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Avatar Cal-PM 2022 Monthly Release 2022.03.00 Acceptance Tests

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Update 18 Summary | Details
Quick Actions - Update Client Data
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • View Definition
  • NX View Definition
  • Quick Actions Page
  • Update Client Data
  • Registry Settings (PM)
  • Site Specific Section Modeling (PM)
  • Form and Table Documentation (PM)
  • Dictionary Update (PM)
Scenario 1: Quick Action - Update Client Data - 9 digit zip code
Specific Setup:
  • Using the "View Definition" form, add the "Quick Actions" widget to the user's HomeView.
  • Using the "NX View Definition" form, add the Quick Action for "Update Client Data".
  • Admit a test client.
Steps
  1. Select the test client.
  2. Navigate to the "Quick Actions" widget.
  3. Locate the "Update Client Data" Quick Action.
  4. Click "Add" button.
  5. Enter an address with a 9-digit zip code.
  6. Validate that once you tab out of the field, it populates with the "City" and "State" values appropriate for the zip code.
  7. Click "Save".
  8. Click "Add" on the "Update Client Data" Quick Action.
  9. Validate the "Zip Code", "City" and "State" fields display appropriately.
  10. Open the "Update Client Data" form.
Scenario 2: Quick Action - Update Client Data - Validate name change
Specific Setup:
  • Using the "View Definition" form, add the "Quick Actions" widget to the user's HomeView.
  • Using the "NX View Definition" form, add the Quick Action for "Update Client Data".
  • Admit a test client.
Steps
  1. Select the test client.
  2. Navigate to the "Quick Actions" widget.
  3. Locate the "Update Client Data" Quick Action.
  4. Click "Add" button.
  5. Change the client's first and last name.
  6. Fill in all other fields.
  7. Click "Save".
  8. Open the "Update Client Data" form.
  9. Validate the first and last name are changed.
  10. Using SQL, validate the name change is reflected in the columns, patient_name, patient_name_first, patient_name_last in SYSTEM.patient_current_demographics SQL.
Scenario 3: Quick Action - Update Client Data - 5 digit zip code
Specific Setup:
  • Using the "View Definition" form, add the "Quick Actions" widget to the user's HomeView.
  • Using the "NX View Definition" form, add the Quick Action for "Update Client Data".
  • Admit a test client.
Steps
  1. Select the test client.
  2. Navigate to the "Quick Actions" widget.
  3. Locate the "Update Client Data" Quick Action.
  4. Click "Add" button.
  5. Enter an address with a 5-digit zip code.
  6. Validate that once you tab out of the field, it populates with the "City" and "State" values appropriate for the zip code.
  7. Click "Save".
  8. Click "Add" on the "Update Client Data" Quick Action.
  9. Validate the "Zip Code", "City" and "State" fields display appropriately.
  10. Open the "Update Client Data" form.
  11. Validate the same fields all display in uppercase letters.
Scenario 4: Quick Action - Update Client Data - Update Financial Eligibility Data enabled
Specific Setup:
  • Using the "View Definition" form, add the "Quick Actions" widget to the user's HomeView.
  • Using the "NX View Definition" form, add the Quick Action for "Update Client Data".
  • Select a client who has existing financial eligibility data.
  • Enable the registry setting "Update Financial Eligibility Data".
Steps
  1. Navigate to the "Quick Action" widget.
  2. Click "Add" on the "Update Client Data" item.
  3. Enter a new name and address for the client with existing financial eligibility data.
  4. Enter the following SQL statement to view the listed fields in SYSTEM.billing_guar_subs_data: SELECT subs_name,subs_name_first,subs_name_last,subs_address_street1,subs_address_street2,subs_address_city,subs_address_state,subs_addess_zip FROM SYSTEM.billing_guar_subs_data to validate that these columns were changed when the Quick Action was filed.
Scenario 5: Quick Action - Update Client Data - Update Financial Eligibility Data disabled
Specific Setup:
  • Using the "View Definition" form, add the "Quick Actions" widget to the user's HomeView.
  • Using the "NX View Definition" form, add the Quick Action for "Update Client Data".
  • Select a client who has existing financial eligibility data.
  • Disable the registry setting "Update Financial Eligibility Data".
Steps
  1. Navigate to the "Quick Action" widget.
  2. Click "Add" on the "Update Client Data" item.
  3. Enter a new name and address for the client with existing financial eligibility data.
  4. Enter the following SQL statement to view the listed fields in SYSTEM.billing_guar_subs_data: SELECT subs_name,subs_name_first,subs_name_last,subs_address_street1,subs_address_street2,subs_address_city,subs_address_state,subs_addess_zip FROM SYSTEM.billing_guar_subs_data to validate that these columns were not changed when the Quick Action was filed.
Scenario 6: Update Client Data - Site Specific Fields
Specific Setup:
  • Add one of each type of site specific section modeling type field, such as single response dictionary, multi response dictionary, date, time, free text (20), free text (40), scrolling free test and a practitioner lookup to the "Update Client Data" form.
  • Add data dictionaries for the single and multiple response site specific fields.
  • Admit a test client.
  • Add the "Quick Actions" widget to the user's HomeView.
Steps
  1. Open the "Update Client Data" form for the test client.
  2. Populate all fields added to the form via Site Specific Section Modeling in setup.
  3. File the form.
  4. Navigate to the "Quick Actions" widget.
  5. Select the "Update Client Data" quick action.
  6. Save the quick action.
  7. Open the "Update Client Data" form for the test client.
  8. Validate the site specific fields display data as it was originally entered.
Topics
• NX • Quick Actions • Site Specific Section Modeling • Update Client Data
Update 26 Summary | Details
Program Maintenance - Cal-OMS Provider No Activity Submission Status
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Registry Settings (PM)
  • Program Maintenance
Scenario 1: Program Maintenance - Cal-OMS Provider No Activity Submission Status
Specific Setup:
  • Registry Settings:
  • Prior to installing the update, the following registry setting has a value of ‘Y or ‘YC’: 'Avatar PM->California Required EDI->CAL OMS Reporting->->->Enable LA County Reporting Requirements’. Note the value.
  • Program Maintenance is used to validate that the 'Cal-OMS Provider No Activity Submission Status' field is not on the form.
Steps
  1. Open ‘Registry Settings’.
  2. Set ‘Limit Registry Settings to the Following Search Criteria’ to ‘Avatar PM->California Required EDI->CAL OMS Reporting->->->Enable LA County Reporting Requirements’.
  3. Click [View Registry Settings].
  4. Set the ‘Registry Setting Value’ to’ Y’.
  5. Click [Submit].
