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Avatar Cal-PM 2022 Monthly Release 2022.01.02 Acceptance Tests

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Update 22 Summary | Details
CSI Assessment - Closure Reason
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Program Maintenance
  • Call Intake
  • CSI Assessment (Call Intake)
  • Form and Table Documentation (PM)
  • SQL Query/Reporting Tool
  • CSI Submission
  • Avatar_Cal_PM_CSI_DIG_ICD10.rpt
  • Dynamic form- Social Security Number
  • Admission (Outpatient)
  • CSI Admission
  • CSI Assessment
Scenario 1: CSI Assessment (Call Intake) - Validating form submission and data validation
Specific Setup:
  • Program Maintenance:
  • Create a new program or identify an existing call intake program setup as a ‘Mental Health Program (CSI)’. Note the program code/value.
  • Call Intake:
  • A client is admitted to a temporary episode in the 'Call Intake' form. Note the client id/ name.
Steps
  1. Open 'CSI Assessment (Call Intake)' form for the client.
  2. Select the desired episode in the Pre-Display
  3. Click [OK].
  4. Set the 'Assessment Appointment First Offer Date' field to the desired date in the future.
  5. Set the 'Assessment Appointment Second Offer Date' field to the desired date in the future.
  6. Set the 'Assessment Appointment Third Offer Date' field to the desired date in the future.
  7. Set the 'Assessment Appointment Accepted Date' field to the desired date.
  8. Set the 'Assessment Start Date' to desired value.
  9. Set the 'Assessment End Date' to desired value.
  10. Set the 'Treatment Appointment First Offer Date' field to the desired date in the future.
  11. Set the 'Treatment Appointment Second Offer Date' field to the desired date in the future.
  12. Set the 'Treatment Appointment Third Offer Date' field to the desired date in the future.
  13. Set the 'Treatment Appointment Accepted Date' field to the desired date.
  14. Select desired value from the 'Closure Reason' list field. Note the entire value.
  15. Set the 'Closed Out Date' field to desired date.
  16. Click [Submit].
  17. Open the 'Crystal Report' or any other SQL data viewer.
  18. Query the 'system.assessment_ca_p_csi_data' SQL table.
  19. Locate the client from above step.
  20. Verify the entire value selected in the 'Closure Reason' field is displays in the 'closure_reason_value' field.
Scenario 2: CSI Assessment - Validating form submission and data validation
Specific Setup:
  • Program Maintenance:
  • Create a new program or identify an existing admit program setup as a ‘Mental Health Program (CSI)’. Note the program code/value.
  • Admission:
  • An existing client is identified that have no prior CSI Assessment record on file or the new client must have been admitted to a CSI program. Note the client id/ name.
