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Avatar CWS 2024 Update 27

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Product Requirements and Recommendations

Avatar CWS required
RADplus required

Recommended Update Level

Avatar Cal-PM 2024 Update 49
Avatar CWS 2024 Monthly Release 2024.01.00
RADplus 2024 Monthly Release 2024.01.00

Product Update Description

Avatar CWS is enhanced to support future functionality.

Required Updates

None

Included Updates

None

Details
NEW1 CHANGED0 FIXED0
New (1)
CWS - Progress Notes - Prolonged Duration
Progress Notes are updated for 'Prolonged Duration' functionality.
Note: At the current time this functionality is only available in myAvatar Cal-PM systems and requires Cal-PM 2024 Update 49 for full functionality.

There must be a 'Duration Range' in the 'Service Fee/Cross Reference Maintenance' record when the 'Service Code Category' = 'Primary Add-On Code'.

Value Added: Prolonged Duration functionality is added to myAvatar Cal-PM systems.
Topics
• Progress Notes
 
Acceptance Tests
AV-95573 Summary | Details
CWS - Progress Notes - Prolonged Duration
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Client Ledger
  • Progress Notes (Group and Individual)
  • ProgressNote Approval
  • Registry Settings (PM)
  • Ambulatory Progress Notes
Scenario 1: Cal-PM - CWS - Progress Notes (Group and Individual) - Prolonged Duration
Specific Setup:
  • Registry Settings:
  • The 'Enable Multiple Add-On Code Per Primary' registry setting is set to 'Y'.
  • The 'Enable Prolonged Duration Add-On Service Generation' is set to 'Y'.
  • 'N' disables the functionality.
  • 'Y' enables the functionality and adds the 'Prolonged Duration Configuration' field to the service code form. It also allows users to manually select/submit add-on services in all the progress note forms.
  • 'YR' enables the functionality and adds the 'Prolonged Duration Configuration' field to the service code form. It prevents users from manually selecting/submitting add-on services in all the progress note forms. The add-on service(s) are created automatically based on the values in the 'Prolonged Duration Configuration' grid.
  • Dictionary Update:
  • File= 'Other Tabled File,
  • Data Element -291, Service Code Type'
  • Dictionary Code = 1
  • Dictionary Value = Evaluation Therapy
  • Extended dictionary 'Allow Multiple Add-On Code' = Yes
  • An existing add-on service code is identified with the following values, or a new add-on code is created with the following values:
  • Service Code Category = Primary Add-On Code
  • Service Code Type = Evaluation Therapy
  • Minutes per unit = 15
  • Unit Rounding Logic = Round Over 1/2 Unit
  • Designated Degree Of Rounding = Whole Unit
  • Type of Service = Individual
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • An existing add-on service code is identified with the following values, or a new add-on code is created with the following values:
  • Service Code Category = Add-On Code
  • Service Code Type = Evaluation Therapy
  • Minutes per unit = 15
  • Unit Rounding Logic = Round Over 1/2 Unit
  • Designated Degree Of Rounding = Whole Unit
  • Type of Service = Individual
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • An existing service code is identified with the following values, or a new add-on code is created with the following values:
  • Primary Service = desired service code
  • Service Code Category = Primary Code
  • Service Code Type = Evaluation Therapy
  • Select Add-On Service Code =Primary add-on and an add-on code defined above are selected.
  • Minutes per unit = 15
  • Unit Rounding Logic = Round Over 1/2 Unit
  • Designated Degree Of Rounding = Whole Unit
  • Type of Service = Individual
  • Enable Prolonged Duration Add-On Service Generation = Yes
  • Prolonged Duration Configuration Grid View:
  • Practitioner Category Column - desired practitioner category defined in each grid row. Note the practitioner category.
  • Location - desired location is defined in each grid row. Note the location.
  • Service Code to Use for Prolonged Duration - desired service code
  • Max Duration Primary Service Must Exceed for Prolonged Duration Add-On Service to Generate = desired duration (In minutes, any integer between 0-1440) defined in each grid row. Note the duration defined.
  • Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate = desired duration (In minutes, any integer between 0-1440) defined in each grid row. Note the duration defined.
  • ·Service Fee/ Cross Reference Maintenance:
  • Primary Service Code - desired duration range is entered and desired fee definition is created.
  • Add-On Service codes = desired duration range is entered and desired fee definition is created.
  • Select an active client for progress note creation. Note client ID and episode number.
  • Select 1-2 active practitioner to be used for progress note with different practitioner category that matches with the 'Practitioner Category' defined in the 'Prolonged Duration Configuration' Grid. Note practitioner ID and category.