  6. Close the form.
  7. Open ‘Program Maintenance’ for desired program. Validate that the 'Cal-OMS Provider No Activity Submission Status' field is not on the form.
  8. Close the form.
  9. Open ‘Registry Settings’.
  10. Set ‘Limit Registry Settings to the Following Search Criteria’ to ‘Avatar PM->California Required EDI->CAL OMS Reporting->->->Enable LA County Reporting Requirements’.
  11. Click [View Registry Settings].
  12. Set the ‘Registry Setting Value’ to ‘YC’.
  13. Click [Submit].
  14. Close the form.
  15. Open ‘Program Maintenance’ for desired program. Validate that the 'Cal-OMS Provider No Activity Submission Status' field is on the form. Set the value to the desired value and file the form.
  16. Reenter the same program and validate that the filed value was retained.
  17. Close the form.
Topics
• Cal-OMS • NX
Update 42 Summary | Details
Database Management - SQL Query
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Registry Settings (PM)
  • CPT Code Definition (PM)
Scenario 1: Cal-PM: File Import - Service Fee/Cross Reference
Specific Setup:
  • Service Codes: Create two new service codes ( Service Code 1 & Service Code 2).
  • Use Service Fee/Cross Reference Maintenance to add a fee to Service Code 1.
  • Create a 'File Import' file for 'Service Fee/Cross Reference' for Service Code 2. Note the service code, from date, and fee.
  • The 'File Import' spreadsheet will be included in the update zip file.
Steps
  1. Open' File Import'.
  2. Load the file created in setup.
  3. Compile the file.
  4. If necessary correct errors, delete the existing file, load and compile again.
  5. Post the compiled file.
  6. Open 'Service Fee/Cross Reference Maintenance'.
  7. Select 'Edit Existing' in 'Enter New Or Edit Existing Fee/Cross Reference'
  8. Enter 'Service Code 2'.
  9. Enter the 'From Date'.
  10. Click [Select Fee/Cross Ref To Edit/Default From Existing].
  11. Select the desired row in the 'Edit Service Fee Definition' grid,
  12. Click [OK].
  13. Validate the data that was submitted in 'File Import' was saved.
Scenario 2: Cal-PM - SQL Table - SYSTEM.billing_tx_xref_table.
Specific Setup:
  • Prior to the update being installed, use Crystal Reports or other SQL reporting tool to process a query of the SYSTEM.billing_tx_xref_table. Save the results.
Steps
  1. After installation of the update, use Crystal Reports or other SQL reporting tool to process a query of the SYSTEM.billing_tx_xref_table. Save the results.
  2. Compare the results of the two queries to verify that the data is the same.
Cal-OMS Submission
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Registry Settings (PM)
  • Dynamic Form - Cal-OMS Annual Update
  • Cal-OMS Annual Update
  • Cal-OMS Submission
Scenario 1: Cal-OMS - Annual Update
Specific Setup:
  • Registry Setting: Note the value of 'Avatar PM->California Required EDI->Cal OMS Reporting->->->Annual Update Number'.
  • A value of 'N' excludes the 'Annual Update Number' field on the 'Cal-OMS Annual Update' form.
  • A value of 'D' includes the 'Annual Update Number' field on the 'Cal-OMS Annual Update' form as a display only field and will contain the previously submitted 'Annual Update Number'
  • A value of 'E' includes the 'Annual Update Number' field on the 'Cal-OMS Annual Update' form as an enabled field. The user can override an existing value, or add a value if blank, if the entry is an integer. If a value is removed and left blank, the standard logic will apply the next time the 'Cal-OMS Annual Update' is processed.
  • Client: Select a client that has a submitted 'Cal-OMS Admission' and is due for the 'Cal-OMS Annual Update'.
Steps
  1. Open 'Cal-OMS Annual Update' for desired client.
  2. Add Data for all required field and desired optional fields. Note the date of entry.
  3. Click [Submit].
  4. Open 'Cal-OMS Submission'.
  5. Select 'Compile' in 'Option'.
  6. Enter a 'Through Date' that includes the date of entry.
  7. Click [Yes].
  8. Select 'Print' in 'Option'.
  9. Select desired file in 'Select File To Print/Submit'.
  10. Click [Print Selected File Annual Update Information].
  11. Validate that the selected client is included in the report.
  12. Close the report.
  13. Close the form.
Cal-OMS Submission - Deletion of submitted Discharge
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Cal-OMS Discharge
  • Cal-OMS Submission
  • Admission (Outpatient)
  • Program Maintenance
  • Cal-OMS Admission
  • Dynamic Form - Cal-OMS File Submission
Scenario 1: Cal-OMS Submission - After Deletion of Cal-OMS Discharge
Specific Setup:
  • All Cal-OMS setup is complete.
  • Client 1: Is age 17 or younger and has a Cal-OMS admission in a Detox program. The admission has been submitted as a ‘Final’ submission.
  • Client 2: Is age 18 or older and has a Cal-OMS admission. The admission has been submitted as a ‘Final’ submission.
Steps
  1. Open ‘Cal-OMS Youth/Detox Discharge’ for Client 1. Note the date of discharge.
  2. Complete all the fields on the form, noting that some fields are disabled based on values in other fields.
  3. Submit the form.
  4. Open ‘Cal-OMS Discharge’ for Client 2. Note the date of discharge.
  5. Complete all the fields, in all sections, of the form, noting that some fields are disabled based on values in other fields.
  6. Submit the form.
  7. Open ‘Cal-OMS Submission’.
  8. Select ‘Compile’ in ‘Option’.
  9. Enter a ‘Through Date’ that included the above dates of discharge.
  10. Click [Submit].
  11. Select 'Print' in 'Option'
  12. Select the compiled file in 'Select File To Print/Submit'.
  13. Click [Print Selected File Discharge Information].
  14. Validate that both clients are in the report and contain no errors.
  15. Close the report.
  16. Close the form.
  17. Open ‘Cal-OMS Youth/Detox Discharge’ for Client 1.
  18. Select 'Discharge Delete' in 'Record to be Submitted'.
  19. Click Submit.
  20. Open ‘Cal-OMS Discharge’ for Client 2
  21. Select 'Discharge Delete' in 'Record to be Submitted'.
  22. Click Submit.
  23. Open ‘Cal-OMS Submission’.
  24. Select ‘Compile’ in ‘Option’.
  25. Enter a ‘Through Date’ that included the above dates of discharge.
  26. Click [Submit].
  27. Select 'Print' in 'Option'
  28. Select the compiled file in 'Select File To Print/Submit'.
  29. Click [Print Selected File Discharge Information].
  30. Validate that both clients are in the report and contain no errors.
  31. Close the report.
  32. Close the form.
Topics
• Database Management • Cal-OMS • NX
Update 50 Summary | Details
Program Maintenance - Substance Abuse Program (Cal-OMS)
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Registry Settings (PM)
  • Program Maintenance
  • Cal-OMS Admission
  • Cal-OMS Submission
  • Admission (Outpatient)
  • Guarantors/Payors
  • Financial Eligibility
  • Client Ledger
  • Electronic Billing
Scenario 1: Verify submission of Cal-OMS Admission
Specific Setup:

