Importing Claim Response Files in NextGen

Are you importing your claim response files?

When you send your claim files through your clearinghouse, you should be receiving two ANSI EDI file types with responses that can be imported into NextGen. Importing these files will give visual indicators to your billing team and allow for reporting. Let’s discuss the life cycle of the EDI files.


The 277 and 999 files should be downloaded and saved to a folder where you can manually upload the file in Practice Management or set the job on the BBP.

999 File Process
Select File > Processes > Claim Acknowledgment Import

Browse to Select File. If the Update Claim Request Acknowledgement Status is unchecked, then only a report is generated.

277 File Process
File > Process > Claim Status Import

Browse to Select File. If the Display Only is checked, then only the report is generated. Blank will update the Encounter statuses.

There are several areas within the application that this information is visible.

Claim Request Look Up for Archived Electronic Claims

Within the Patient Chart > Clinical History Notes Tab > Chart Note. You can open this to view the Note. Some Payers will also return a Claim number that can be helpful in Timely Filing Disputes.

In your Encounter Claims Window

And in 6.2021.1 On the Encounters Tab within the Patient Chart

You can also run the Claim Requests Report.

On Filter 1, Select the desired Date Range and Archived Electronic Claims.

 

Have any questions about importing your claim response files? Feel free to reach out to eMedApps, we are here to help.

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About the Author:

Betsy is a NextGen Certified Professional who has been with eMedApps over 9 years. She is an EPM implementation specialist with a strong revenue cycle management background. She has helped multiple organizations with her powerful analytical skills to identify process issues and implement improvements among a complex payer and specialty mix.