  • Select 1-2 active practitioner to be used for progress note with different practitioner category that does not match with the 'Practitioner Category' defined in the 'Prolonged Duration Configuration' Grid. Note practitioner ID and category.
  • Identify 1-2 dictionary codes/values for the 'Location' to be used for the progress note that matches with the 'Location' defined in the 'Prolonged Duration Configuration' Grid. Note practitioner ID and category.
  • Identify 1-2 dictionary codes/values for the 'Location' to be used for the progress note that matches with the 'Location' defined in the 'Prolonged Duration Configuration' Grid. Note practitioner ID and category.
  • Please review: The prolonged service generation logic:
  1. System identifies the practitioner category and location for the primary service because both of these parameters are needed to know which row should be evaluated in the ''Prolonged Duration Configuration' grid. The logic for evaluating if Avatar should automatically generate a prolonged duration add-on service will not occur within the progress note form until all three parameters Practitioner Category, Location and Duration have been entered.
  2. If the duration entered in the 'Service Duration' field exceeds the duration specified for the service code in the 'Max Duration Primary Service Must Exceed for Prolonged Duration Add-On Service to Generate' column in the 'Prolonged Duration Configuration' grid, Avatar will file the duration amount entered in the 'Max Duration Primary Service Must Exceed for Prolonged Duration Add-On Service to Generate' column in the 'Prolonged Duration Configuration' grid for the primary service code when the service is created.
  3. If the remaining duration amount above the duration specified for the primary service code in the new 'Max Duration Primary Service Must Exceed for Prolonged Duration Add-On Service to Generate' column in the 'Prolonged Duration Configuration' grid, s equal to or greater than the amount entered in the 'Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate' column in the 'Prolonged Duration Configuration' grid, then system automatically creates and 'saves' the add-on service for prolonged duration that is specified for the primary service code in the 'Service Code to Use For Prolonged Duration' field in the 'Service Codes' form. File the remaining duration amount as the duration for the add-on service when created. This entry within the 'Select Multiple Add-On Codes' field will not be editable via the 'Select Add-On Service Entry to Edit/Remove' dropdown option prior to finalizing the progress note. The Prolonged Duration Add-On Service that Avatar generates automatically will be displayed as the first row in the 'Selected Add-On Services' field.
  4. If the value entered for the 'Practitioner', 'Location' or 'Service Duration' field are changed, Avatar will need to rerun the process/logic to evaluate if that updated duration exceeds the duration specified for the service code in the 'Max Duration Primary Service Must Exceed for Prolonged Duration Add-On Service to Generate Column' column in the Prolonged Duration Configuration grid and update the add-on row that was system generated to now list the appropriate add-on duration amount. Likewise, if the updated duration entered in the 'Service Duration' field does now not exceed the duration specified for the service code in the 'Max Duration Primary Service Must Exceed for Prolonged Duration Add-On Service to Generate' column in the 'Prolonged Duration Configuration' grid, Avatar will remove the row that was previously saved as a prolonged duration add-on is no longer needed. The same idea will extend to the Practitioner Category, Location, and Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate columns that can be configured in the Prolonged Duration Configuration grid. If the Location or practitioner is changed – that will need to reevaluate the logic configured for that in the Prolonged Duration Configuration grid.
Steps
  1. Open the 'Progress Notes (Group and Individual)' form.
  2. Select desired client from the ‘Select Client’ field by name or ID.
  3. Select desired episode in the 'Select Episode' field.
  4. Select ‘New Service’ in the 'Progress Note For' field.
  5. Enter any value in the 'Note Type' field.
  6. Enter any value in the 'Notes Field' field.
  7. Enter desired date in the 'Date Of Service' field.
  8. Enter the 'Evaluation Management', 'Primary Code' defined in the setup.
  9. Validate the prolonged duration service codes display in the ‘Add On Services’ field to be manually selected and that no 'Add-On Service' was automatically created.
  10. Select the 'Practitioner' whose practitioner category matches with the practitioner category defined in one of the ‘Practitioner Category’ column of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form.