Cal-OMS setup exists.

Program Maintenance:

Program 1: Contains a value of ‘Yes (Reportable)’ in ‘Substance Abuse Program (Cal-OMS)’.

Program 2: : Contains a value of ‘Yes (Not Reportable)’ in ‘Substance Abuse Program (Cal-OMS)’.

Client 1: Is enrolled in Program 1.

Client 2: Is enrolled in Program 2.

Steps
  1. Open 'Cal-OMS Admission for Client 1.
  2. Enter data for all required and desired non-required fields. Note the admission date.
  3. Click [Submit].
  4. Open 'Cal-OMS Admission for Client 2.
  5. Validate the error message contains: Client does not have any Inpatient/Outpatient/Partial(Day) episodes within the current system code'.
  6. Open 'Cal-OMS Submission'.
  7. Select 'Compile' in 'Option'.
  8. Enter a 'Through Date' that includes the admission date for Client 1.
  9. Click [Submit].
  10. Click [Yes].
  11. Select 'Print' in 'Option'.
  12. Selected desired file in 'Select File To Print/Submit'.
  13. Click [Print Selected File Admission Information].
  14. Review the report to verify the data for Client 1.
  15. If desired, submit the file in review or final mode.
  16. Review the data in the submitted file.
  17. Close the form.
Scenario 2: 837 Professional - Cal-OMS Program
Specific Setup:

Cal-OMS setup exists.

Program Maintenance:

Program 1: Contains a value of ‘Yes (Reportable)’ in ‘Substance Abuse Program (Cal-OMS)’.

