We highly suggest that you check the payer maintenance set up prior to starting claim submission to ensure that all claims are submitted correctly.
To check the payers follow these steps:
Choose your payer from the Nextgen Office Payers and click Add to add it on your payer list:
Details About Payers
There are three types of electronic payers: Claims Only, Real-Time Only, and both Claims and Real-Time. The payer type is indicated by the Payer Id information in the parenthesis following their Payer Name. The Payer Id acts as the electronic mailing address. The parenthesis displays the Real-Time Payer Id followed by a slash “/” and then the Claim Payer Id.
Real-Time Payers
The first number inside the parenthesis preceding the slash “/” is the Real-Time Payer Id.
The Payer Id “NRT” indicates the payer does not support Real-Time Eligibility.
Note: “NRT” may not always mean that the payer does not support Real-Time Eligibility, e.g. The Payer Id for “AARP” is displayed as “NRT,” but the eligibility is processed through United Healthcare.
For a complete list of eligibility payers, save the payer list in “Payer Maintenance” and go to “Administration: Payer Auto-Eligibility.”
Claims Payers
The Payer Id following the slash is the Claims Payer Id. Payers colored-coded in red require enrollment before claims can be electronically submitted.
It will always be best to check with the Nextgen/Healthfusion enrollment team which payers are in need of enrollment and not. You will need to coordinate all payer enrollment inquiries and matters to the Nextgen/Healthfusion enrollment specialist.
Please be advised that for payers that are NOT on the Nextgen Office Payers list, these are not electronically connected.
If you are unable to find the payer in the Nextgen Office Payers list, you will be able to add your payer. by clicking the Add a Payer:
There are two types of paper payers that can be added. Select the option on the right to indicate what process will be used:
- HealthFusion print and mail service (Fee = Cost of a Stamp)
- Print to my local printer on CMS1500 (No fee)
- Note: There is a third option, “SFTP claims.” This is used to export an ANSI file to a clearinghouse of the user’s choice. Only Customer Support can set up this option. Please contact Customer Support for setup.
Add Additional Mailing Addresses (optional)
- Highlight the payer on the right.
- Click “View Selected Payer.”
- Click “Add a Mailing Address.”
- Enter address.
- Click “Save Address.”
- Note: Multiple addresses can be added to one payer.