  11. Select the 'Location' of the service matches with the location code with the location defined in one of the ‘Location’ column of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form.
  12. Enter desired duration in the ‘Service Duration’ that is above the 'Max Duration Primary Service Must Exceed For Prolonged Duration Add-On Service to Generate' and has enough surplus over that so that the remaining duration is greater than or equal to 'Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate' column of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form.
  13. Verify the prolonged duration service code will be automatically created and added to 'Selected Add-On Services' field.
  14. Select ‘Final’ from the 'Draft/Final' field.
  15. Click [File Note].
  16. Validate a Note Filed message is displayed.
  17. Click [OK].
  18. Click [Close Form].
  19. Open the 'Client Ledger' form.
  20. Select desired client, episode and 'Ledger Type' as 'Simple'.
  21. Click [Process].
  22. Verify the primary service and prolonged add-on service created with the correct units for the service and correct service code.
  23. Close the form.
  24. Open the ‘Registry Setting’ form.
  25. Set the 'Enable Prolonged Duration Add-On Service Generation' registry setting to ‘YR’.
  26. Close the form.
  27. Open the 'Progress Notes (Group and Individual)' form.
  28. Select desired client from the ‘Select Client’ field by name or ID.
  29. Select desired episode in the 'Select Episode' field.
  30. Select ‘New Service’ in the 'Progress Note For' field.
  31. Enter any value in the 'Note Type' field.
  32. Enter any value in the 'Notes Field' field.
  33. Enter desired date in the 'Date Of Service' field that falls within the ‘Effective Date’ and Expiration Date’ defined in one of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form. Select desired value in the 'Service Charge Code' field that match.
  34. Enter the 'Evaluation Management', 'Primary Code' defined in the setup.
  35. Verify the prolonged duration service codes does not display in the ‘Add On Services’ field to be manually selected.
  36. Select the 'Practitioner' whose practitioner category that matches with the practitioner category defined in one of the ‘Practitioner Category’ column of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form.
  37. Select the 'Location' of the service that matches with the location code with the location defined in one of the ‘Location’ column of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form.
  38. Enter desired duration in the ‘Service Duration’ that is above the 'Max Duration Primary Service Must Exceed For Prolonged Duration Add-On Service to Generate' and has enough surplus over that so that the remaining duration is greater than or equal to 'Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate' column of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form.
  39. Verify the prolonged duration service code will be added to 'Selected Add-On Services' field.
  40. Change the ‘Service Duration’ to be above the 'Max Duration Primary Service Must Exceed For Prolonged Duration Add-On Service to Generate' but less than the 'Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate'.
  41. Verify the prolonged duration service code will be removed from the 'Selected Add-On Services' field.
  42. Enter a duration in the ‘Service Duration’ field again that is above the 'Max Duration Primary Service Must Exceed For Prolonged Duration Add-On Service to Generate' and has enough surplus over that so that the remaining duration is greater than or equal to 'Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate' of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form.
  43. Verify the prolonged duration service code will be added to 'Selected Add-On Services' field.
  44. Change the 'Service Date', 'Location' and ‘Practitioner’ (category) fields to values that do not match with the values defined for the primary service code in the ‘Prolonged Duration Configuration’ grid in the ‘Service Code’ form.
  45. Verify the prolonged duration service code will be removed from the 'Selected Add-On Services' field.
  46. Change the 'Service Date', 'Location' and ‘Practitioner’ (category) fields to the original values that match with the values defined for the primary service code in the ‘Prolonged Duration Configuration’ grid in the ‘Service Code’ form.
  47. Verify the prolonged duration service code will be added from the 'Selected Add-On Services' field.
  48. Select ‘Final’ from the 'Draft/Final' field.
  49. Click [File Note].
  50. Validate a Note Filed message is displayed.
  51. Click [OK].
  52. Click [Close Form].
  53. Open the 'Client Ledger' form.
  54. Select desired client, episode and 'Ledger Type' as 'Simple'.
  55. Click [Process].
  56. Verify the primary service and prolonged add-on service created with the correct units for the service and correct service code.
  57. Close the form.