Program 2: Contains a value of ‘Yes (Not Reportable)’ in ‘Substance Abuse Program (Cal-OMS)’.

Client 1:

Is enrolled in Program 1.

Has financial eligibility and diagnosis records.

Has closed, unclaimed services. Note the date range and the guarantor.

If necessary, review the Guarantors/Payors form to note the 'Financial Class' of the guarantor.

Create Interim Billing Batch File has been used to create a batch specific to Client 1.

Client 2:

Is enrolled in Program 2.

Has financial eligibility and diagnosis records.

Has closed, unclaimed services. Note the date range and the guarantor.

If necessary, review the Guarantors/Payors form to note the 'Financial Class' of the guarantor.

Create Interim Billing Batch File has been used to create a batch specific to Client 2.

Steps
  1. Open ‘Electronic Billing’.
  2. Select ‘837 Professional’ in ‘Billing Form’.
  3. Select the desired ‘HIPAA Transaction Version’.
  4. Select the ‘Financial Class’ in ‘Type Of Bill’. This is for Client 1.
  5. Select ‘Individual’ in ‘Individual Or All Guarantors’.
  6. Select the desired ‘Guarantor’.
  7. Select ‘Outpatient’ in ‘Billing Type’.
  8. Select ‘Sort File’ in ‘ Billing Options’.
  9. Enter desired ‘File Description/Name’.
  10. Select ‘Interim Batch’ in ‘All Clients or Interim Billing Batch’.
  11. Select desired ‘Interim Batch Number’.
  12. Select desired value in ‘Create Claims’. If yes, enter a value on ‘Date of Claim’.
  13. Enter desired value in ‘First Date Of Service To Include’.
  14. Enter desired value in ‘Last Date Of Service To Include’.
  15. Select ‘All’ in ‘Include Primary and/or Secondary Billing’.
  16. Click [Process].
  17. Click [OK].
  18. Select ‘Dump File’ in ‘Billing Options’.
  19. Select ‘Print’ in ’Print Or Delete Report’.
  20. Select the desired ‘File’.
  21. Click [Process].
  22. Validate the date within the file to ensure expected services are output with expected data.
  23. Close the report.
  24. Close the form.
Topics
• 837 Professional • Cal-OMS
Update 58 Summary | Details
'Guarantors/Payors' Form 'Treatment Plan Requirements' Fields
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Registry Settings (PM)
  • Guarantors/Payors
  • File Import - Guarantors/Payors Treatment Plan Requirements
  • File Import - Compile/Post Report
  • Electronic Billing
  • Electronic Billing - Electronic Billing report
  • Treatment Plan
Scenario 1: 'Guarantors/Payors' - Verification of 'Treatment Plan Requirement' Form Section/Fields
Specific Setup:
  • Avatar Cal-PM Registry Setting 'Exclude Services If No Treatment Plan' must be enabled (set to 'P')
  • Crystal Reports or other SQL reporting tool
Steps
  1. Open Avatar Cal-PM 'Guarantors/Payors' form.
  2. Select Add or Edit action in 'Add New or Edit Existing Guarantor' field.
  3. Enter new (or select existing) Guarantor Code.
  4. Complete all required/desired fields in main section of 'Guarantors/Payors' form.
  5. Navigate to 'Treatment Plan Requirements' section of 'Guarantors/Payors' form.
  6. Ensure that the 'Requirement Start Date' and 'Requirement End Date' fields are available in form.
  7. If the date of service falls outside of the Requirement Start/End Date Range it will not be included in the Treatment Plan Requirements definition/check
  8. 'Requirement Start Date' and 'Requirement End Date' fields are not required; if no value entered, the Treatment Plan Requirement definition/check will apply to all dates
  9. If value is entered for either 'Requirement Start Date' or 'Requirement End Date' field, value must be entered for both fields
  10. Enter value for 'Requirement Start Date' and 'Requirement End Date' fields (and any other required/desired fields in 'Treatment Plan Requirements' section of form).
  11. Click 'Update' button to save Treatment Plan Requirement entry; repeat entry for additional Treatment Plan Requirements if desired.
  12. Navigate to main section of 'Guarantors/Payors' form.
  13. Click 'File' button to save/file Guarantor/Payor definition information.
  14. Select 'Edit' action and select previously filed Guarantor Code.
  15. Navigate to 'Treatment Plan Requirements' section of 'Guarantors/Payors' form.
  16. Select previously entered/filed Treatment Plan Requirement in 'Select Treatment Plan Requirements' field.
  17. Ensure that previously entered/filed values for 'Requirement Start Date' and 'Requirement End Date' fields are present in form (as well as values for all other fields in 'Treatment Plan Requirements' section of form).
  18. Open Crystal Reports or other SQL reporting tool.
  19. In Avatar Cal-PM SQL table 'SYSTEM.billing_guar_table_tpreq', ensure that fields 'requirement_start_date' and 'requirement_end_date' are present, and reflect values filed via 'Guarantors/Payors' form for 'Requirement Start Date' and 'Requirement End Date' fields (respectively).
Scenario 2: 'File Import' - Verification of 'Guarantors/Payors - Treatment Plan Requirements' Import
Specific Setup:
  • Avatar Cal-PM Registry Setting 'Exclude Services If No Treatment Plan' must be enabled (set to 'P')
  • Avatar Cal-PM 'Guarantors/Payors - Treatment Plan Requirements' import file containing one or more valid import data rows, including values for 'Requirement Start Date' and 'Requirement End Date' segments/fields
