corrected claim via NextGen? Specifically, a 1500? I have found how to make sure the Payer File is set up to handle resubmission #s and orig ICN on rebilled claims, but, I cannot figure out how to get the actual encounter/claim to reflect the resubmission #.
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Wiki PLEASE HELP: Need guidance on submitting an electronic corrected claim (1500 - PB) out of NextGen PM
- Thread starter cosmogirl1308@gmail.com
- Start date
trarut
True Blue
Hi, there. I just saw and responded to the other thread where you asked this so pasting that response here too:
Did you check that your Claim Print Library is correctly set up? Check which Library is attached to the Payer then open that Library. Scroll down under the 1500 header to find the lines for claim Box 22. Are those set up for the resub numbers?
Did you check that your Claim Print Library is correctly set up? Check which Library is attached to the Payer then open that Library. Scroll down under the 1500 header to find the lines for claim Box 22. Are those set up for the resub numbers?
YOU ARE AN ANGEL!! Thank you so much. Will check this.Hi, there. I just saw and responded to the other thread where you asked this so pasting that response here too:
Did you check that your Claim Print Library is correctly set up? Check which Library is attached to the Payer then open that Library. Scroll down under the 1500 header to find the lines for claim Box 22. Are those set up for the resub numbers?
trarut
True Blue
No problem at all. Hope it helps.
While I have you
Any recommendations on how to fix auto-adjustments? I am stumped trying to assist a client. I have scrubbed each adj code individually to make sure the "write off remaining balance" is unchecked, and I have also checked the remittance advice library to make sure auto-adj is turned off. Yet, they are indicating they are still experiencing the issue. I have asked them for a specific encounter that I can review to ensure it's not maybe tied to a specific payer (or, perhaps, even user-error). Is this something you have dealt with before? (sorry to bother you again).trarut
True Blue
Haha! No bother, answering questions gives me a break from writing SOPs
In the Reason Code Library, there's a Skip Adjustment Code setting that should be set to "Skip ERA Adjustment" for any reason code that you don't want to write off. For instance, we have CO-96 set to skip the ERA adjustment with a Transaction Detail Status of None so that it doesn't automatically move the balance to the next COB bucket.
If your client has Contracts set up for those payers, you'll want to check they haven't enabled the option to automatically adjust charges by mistake. It's on the General tab in the Contract Maintenance window. This one is probably less likely to happen but you never know.
If I think of any other place in NextGen there could be an auto-adjustment, I'll update the thread.
In the Reason Code Library, there's a Skip Adjustment Code setting that should be set to "Skip ERA Adjustment" for any reason code that you don't want to write off. For instance, we have CO-96 set to skip the ERA adjustment with a Transaction Detail Status of None so that it doesn't automatically move the balance to the next COB bucket.
If your client has Contracts set up for those payers, you'll want to check they haven't enabled the option to automatically adjust charges by mistake. It's on the General tab in the Contract Maintenance window. This one is probably less likely to happen but you never know.
If I think of any other place in NextGen there could be an auto-adjustment, I'll update the thread.
incredible! I appreciate you. I will be looking into this tonight.Haha! No bother, answering questions gives me a break from writing SOPs
In the Reason Code Library, there's a Skip Adjustment Code setting that should be set to "Skip ERA Adjustment" for any reason code that you don't want to write off. For instance, we have CO-96 set to skip the ERA adjustment with a Transaction Detail Status of None so that it doesn't automatically move the balance to the next COB bucket.
If your client has Contracts set up for those payers, you'll want to check they haven't enabled the option to automatically adjust charges by mistake. It's on the General tab in the Contract Maintenance window. This one is probably less likely to happen but you never know.
If I think of any other place in NextGen there could be an auto-adjustment, I'll update the thread.