Scenario 2: Cal-PM - CWS - Inpatient Progress Notes - Prolonged Duration
Specific Setup:
  • Registry Settings:
  • The 'Enable Multiple Add-On Code Per Primary' registry setting is set to 'Y'.
  • The 'Enable Prolonged Duration Add-On Service Generation' is set to 'Y'.
  • 'N' disables the functionality.
  • 'Y' enables the functionality and adds the 'Prolonged Duration Configuration' field to the service code form. It also allows users to manually select/submit add-on services in all the progress note forms.
  • 'YR' enables the functionality and adds the 'Prolonged Duration Configuration' field to the service code form. It prevents users from manually selecting/submitting add-on services in all the progress note forms. The add-on service(s) are created automatically based on the values in the 'Prolonged Duration Configuration' grid.
  • Dictionary Update:
  • File= 'Other Tabled File,
  • Data Element -291, Service Code Type'
  • Dictionary Code = 1
  • Dictionary Value = Evaluation Therapy
  • Extended dictionary 'Allow Multiple Add-On Code' = Yes
  • An existing add-on service code is identified with the following values or a new add-on code is created with the following values:
  • Service Code Category = Primary Add-On Code
  • Service Code Type = Evaluation Therapy
  • Minutes per unit = 15
  • Unit Rounding Logic = Round Over 1/2 Unit
  • Designated Degree Of Rounding = Whole Unit
  • Type of Service = Individual
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • An existing add-on service code is identified with the following values or a new add-on code is created with the following values:
  • Service Code Category = Add-On Code
  • Service Code Type = Evaluation Therapy
  • Minutes per unit = 15
  • Unit Rounding Logic = Round Over 1/2 Unit
  • Designated Degree Of Rounding = Whole Unit
  • Type of Service = Individual
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • An existing service code is identified with the following values or a new add-on code is created with the following values::
  • Primary Service = desired service code
  • Service Code Category = Primary Code
  • Service Code Type = Evaluation Therapy
  • Select Add-On Service Code =Primary add-on and an add-on code defined above are selected.
  • Minutes per unit = 15
  • Unit Rounding Logic = Round Over 1/2 Unit
  • Designated Degree Of Rounding = Whole Unit
  • Type of Service = Individual
  • Enable Prolonged Duration Add-On Service Generation = Yes
  • Prolonged Duration Configuration Grid View:
  • Practitioner Category Column - desired practitioner category defined in each grid row. Note the practitioner category.
  • Location - desired location is defined in each grid row. Note the location.
  • Service Code to Use for Prolonged Duration - desired service code
  • Max Duration Primary Service Must Exceed for Prolonged Duration Add-On Service to Generate = desired duration (In minutes, any integer between 0-1440) defined in each grid row. Note the duration defined.
  • Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate = desired duration (In minutes, any integer between 0-1440) defined in each grid row. Note the duration defined.
  • ·Service Fee/ Cross Reference Maintenance:
  • Primary Service Code - desired duration range is entered and desired fee definition is created.
  • Add-On Service codes = desired duration range is entered and desired fee definition is created.
  • Select an active inpatient client for progress note creation. Note client ID and episode number.
  • Select 1-2 active practitioner to be used for progress note with different practitioner category that matches with the 'Practitioner Category' defined in the 'Prolonged Duration Configuration' Grid. Note practitioner ID and category.
  • Select 1-2 active practitioner to be used for progress note with different practitioner category that does not match with the 'Practitioner Category' defined in the 'Prolonged Duration Configuration' Grid. Note practitioner ID and category.
  • Identify 1-2 dictionary codes/values for the 'Location' to be used for the progress note that matches with the 'Location' defined in the 'Prolonged Duration Configuration' Grid. Note practitioner ID and category.
  • Identify 1-2 dictionary codes/values for the 'Location' to be used for the progress note that matches with the 'Location' defined in the 'Prolonged Duration Configuration' Grid. Note practitioner ID and category.
  • Please review: The prolonged service generation logic:
  1. System identifies the practitioner category and location for the primary service because both of these parameters are needed to know which row should be evaluated in the 'Prolonged Duration Configuration' grid. The logic for evaluating if Avatar should automatically generate a prolonged duration add-on service will not occur within the progress note form until all three parameters Practitioner Category, Location and Duration have been entered.
  2. If the duration entered in the 'Service Duration' field exceeds the duration specified for the service code in the 'Max Duration Primary Service Must Exceed for Prolonged Duration Add-On Service to Generate' column in the 'Prolonged Duration Configuration' grid., Avatar will file the duration amount entered in the 'Max Duration Primary Service Must Exceed for Prolonged Duration Add-On Service to Generate' column in the 'Prolonged Duration Configuration' grid for the primary service code when the service is created.
  3. If the remaining duration amount above the duration specified for the primary service code in the new 'Max Duration Primary Service Must Exceed for Prolonged Duration Add-On Service to Generate' column in the 'Prolonged Duration Configuration' grid, is equal to or greater than the amount entered in the 'Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate' column in the 'Prolonged Duration Configuration' grid, then system automatically create and 'save' the add-on service for prolonged duration that is specified for the primary service code in the 'Service Code to Use For Prolonged Duration' field in the 'Service Codes' form. File the remaining duration amount as the duration for the add-on service when created. This entry within the 'Select Multiple Add-On Codes' field will not be editable via the 'Select Add-On Service Entry to Edit/Remove' dropdown option prior to finalizing the progress note. The Prolonged Duration Add-On Service that Avatar generates automatically will be displayed as the first row in the 'Selected Add-On Services' field.
  4. If the value entered for the 'Practitioner', 'Location' or 'Service Duration' field are changed, Avatar will need to rerun the process/logic to evaluate if that updated duration exceeds the duration specified for the service code in the 'Max Duration Primary Service Must Exceed for Prolonged Duration Add-On Service to Generate Column' column in the Prolonged Duration Configuration grid and update the add-on row that was system generated to now list the appropriate add-on duration amount. Likewise, if the updated duration entered in the 'Service Duration' field does now not exceed the duration specified for the service code in the 'Max Duration Primary Service Must Exceed for Prolonged Duration Add-On Service to Generate' column in the 'Prolonged Duration Configuration' grid, Avatar will remove the row that was previously saved as a prolonged duration add-on is no longer needed. The same idea will extend to the Practitioner Category, Location, and Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate columns that can be configured in the Prolonged Duration Configuration grid. If the Location or practitioner is changed – that will need to reevaluate the logic configured for that in the Prolonged Duration Configuration grid.