  • Updated import file layout document 'Avatar_Cal-PM_File_Import_Record_Layouts.xls' included with update package
  • Crystal Reports or other SQL reporting tool
Steps
  1. Open Avatar Cal-PM 'File Import' form.
  2. Select File Type 'Guarantors/Payors - Treatment Plan Requirements'.
  3. Select 'Upload New File' in 'Action' field and Click 'Process Action' button.
  4. Select Avatar Cal-PM 'Guarantors/Payors - Treatment Plan Requirements' import file and click 'Open' button.
  5. Select 'Compile/Validate File' in 'Action' field.
  6. Select loaded import file and click 'Process Action' button.
  7. Ensure that 'Compile/Validate File' action completes, and message 'Compiled' or '(File Name) contains one or more errors. These errors can be reviewed using 'Print Errors' action' is displayed.
  8. Click 'OK' button.
  9. Select 'Print Errors' in 'Action' field if errors encountered in compile; Select compiled import file with errors and click 'Process Action' button.
  10. In 'Guarantors/Payors - Treatment Plan Requirements' File Import Error Report, ensure that all invalid/errored import row(s) are included in report with segment/value reference and error message detail.
  11. Examples of 'Guarantors/Payors - Treatment Plan Requirements' File Import errors related to 'Requirement Start Date' and 'Requirement End Date' segments/fields:
  12. 'Invalid date or format'
  13. 'End Date is prior to Start Date'
  14. 'Missing start date'
  15. 'Missing end date'
  16. Select 'Print File' in 'Action' field to view successfully compiled import data; Select compiled import file and click 'Process Action' button.
  17. In 'Guarantors/Payors - Treatment Plan Requirements' File Import Report, ensure that all valid import row(s) are included in report with segment/value details, including 'Requirement Start Date' and 'Requirement End Date' segments/fields.
  18. Select 'Post File' in 'Action' field to post successfully compiled import data; Select compiled import file and click 'Process Action' button.
  19. Ensure that 'Compile/Validate File' action completes, and message 'Posted' and/or 'The selected file contains one or more lines with compilation errors. Only those lines without compilation errors will be posted' is displayed.
  20. Open Avatar Cal-PM 'Guarantors/Payors' form.
  21. Select Edit action in 'Add New or Edit Existing Guarantor' field, and select Guarantor where Treatment Plan Requirement entry was created/updated via File Import filing.
  22. Navigate to 'Treatment Plan Requirements' section of 'Guarantors/Payors' form.
  23. Select Treatment Plan Requirement entry filed via File Import in 'Select Treatment Plan Requirements' field.
  24. Ensure that values for 'Requirement Start Date' and 'Requirement End Date' fields filed via File Import are present in form (as well as values for all other fields in 'Treatment Plan Requirements' section of form according to File Import data).
  25. Open Crystal Reports or other SQL reporting tool.
  26. In Avatar Cal-PM SQL table 'SYSTEM.file_import_guar_tp_req', ensure that fields 'requirement_start_date' and 'requirement_end_date' are present, and reflect values filed via File Import for 'Requirement Start Date' and 'Requirement End Date' fields (respectively).
Scenario 3: 'Electronic Billing' - Verification of 'Treatment Plan Requirement' Restrictions
Specific Setup:
  • Avatar Cal-PM Registry Setting 'Exclude Services If No Treatment Plan' must be enabled (set to 'P')
  • One or more Guarantor(s) where values are selected/defined for 'Requirement Start Date' and 'Requirement End Date' fields (via Avatar Cal-PM 'Guarantors/Payors' form, 'Treatment Plan Requirements' section)
  • Avatar CWS Treatment Plan form (including Draft/Final Status field)
  • One or more service(s) eligible for Avatar Cal-PM 837 Professional or 837 Institutional file inclusion under applicable Guarantor(s) (via 'Electronic Billing' form)
Steps
  1. Open Avatar Cal-PM 'Electronic Billing' form.
  2. Note, acceptance testing may also be confirmed via Avatar Cal-PM 'Quick Billing' form/functionality
  3. Select '837 Professional' or '837 Institutional' in the 'Billing Form' field.
  4. Select 'Sort File' in the 'Billing Options' field.
  5. Enter/select 837 Professional/837 Institutional file sorting criteria.
  6. Click 'Process' button to sort/generate 837 Professional/837 Institutional file.
  7. Select 'Run Report' in the 'Billing Options' field.
  8. Select 'Print' in the 'Print Or Delete Report' field.
  9. Select 837 Professional/837 Institutional file sorted which includes services(s), and click 'Process' button to display 837 Professional/837 Institutional outbound file report.
  10. In Avatar Cal-PM 837 Professional/837 Institutional format outbound electronic billing file report:
  11. In case where 'Final' status 'Treatment Plan' record does not exist applicable to client/service(s) to be included in 837 file and no 'Requirement Start Date'/'Requirement End Date' values are defined for applicable Guarantor/Treatment Plan Requirements - Ensure that error is reported/included for service(s) in 'Required Data Missing: Patient Service Data' section of report (and service is not included in 837 file claim/service information).