Steps
  1. Open the 'CSI Assessment' form for the client identified in the setup.
  2. Select the desired episode in the Pre-Display
  3. Click [OK].
  4. Set the 'Assessment Appointment First Offer Date' field to the desired date in the future.
  5. Set the 'Assessment Appointment Second Offer Date' field to the desired date in the future.
  6. Set the 'Assessment Appointment Third Offer Date' field to the desired date in the future.
  7. Set the 'Assessment Appointment Accepted Date' field to the desired date.
  8. Set the 'Assessment Start Date' to desired value.
  9. Set the 'Assessment End Date' to desired value.
  10. Set the 'Treatment Appointment First Offer Date' field to the desired date in the future.
  11. Set the 'Treatment Appointment Second Offer Date' field to the desired date in the future.
  12. Set the 'Treatment Appointment Third Offer Date' field to the desired date in the future.
  13. Set the 'Treatment Appointment Accepted Date' field to the desired date.
  14. Select desired value from the 'Closure Reason' list field. Note the entire value.
  15. Set the 'Closed Out Date' field to desired date.
  16. Click [Submit].
  17. Open the 'Crystal Report' or any other SQL data viewer.
  18. Query the 'system.assessment_ca_csi_data' SQL table.
  19. Locate the client from above step.
  20. Verify the entire value selected in the 'Closure Reason' field is displays in the 'closure_reason_value' field.
Topics
• NX • CSI Assessment (Call Intake) • Csi Admission • CSI Assessment
Update 28 Summary | Details
'Electronic Billing' Support for Services Originating in Avatar MSO
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Electronic Billing
  • 837 Health Care Claim Professional
  • 837 Health Care Claim Institutional
Scenario 1: 'Electronic Billing' - Verification of 2320 AMT Values in 837 Professional (Services Originating in Avatar MSO)
Specific Setup:
  • Avatar Cal-PM Registry Setting 'Support MSO Other Healthcare Coverage' must be enabled
  • Avatar Cal-PM Registry Setting 'Include Service Level Adjudication Info' must be enabled (and 'Include Service Level Adjudication Information (2430)' field set to 'Yes' via 'Guarantor/Program Billing Defaults' form '837 Professional' section for applicable Guarantor/Program)
  • Avatar Cal-PM Registry Setting 'Include Patient Remaining Liability' must be enabled (and 'Select Type Of Information To Include In Patient Remaining Liability' field defined via 'Guarantor/Program Billing Defaults' form '837 Professional' section for applicable Guarantor/Program)
  • Avatar MSO Registry Setting 'Add Support For The Input Of Third Party Payer Amounts' must be enabled
  • One or more service(s) eligible for Avatar Cal-PM 837 Professional file inclusion (via 'Electronic Billing' form) originating in Avatar MSO inbound 837 file processing and including Third Party Payment/Adjustment 'Other Healthcare Coverage' information
Steps
  1. Open Avatar Cal-PM 'Electronic Billing' form. (Note, acceptance testing may also be confirmed via Avatar Cal-PM 'Quick Billing' form/functionality.)
  2. Select '837 Professional' in the 'Billing Form' field.
  3. Select 'Sort File' in the 'Billing Options' field.
  4. Enter/select 837 Professional file sorting criteria.
  5. Click 'Process' button to sort/generate 837 Professional file.
  6. Select 'Dump File' in the 'Billing Options' field (or select 'Create File On Server' to review output file directly).
  7. Select 'Print' in the 'Print Or Delete Report' field.
  8. Select 837 Professional file sorted which includes services(s) originating via Avatar MSO inbound 837 claim(s), and click 'Process' button to display 837 Professional outbound file data.
  9. In Avatar PM 837 Professional format outbound electronic billing file data - for services originating via Avatar MSO inbound 837 file claims including 'Other Healthcare Coverage' information where 2320-AMT Coordination Of Benefits (COB) Payer Paid Amount value is present in original inbound 837 claim, ensure that 2320-AMT Coordination Of Benefits (COB) Payer Paid Amount loop/segment value is present and reflects same/original Avatar MSO 'Other Healthcare Coverage' inbound 837 claim value.
  10. Example: AMT*D*2~
  11. In Avatar PM 837 Professional format outbound electronic billing file data - for services originating via Avatar MSO inbound 837 file claims including 'Other Healthcare Coverage' information where 2320-AMT Remaining Patient Liability Amount value is present in original inbound 837 claim, ensure that 2320-AMT Remaining Patient Liability Amount loop/segment is present and reflects same/original Avatar MSO 'Other Healthcare Coverage' inbound 837 claim value.