Steps
  1. Open the 'Inpatient Progress Notes' form.
  2. Select desired client from the ‘Select Client’ field by name or ID.
  3. Select desired episode in the 'Select Episode' field.
  4. Select ‘New Service’ in the 'Progress Note For' field.
  5. Enter any value in the 'Note Type' field.
  6. Enter any value in the 'Notes Field' field.
  7. Enter desired date in the 'Date Of Service' field that falls within the ‘Effective Date’ and Expiration Date’ defined in one of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form. Select desired value in the 'Service Charge Code' field that match.
  8. Enter the 'Evaluation Management', 'Primary Code' defined in the setup.
  9. Validate the prolonged duration service codes displays in the ‘Add On Services’ field to be manually selected and that no 'Add-On Service' was automatically created.
  10. Select the 'Practitioner' whose practitioner category matches with the practitioner category defined in one of the ‘Practitioner Category’ column of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form. Note the row #.
  11. Select the 'Location' of the service that matches with the location code with the location defined in one of the ‘Location’ column of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form. Note the row #.
  12. Enter desired duration in the ‘Service Duration’ that is above the 'Max Duration Primary Service Must Exceed For Prolonged Duration Add-On Service to Generate' and has enough surplus over that so that the remaining duration is greater than or equal to 'Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate' column of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form.
  13. Verify the prolonged duration service code will be automatically created and added to 'Selected Add-On Services' field.
  14. Select ‘Final’ from the 'Draft/Final' field.
  15. Click [File Note].
  16. Validate a Note Filed message is displayed.
  17. Click [OK].
  18. Click [Close Form].
  19. Open the 'Client Ledger' form.
  20. Select desired client, episode and 'Ledger Type' as 'Simple'.
  21. Click [Process].
  22. Verify the primary service and prolonged add-on service created with the correct units for the service and correct service code.
  23. Close the form.
  24. Open the ‘Registry Setting’ form.
  25. Set the 'Enable Prolonged Duration Add-On Service Generation' registry setting to ‘YR’.
  26. Close the form.
  27. Open the 'Inpatient Progress Notes' form.
  28. Select desired client from the ‘Select Client’ field by name or ID.
  29. Select desired episode in the 'Select Episode' field.
  30. Select ‘New Service’ in the 'Progress Note For' field.
  31. Enter any value in the 'Note Type' field.
  32. Enter any value in the 'Notes Field' field.
  33. Enter desired date in the 'Date Of Service' field that falls within the ‘Effective Date’ and Expiration Date’ defined in one of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form. Select desired value in the 'Service Charge Code' field that match.
  34. Enter the 'Evaluation Management', 'Primary Code' defined in the setup.
  35. Verify the prolonged duration service codes does not display up in the ‘Add On Services’ field to be manually selected.
  36. Select the 'Practitioner' whose practitioner category that matches with the practitioner category defined in one of the ‘Practitioner Category’ column of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form. Note the row #.
  37. Select the 'Location' of the service that matches with the location code with the location defined in one of the ‘Location’ column of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form. Note the row #.
  38. Enter desired duration in the ‘Service Duration’ that is above the 'Max Duration Primary Service Must Exceed For Prolonged Duration Add-On Service to Generate' and has enough surplus over that so that the remaining duration is greater than or equal to 'Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate' column of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form.
  39. Verify the prolonged duration service code will be added to 'Selected Add-On Services' and the cost of service will be updated to reflect the cost the primary service will file with (using the max duration).
  40. Change the ‘Service Duration’ to be above the 'Max Duration Primary Service Must Exceed For Prolonged Duration Add-On Service to Generate' but less than the 'Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate'.
  41. Verify the prolonged duration service code will be removed from the 'Selected Add-On Services' field.
  42. Enter a duration in the ‘Service Duration’ field again that is above the 'Max Duration Primary Service Must Exceed For Prolonged Duration Add-On Service to Generate' and has enough surplus over that so that the remaining duration is greater than or equal to 'Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate' of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form.
  43. Verify the prolonged duration service code will be added to 'Selected Add-On Services' field.
  44. Change the 'Service Date', 'Location' and ‘Practitioner’ (category) fields to values that do not match with the values defined for the primary service code in the ‘Prolonged Duration Configuration’ grid in the ‘Service Code’ form.
  45. Verify the prolonged duration service code will be removed from the 'Selected Add-On Services' field.
  46. Change the 'Service Date', 'Location' and ‘Practitioner’ (category) fields to the original values that match with the values defined for the primary service code in the ‘Prolonged Duration Configuration’ grid in the ‘Service Code’ form.
  47. Verify the prolonged duration service code will be added from the 'Selected Add-On Services' field.
  48. Select ‘Final’ from the 'Draft/Final' field.
  49. Click [File Note].
  50. Validate a Note Filed message is displayed.
  51. Click [OK].
  52. Click [Close Form].
  53. Open the 'Client Ledger' form.
  54. Select desired client, episode and 'Ledger Type' as 'Simple'.
  55. Click [Process].
  56. Verify the primary service and prolonged add-on service created with the correct units for the service and correct service code.
  57. Close the form.