  12. Error Message Example:
  13. 'No Final Treatment Plan In Effect For Service: [Service Code] - Service Date: [Service Date]'
  14. In case where 'Final' status 'Treatment Plan' record does not exist applicable to client/service(s) to be included in 837 file and service date is within 'Requirement Start Date'/'Requirement End Date' values defined for applicable Guarantor/Treatment Plan Requirements - Ensure that error is reported/included for service(s) in 'Required Data Missing: Patient Service Data' section of report (and service is not included in 837 file claim/service information).
  15. Error Message Example:
  16. 'No Final Treatment Plan In Effect For Service: [Service Code] - Service Date: [Service Date]'
  17. In case where 'Final' status 'Treatment Plan' record does not exist applicable to client/service(s) to be included in 837 file and service date is outside of 'Requirement Start Date'/'Requirement End Date' values defined for applicable Guarantor/Treatment Plan Requirements - Ensure that Treatment Plan-related error is not reported/included for service(s) in 'Required Data Missing: Patient Service Data' section of report and service(s) is/are included in 837 file information as expected (subject to all other 837 sorting criteria/requirements).
  18. In case where 'Final' status 'Treatment Plan' record exists applicable to client/service(s) to be included in 837 file (regardless of 'Requirement Start Date'/'Requirement End Date' values defined for applicable Guarantor/Treatment Plan Requirements) - Ensure that Treatment Plan-related error is not reported/included for service(s) in 'Required Data Missing: Patient Service Data' section of report and service(s) is/are included in 837 file information as expected (subject to all other 837 sorting criteria/requirements).
  19. Select 'Create File On Server' in the 'Billing Options' field.
  20. Select 837 Professional/837 Institutional file sorted which includes services(s), and click 'Process' button to create 837 Professional/837 Institutional outbound file on server.
Topics
• Electronic Billing • File Import • Guarantor • NX • Registry Settings • Treatment Plan
Update 69 Summary | Details
Diagnosis - 'SearchDiagnosisCodes' web service
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • SOAPUI - DiagnosisV2 - SearchDiagnosisCode
Scenario 1: Diagnosis - Validate the 'SearchDiagnosisCode' web service
Steps
  1. Access SoapUI for the 'DiagnosisV2' - 'SearchDiagnosisCodes' web service.
  2. Enter the system code that will be used to log into Avatar in the 'SystemCode' field.
  3. Enter the user name that will be used to log into Avatar in the 'UserName' field.
  4. Enter the password that will be used to log into Avatar in the 'Password' field.
  5. Enter the desired diagnosis search term in the 'ClinicalSearchTerm' field.
  6. Click [Run].
  7. Validate the 'SearchDiagnosisCodeResult' field contains all related diagnosis codes.
Support is added for other products and modules
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Delete Last Practitioner Termination Date
  • Practitioner Termination
  • CareFabric Monitor
  • Crystal Report Viewer
Scenario 1: Delete Last Practitioner Termination Date - Validate form functionality
Specific Setup:
  • A practitioner has been terminated in the 'Practitioner Termination' form (Practitioner A).
Steps
  1. Access the 'Delete Last Practitioner Termination Date' form for "Practitioner A".
  2. Validate the 'Termination Date' field contains the termination date.
  3. Click [Submit].
  4. Validate a message is displayed stating: Are you sure you want to delete termination date ##/##/#### for practitioner "Practitioner A".
  5. Click [Yes].
  6. Access the 'Practitioner Termination' form for "Practitioner A".
  7. Validate the 'Termination Date' field does not contain a value.
  8. Validate the 'Reason For Termination' field does not contain a value.
  9. Close the form.
Scenario 2: Delete Last Practitioner Termination Date - Validate the 'ProviderUpdated' SDK event
Specific Setup:
  • An active practitioner is defined that has hours for scheduling in the 'Staff Members Hours and Exceptions' form (Practitioner A).
Steps
  1. Access the 'Practitioner Termination' form for "Practitioner A".
  2. Enter the desired date in the 'Termination Date' field.
  3. Populate any other desired fields.
  4. Click [Submit].
  5. Access the 'CareFabric Monitor' form.
  6. Enter the current date in the 'From Date' and 'Through Date' fields.
  7. Search for and select "ProviderUpdated" in the 'Event/Action Search' field.
  8. Click [View Activity Log].
  9. Validate the 'CareFabric Monitor Report' contains a "ProviderUpdated" event triggered from the 'Practitioner Termination' form.
  10. Click [Click To View Record].
  11. Validate the 'isActive' field contains "false".
  12. Close the report and the form.
  13. Access the 'Delete Last Practitioner Termination' form for "Practitioner A".
  14. Validate the 'Termination Date' field contains the termination date.
  15. Click [Submit].