  12. Example: AMT*EAF*58~
Scenario 2: 'Electronic Billing' - Verification of 2320 AMT Values in 837 Institutional (Services Originating in Avatar MSO)
Specific Setup:
  • Avatar Cal-PM Registry Setting 'Support MSO Other Healthcare Coverage' must be enabled
  • Avatar Cal-PM Registry Setting 'Include Service Level Adjudication Info' must be enabled (and 'Include Service Level Adjudication Information (2430)' field set to 'Yes' via 'Guarantor/Program Billing Defaults' form '837 Institutional' section for applicable Guarantor/Program)
  • Avatar Cal-PM Registry Setting 'Include Patient Remaining Liability' must be enabled (and 'Select Type Of Information To Include In Patient Remaining Liability' field defined via 'Guarantor/Program Billing Defaults' form '837 Institutional' section for applicable Guarantor/Program)
  • Avatar MSO Registry Setting 'Add Support For The Input Of Third Party Payer Amounts' must be enabled
  • One or more service(s) eligible for Avatar Cal-PM 837 Institutional file inclusion (via 'Electronic Billing' form) originating in Avatar MSO inbound 837 file processing and including Third Party Payment/Adjustment 'Other Healthcare Coverage' information
Steps
  1. Open Avatar Cal-PM 'Electronic Billing' form. (Note, acceptance testing may also be confirmed via Avatar Cal-PM 'Quick Billing' form/functionality.)
  2. Select '837 Institutional' in the 'Billing Form' field.
  3. Select 'Sort File' in the 'Billing Options' field.
  4. Enter/select 837 Institutional file sorting criteria.
  5. Click 'Process' button to sort/generate 837 Institutional file.
  6. Select 'Dump File' in the 'Billing Options' field (or select 'Create File On Server' to review output file directly).
  7. Select 'Print' in the 'Print Or Delete Report' field.
  8. Select 837 Institutional file sorted which includes services(s) originating via Avatar MSO inbound 837 claim(s), and click 'Process' button to display 837 Institutional outbound file data.
  9. In Avatar PM 837 Institutional format outbound electronic billing file data - for services originating via Avatar MSO inbound 837 file claims including 'Other Healthcare Coverage' information where 2320-AMT Coordination Of Benefits (COB) Payer Paid Amount value is present in original inbound 837 claim, ensure that 2320-AMT Coordination Of Benefits (COB) Payer Paid Amount loop/segment value is present and reflects same/original Avatar MSO 'Other Healthcare Coverage' inbound 837 claim value.
  10. Example: AMT*D*2~
  11. In Avatar PM 837 Institutional format outbound electronic billing file data - for services originating via Avatar MSO inbound 837 file claims including 'Other Healthcare Coverage' information where 2320-AMT Remaining Patient Liability Amount value is present in original inbound 837 claim, ensure that 2320-AMT Remaining Patient Liability Amount loop/segment is present and reflects same/original Avatar MSO 'Other Healthcare Coverage' inbound 837 claim value.
  12. Example: AMT*EAF*58~
Topics
• Electronic Billing • 837 Professional • 837 Institutional
Update 33 Summary | Details
Avatar Cal-PM Financial Eligibility Web Service
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Financial Eligibility Web Service
Scenario 1: Financial Eligibility Web Service - Verification of web service filing
Specific Setup:
  • Netsmart ProviderConnect (or other application utilizing the Avatar Cal-PM 'Financial Eligibility' web service)
  • Client record with one or more episodes eligible for Financial Eligibility record entry/update
Steps
  1. In ProviderConnect Main Menu, open 'Lookup Client' form.
  2. Enter lookup criteria for desired client and click 'Search by Criteria' button.
  3. In 'Client Lookup' results, open client record.
  4. Navigate to 'Financial Eligibility' pre-display.
  5. Click 'Add Financial Eligibility Record' button (or click date/time link for edit of existing Financial Eligibility record).
  6. Select and add/edit/remove Guarantor(s) in ProviderConnect 'Financial Eligibility' form.
  7. Complete all desired/required fields within Guarantor entry form (including Benefit Plan information entry if applicable) and save Guarantor entry/entries.
  8. Click 'Submit' button to file 'Financial Eligibility' form/record in ProviderConnect and send to Avatar Cal-PM.
  9. In myAvatar, open Avatar Cal-PM 'Financial Eligibility' form for same client and episode as filed in ProviderConnect.
  10. In Avatar Cal-PM 'Financial Eligibility' form, ensure that all Guarantor information added/edited/removed via ProviderConnect is present/reflected.
Topics
• Financial Eligibility • Web Services