Scenario 3: Cal-PM - CWS - Ambulatory Progress Notes - Prolonged Duration
Specific Setup:
  • Registry Settings:
  • The 'Enable Multiple Add-On Code Per Primary' registry setting is set to 'Y'.
  • The 'Enable Prolonged Duration Add-On Service Generation' is set to 'Y'.
  • 'N' disables the functionality.
  • 'Y' enables the functionality and adds the 'Prolonged Duration Configuration' field to the service code form. It also allows users to manually select/submit add-on services in all the progress note forms.
  • 'YR' enables the functionality and adds the 'Prolonged Duration Configuration' field to the service code form. It prevents users from manually selecting/submitting add-on services in all the progress note forms. The add-on service(s) are created automatically based on the values in the 'Prolonged Duration Configuration' grid.
  • Dictionary Update:
  • File= 'Other Tabled File,
  • Data Element -291, Service Code Type'
  • Dictionary Code = 1
  • Dictionary Value = Evaluation Therapy
  • Extended dictionary 'Allow Multiple Add-On Code' = Yes
  • An existing add-on service code is identified with the following values or a new add-on code is created with the following values:
  • Service Code Category = Primary Add-On Code
  • Service Code Type = Evaluation Therapy
  • Minutes per unit = 15
  • Unit Rounding Logic = Round Over 1/2 Unit
  • Designated Degree Of Rounding = Whole Unit
  • Type of Service = Individual
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • An existing add-on service code is identified with the following values or a new add-on code is created with the following values:
  • Service Code Category = Add-On Code
  • Service Code Type = Evaluation Therapy
  • Minutes per unit = 15
  • Unit Rounding Logic = Round Over 1/2 Unit
  • Designated Degree Of Rounding = Whole Unit
  • Type of Service = Individual
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • An existing service code is identified with the following values or a new add-on code is created with the following values::
  • Primary Service = desired service code
  • Service Code Category = Primary Code
  • Service Code Type = Evaluation Therapy
  • Select Add-On Service Code =Primary add-on and an add-on code defined above are selected.
  • Minutes per unit = 15
  • Unit Rounding Logic = Round Over 1/2 Unit
  • Designated Degree Of Rounding = Whole Unit
  • Type of Service = Individual
  • Enable Prolonged Duration Add-On Service Generation = Yes
  • Prolonged Duration Configuration Grid View:
  • Practitioner Category Column - desired practitioner category defined in each grid row. Note the practitioner category.
  • Location - desired location is defined in each grid row. Note the location.
  • Service Code to Use for Prolonged Duration - desired service code
  • Max Duration Primary Service Must Exceed for Prolonged Duration Add-On Service to Generate = desired duration (In minutes, any integer between 0-1440) defined in each grid row. Note the duration defined.
  • Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate = desired duration (In minutes, any integer between 0-1440) defined in each grid row. Note the duration defined.
  • ·Service Fee/ Cross Reference Maintenance:
  • Primary Service Code - desired duration range is entered and desired fee definition is created.
  • Add-On Service codes = desired duration range is entered and desired fee definition is created.
  • Select an active outpatient client for progress note creation. Note client ID and episode number.
  • Select 1-2 active practitioner to be used for progress note with different practitioner category that matches with the 'Practitioner Category' defined in the 'Prolonged Duration Configuration' Grid. Note practitioner ID and category.
  • Select 1-2 active practitioner to be used for progress note with different practitioner category that does not match with the 'Practitioner Category' defined in the 'Prolonged Duration Configuration' Grid. Note practitioner ID and category.
  • Identify 1-2 dictionary codes/values for the 'Location' to be used for the progress note that matches with the 'Location' defined in the 'Prolonged Duration Configuration' Grid. Note practitioner ID and category.
  • Identify 1-2 dictionary codes/values for the 'Location' to be used for the progress note that matches with the 'Location' defined in the 'Prolonged Duration Configuration' Grid. Note practitioner ID and category.
  • Please review: The prolonged service generation logic:
  1. System identifies the practitioner category and location for the primary service because both of these parameters are needed to know which row should be evaluated in the 'Prolonged Duration Configuration' grid. The logic for evaluating if Avatar should automatically generate a prolonged duration add-on service will not occur within the progress note form until all three parameters Practitioner Category, Location and Duration have been entered.