  16. Validate a message is displayed stating: Are you sure you want to delete termination date ##/##/#### for practitioner "Practitioner A".
  17. Click [Yes].
  18. Access the 'CareFabric Monitor' form.
  19. Enter the current date in the 'From Date' and 'Through Date' fields.
  20. Search for and select "ProviderUpdated" in the 'Event/Action Search' field.
  21. Click [View Activity Log].
  22. Validate the 'CareFabric Monitor Report' contains a "ProviderUpdated" event triggered from the 'Delete Last Practitioner Termination' form.
  23. Click [Click To View Record].
  24. Validate the 'isActive' field contains "true".
  25. Close the report and the form.
Scenario 3: Delete Last Practitioner Termination Date - Validate the 'StaffMemberUpdated' SDK event
Specific Setup:
  • An active practitioner is defined in 'Practitioner Enrollment' (Practitioner A).
Steps
  1. Access the 'Practitioner Termination' form for "Practitioner A".
  2. Enter the desired date in the 'Termination Date' field.
  3. Populate any other desired fields.
  4. Click [Submit].
  5. Access the 'CareFabric Monitor' form.
  6. Enter the current date in the 'From Date' and 'Through Date' fields.
  7. Search for and select "StaffMemberUpdated" in the 'Event/Action Search' field.
  8. Click [View Activity Log].
  9. Validate the 'CareFabric Monitor Report' contains a "StaffMemberUpdated" event triggered from the 'Practitioner Termination' form.
  10. Click [Click To View Record].
  11. Validate the 'terminatedDate' field contains the 'Termination Date' filed.
  12. Close the report and the form.
  13. Access the 'Delete Last Practitioner Termination' form for "Practitioner A".
  14. Validate the 'Termination Date' field contains the termination date.
  15. Click [Submit].
  16. Validate a message is displayed stating: Are you sure you want to delete termination date ##/##/#### for practitioner "Practitioner A".
  17. Click [Yes].
  18. Access the 'CareFabric Monitor' form.
  19. Enter the current date in the 'From Date' and 'Through Date' fields.
  20. Search for and select "StaffMemberUpdated" in the 'Event/Action Search' field.
  21. Click [View Activity Log].
  22. Validate the 'CareFabric Monitor Report' contains a "StaffMemberUpdated" event triggered from the 'Delete Last Practitioner Termination' form.
  23. Click [Click To View Record].
  24. Validate the 'terminatedDate' field contains "null".
  25. Close the report and the form.
Scenario 4: Delete Last Practitioner Termination Date - Validate the 'EvvResourceUpdated' SDK event
Specific Setup:
  • Avatar is configured to integrate with Mobile CareGiver+. Please note: This must be done by a Netsmart Representative.
  • One or more program(s) is defined with a value populated in the 'EVV Provider Organization ID' field in the 'Program Maintenance' form.
  • A service code must be defined that has "Yes" selected in the 'Does This Service Require Electronic Visit Verification' field in the 'Service Codes' form and must be assigned to "Program A".
  • An active practitioner is defined in 'Practitioner Enrollment' with the following on file: 'Name', 'Date Of Birth', 'Cellular Telephone', 'Staff EVV ID', 'Email Address', 'Staff EVV Type'.
Steps
  1. Access the 'Practitioner Termination' form for "Practitioner A".
  2. Enter the desired date in the 'Termination Date' field.
  3. Populate any other desired fields.
  4. Click [Submit].
  5. Access the 'CareFabric Monitor' form.
  6. Enter the current date in the 'From Date' and 'Through Date' fields.
  7. Search for and select "EvvResourceUpdated" in the 'Event/Action Search' field.
  8. Click [View Activity Log].
  9. Validate the 'CareFabric Monitor Report' contains a "EvvResourceUpdated" event triggered from the 'Practitioner Termination' form.
  10. Click [Click To View Record].
  11. Validate the 'isActive' field contains "false".
  12. Close the report and the form.
  13. Access the 'Delete Last Practitioner Termination' form for "Practitioner A".
  14. Validate the 'Termination Date' field contains the termination date.
  15. Click [Submit].
  16. Validate a message is displayed stating: Are you sure you want to delete termination date ##/##/#### for practitioner "Practitioner A".
  17. Click [Yes].
  18. Access the 'CareFabric Monitor' form.
  19. Enter the current date in the 'From Date' and 'Through Date' fields.
  20. Search for and select "EvvResourceUpdated" in the 'Event/Action Search' field.
  21. Click [View Activity Log].
  22. Validate the 'CareFabric Monitor Report' contains a "EvvResourceUpdated" event triggered from the 'Delete Last Practitioner Termination' form.
  23. Click [Click To View Record].
  24. Validate the 'isActive' field contains "true".
  25. Close the report and the form.
Topics
• Diagnosis • Web Services • Practitioner
Update 72 Summary | Details
Practitioner Enrollment - The 'Office Location ID, 'Staff EVV ID', 'Staff EVV Type' and 'Email Address' fields
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Practitioner Enrollment
Scenario 1: 'ClinicianServicesV2' Web Service - Verification Of 'putClinicianCreation' Filing
Steps
  1. Using the 'ClinicianServicesV2' web service, submit a request using the 'putClinicianCreation' method to create new 'Practitioner Enrollment' record (and optionally Avatar MSO Performing Provider Registration record), including values for the 'StaffEVVID', 'OfficeLocationID', 'EmailAddress' and 'StaffEVVType' fields/segments.
  2. Confirm the 'ClinicianServicesV2' web service responds with confirmation data on successful filing of 'putClinicianCreation' method.
  3. Example: "<Confirmation>Practitioner ID:000017||||First Name:FIRSTNAME||Last Name:LASTNAME||Registration Date:01/01/2022||NPI:123456789</Confirmation>"
  4. Confirm the 'ClinicianServicesV2' web service responds with confirmation message on successful filing of 'putClinicianCreation' method.
  5. Example: "<Message>Clinician Services web service has been filed successfully.</Message>"
  6. Confirm the 'ClinicianServicesV2' web service responds with successful status value on successful filing of 'putClinicianCreation' method.
  7. Example: " <Status>1</Status>"
  8. Access the 'Practitioner Enrollment' form and select the 'Practitioner Enrollment' record filed via web service for view/update.
  9. Confirm new 'Practitioner Enrollment' record is created with values/data submitted via web service including 'Staff EVV ID', 'Office Location ID', 'Email Address' and 'Staff EVV Type' field values (as well as values assigned for Avatar MSO 'Performing Provider' and 'Performing Provider Registration' practitioner association/link fields if enabled).
Scenario 2: 'ClinicianServicesV2' Web Service - Verification Of 'putClinicianUpdate' Filing
Steps
  1. Using the 'ClinicianServicesV2' web service, submit a request using the 'putClinicianUpdate' method to edit/update a 'Practitioner Enrollment' record (and optionally Avatar MSO Performing Provider Registration record if linked), including values for the 'StaffEVVID', 'OfficeLocationID', 'EmailAddress' and 'StaffEVVType' fields/segments.
  2. Confirm the 'ClinicianServicesV2' web service responds with confirmation data on successful filing of 'putClinicianUpdate' method.
  3. Example: "<Confirmation>Practitioner ID:000017||||First Name:FIRSTNAME||Last Name:LASTNAME||Registration Date:01/01/2022||NPI:123456789</Confirmation>"
  4. Confirm the 'ClinicianServicesV2' web service responds with confirmation message on successful filing of 'putClinicianUpdate' method.
  5. Example: "<Message>Clinician Services web service has been filed successfully.</Message>"
  6. Confirm the 'ClinicianServicesV2' web service responds with successful status value on successful filing of 'putClinicianUpdate' method.
  7. Example: " <Status>1</Status>"
  8. Access the 'Practitioner Enrollment' form and select the 'Practitioner Enrollment' record filed via web service for view/update.
  9. Confirm the 'Practitioner Enrollment' record is updated with values/data submitted via web service including 'Staff EVV ID', 'Office Location ID', 'Email Address' and 'Staff EVV Type' field values.
Scenario 3: 'Practitioner Enrollment' - Form Verification
Specific Setup:
  • Crystal Reports or other SQL Reporting Tool.
Steps
  1. Access the 'Practitioner Enrollment' form.
  2. Select any existing practitioner for view/update.
  3. Validate the 'Staff EVV ID', 'Office Location ID', 'Staff EVV Type' and 'Email Address' fields are displayed.
  4. Enter any value in the 'Staff EVV ID' field.
  5. Enter any value in the 'Office Location ID' field.
  6. Enter any value in the 'Staff EVV Type' field.
  7. Enter any value in the 'Email Address' field.
  8. Populate any other required and desired fields.
  9. Click [Submit].
  10. Access the 'Practitioner Enrollment' form.
  11. Select the same practitioner from the previous steps.
  12. Validate the 'Staff EVV ID' field contains the value filed in the previous steps.
  13. Validate the 'Office Location ID' field contains the value filed in the previous steps.
  14. Validate the 'Staff EVV Type' field contains the value filed in the previous steps.
  15. Validate the 'Email Address' field contains the value filed in the previous steps.
  16. Validate any other previously field data is displayed.
  17. Close the form.
  18. Access Crystal Reports or other SQL Reporting Tool.
  19. Create a report using the 'SYSTEM.staff_enrollment_history' SQL table.
  20. Navigate to the row for the practitioner used in the previous steps.
  21. Validate the 'Staff_EVV_ID' field contains the value filed in the previous steps.
  22. Validate the 'Staff_EVV_Type' field contains the value filed in the previous steps.
  23. Validate the 'office_location_ID' field contains the value filed in the previous steps.
  24. Validate the 'email_address' field contains the value filed in the previous steps.
  25. Close the report.
  26. Create a report using the 'SYSTEM.staff_current_demographics' SQL table.
  27. Validate the 'Staff_EVV_ID' field contains the value filed in the previous steps.
  28. Validate the 'Staff_EVV_Type' field contains the value filed in the previous steps.
  29. Validate the 'office_location_ID' field contains the value filed in the previous steps.
  30. Validate the 'email_address' field contains the value filed in the previous steps.
  31. Close the report.
Topics
• Practitioner • Web Services