  2. If the duration entered in the 'Service Duration' field exceeds the duration specified for the service code in the 'Max Duration Primary Service Must Exceed for Prolonged Duration Add-On Service to Generate' column in the 'Prolonged Duration Configuration' grid., Avatar will file the duration amount entered in the 'Max Duration Primary Service Must Exceed for Prolonged Duration Add-On Service to Generate' column in the 'Prolonged Duration Configuration' grid for the primary service code when the service is created.
  3. If the remaining duration amount above the duration specified for the primary service code in the new 'Max Duration Primary Service Must Exceed for Prolonged Duration Add-On Service to Generate' column in the 'Prolonged Duration Configuration' grid, is equal to or greater than the amount entered in the 'Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate' column in the 'Prolonged Duration Configuration' grid, then system automatically create and 'save' the add-on service for prolonged duration that is specified for the primary service code in the 'Service Code to Use For Prolonged Duration' field in the 'Service Codes' form. File the remaining duration amount as the duration for the add-on service when created. This entry within the 'Select Multiple Add-On Codes' field will not be editable via the 'Select Add-On Service Entry to Edit/Remove' dropdown option prior to finalizing the progress note. The Prolonged Duration Add-On Service that Avatar generates automatically will be displayed as the first row in the 'Selected Add-On Services' field.
  4. If the value entered for the 'Practitioner', 'Location' or 'Service Duration' field are changed, Avatar will need to rerun the process/logic to evaluate if that updated duration exceeds the duration specified for the service code in the 'Max Duration Primary Service Must Exceed for Prolonged Duration Add-On Service to Generate Column' column in the Prolonged Duration Configuration grid and update the add-on row that was system generated to now list the appropriate add-on duration amount. Likewise, if the updated duration entered in the 'Service Duration' field does now not exceed the duration specified for the service code in the 'Max Duration Primary Service Must Exceed for Prolonged Duration Add-On Service to Generate' column in the 'Prolonged Duration Configuration' grid, Avatar will remove the row that was previously saved as a prolonged duration add-on is no longer needed. The same idea will extend to the Practitioner Category, Location, and Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate columns that can be configured in the Prolonged Duration Configuration grid. If the Location or practitioner is changed – that will need to reevaluate the logic configured for that in the Prolonged Duration Configuration grid.
Steps
  1. Open the 'Ambulatory Progress Notes' form.
  2. Select desired client from the ‘Select Client’ field by name or ID.
  3. Select desired episode in the 'Select Episode' field.
  4. Select ‘New Service’ in the 'Progress Note For' field.
  5. Enter any value in the 'Note Type' field.
  6. Enter any value in the 'Notes Field' field.
  7. Enter desired date in the 'Date Of Service' field that falls within the ‘Effective Date’ and Expiration Date’ defined in one of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form. Select desired value in the 'Service Charge Code' field that match.
  8. Enter the 'Evaluation Management', 'Primary Code' defined in the setup.
  9. Validate the prolonged duration service codes displays in the ‘Add On Services’ field to be manually selected and that no 'Add-On Service' was automatically created.
  10. Select the 'Practitioner' whose practitioner category that matches with the practitioner category defined in one of the ‘Practitioner Category’ column of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form. Note the row #.
  11. Select the 'Location' of the service that matches with the location code with the location defined in one of the ‘Location’ column of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form. Note the row #.
  12. Enter desired duration in the ‘Service Duration’ that is above the 'Max Duration Primary Service Must Exceed For Prolonged Duration Add-On Service to Generate' and has enough surplus over that so that the remaining duration is greater than or equal to 'Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate' column of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form.
  13. Verify the prolonged duration service code will be automatically created and added to 'Selected Add-On Services' field.
  14. Select ‘Final’ from the 'Draft/Final' field.
  15. Click [File Note].
  16. Validate a Note Filed message is displayed.
  17. Click [OK].
  18. Click [Close Form].
  19. Open the 'Client Ledger' form.
  20. Select desired client, episode and 'Ledger Type' as 'Simple'.
  21. Click [Process].
  22. Verify the primary service and prolonged add-on service created with the correct units for the service and correct service code.
  23. Close the form.
  24. Open the ‘Registry Setting’ form.
  25. Set the 'Enable Prolonged Duration Add-On Service Generation' registry setting to ‘YR’.
  26. Close the form.
  27. Open the 'Ambulatory Progress Notes' form.
  28. Select desired client from the ‘Select Client’ field by name or ID.
  29. Select desired episode in the 'Select Episode' field.
  30. Select ‘New Service’ in the 'Progress Note For' field.
  31. Enter any value in the 'Note Type' field.
  32. Enter any value in the 'Notes Field' field.
  33. Enter desired date in the 'Date Of Service' field that falls within the ‘Effective Date’ and Expiration Date’ defined in one of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form. Select desired value in the 'Service Charge Code' field that match.
  34. Enter the 'Evaluation Management', 'Primary Code' defined in the setup.
  35. Verify the prolonged duration service codes does not display in the ‘Add On Services’ field to be manually selected.
  36. Select the 'Practitioner' whose practitioner category that matches with the practitioner category defined in one of the ‘Practitioner Category’ column of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form. Note the row #.
  37. Select the 'Location' of the service that matches with the location code with the location defined in one of the ‘Location’ column of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form. Note the row #.
  38. Enter desired duration in the ‘Service Duration’ that is above the 'Max Duration Primary Service Must Exceed For Prolonged Duration Add-On Service to Generate' and has enough surplus over that so that the remaining duration is greater than or equal to 'Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate' column of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form.
  39. Verify the prolonged duration service code will be added to 'Selected Add-On Services' and the cost of service will be updated to reflect the cost the primary service will file with (using the max duration).
  40. Change the ‘Service Duration’ to be above the 'Max Duration Primary Service Must Exceed For Prolonged Duration Add-On Service to Generate' but less than the 'Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate'.
  41. Verify the prolonged duration service code will be removed from the 'Selected Add-On Services' field.
  42. Enter a duration in the ‘Service Duration’ field again that is above the 'Max Duration Primary Service Must Exceed For Prolonged Duration Add-On Service to Generate' and has enough surplus over that so that the remaining duration is greater than or equal to 'Minimum Remaining Duration to be Met for Prolonged Duration Add-On Service to Generate' of the ‘Prolonged Duration Configuration’ grid for the service code in the ‘Service Code’ form.
  43. Verify the prolonged duration service code will be added to 'Selected Add-On Services' field.
  44. Change the 'Service Date', 'Location' and ‘Practitioner’ (category) fields to values that do not match with the values defined for the primary service code in the ‘Prolonged Duration Configuration’ grid in the ‘Service Code’ form.
  45. Verify the prolonged duration service code will be removed from the 'Selected Add-On Services' field.
  46. Change the 'Service Date, 'Location' and ‘Practitioner’ (category) fields to the original values that match with the values defined for the primary service code in the ‘Prolonged Duration Configuration’ grid in the ‘Service Code’ form.
  47. Verify the prolonged duration service code will be added from the 'Selected Add-On Services' field.
  48. Select ‘Final’ from the 'Draft/Final' field.
  49. Click [File Note].
  50. Validate a Note Filed message is displayed.
  51. Click [OK].
  52. Click [Close Form].
  53. Open the 'Client Ledger' form.
  54. Select desired client, episode and 'Ledger Type' as 'Simple'.
  55. Click [Process].
  56. Verify the primary service and prolonged add-on service created with the correct units for the service and correct service code.
  57. Close the form.
Topics
• Progress Notes

 

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  2. Tags
    1. Avatar CWS 2024 Update 27
    2. content:release
    3. llm-no-index
    4. Progress Notes
    5. role:sysadmin