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Avatar Cal-PM 2022 Quarterly Release 2022.01 Details

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Product Requirements / Recommendations

Avatar Cal-PM required
RADplus required

  • Avatar AM 2021 is Installed
    Installation will upgrade to the 2022 version. This will not change any current functionality.
Included Updates
None
Product Update Form Description
Avatar Cal-PM 2021 is updated to Avatar Cal-PM 2022
Topics
• Upgrade
  • Avatar Cal-PM 'Support MSO Other Healthcare Coverage' Registry Setting
    The help/description message for Avatar Cal-PM Registry Setting 'Support MSO Other Healthcare Coverage' is updated.
    The help/description message for Avatar Cal-PM Registry Setting 'Support MSO Other Healthcare Coverage' is updated to include the following information: "In order to enable this setting, the registry setting "Enable Fee Override in PM" must be set to either '1', '2', or '3'."
Included Updates
None
Product Update Form Description
The following Registry Setting help message is updated: 'Support MSO Other Healthcare Coverage'
Topics
• Registry Settings • NX
  • 'Electronic Billing' - 837 Professional 2400-SV1 Service Information
    An issue is resolved to ensure that applicable 'Service Unit Of Measurement Code'/'Quantity' overrides defined in the 'Service Fee/Cross Reference Maintenance' form (Guarantor Definition section) are utilized when generating an 837 Professional bill via the Avatar PM 'Electronic Billing' form/function.
Included Updates
None
Product Update Form Description
The issue is resolved where the unit override defined in the 'Quantity' field on the 'Service Fee/Cross Reference Maintenance' form (Guarantor Definition section) is not utilized when billing an 837 Professional bill.
Topics
• Service Fee/Cross Reference Maintenance • Electronic Billing • NX
  • 'Quick Billing Rule Definition' Form
    The field 'Include Primary and/or Secondary Billing' is now required in the 'Quick Billing Rule Definition' form when selecting either '837 Institutional' or '837 Professional' in the 'Billing Form' field.
Included Updates
None
Product Update Form Description
In the form 'Quick Billing Rule Definition' when selecting either 837 Institutional or 837 Professional in the field 'Billing Form', the field 'Include Primary and/or Secondary Billing' now becomes required.
Topics
• Quick Billing • NX
  • Avatar Cal-PM 'Payor Based Authorizations'
    The 'Payor Based Authorizations' form is introduced to Avatar Cal-PM.
    Avatar Cal-PM Registry Settings 'Enable Payor Based Authorizations' and 'Enable CPT Based Payor Authorizations' are added. These Registry Settings will enable/configure the 'Payor Based Authorizations' form and related functionality in Avatar Cal-PM Client Charge Input, Electronic Billing and Appointment Scheduling (Scheduling Calendar) functions.
Included Updates
None
Product Update Form Description
The form 'Payor Based Authorizations' is introduced.
Topics
• Registry Settings • Service Authorizations • NX • Client Charge Input • Electronic Billing • Scheduling Calendar
  • 'Women's Health History' form
    Ensure the 'Women's Health History' form allows data entry for clients with a sex of either "Female" or "Transgender (F to M)".
  • 'CSI Admission' web service
    Ensure the 'CSI Admission' web service files successfully without having the 'Birth Name (Middle)' field populated as this is not a required field.
Included Updates
None
Product Update Form Description
The following issues are resolved: 1) The 'Women's Health History' form may not allow data entry for valid clients. 2) The 'CSI Admission' web service will fail to file if the "Birth Name (Middle)" is not provided even when not required.
Topics
• Women's Heath History • Pregnancy • Csi Admission • Web Services
  • 274 - Provider Directory Definition - inactive provider
    The '274 - Provider Directory Definition' has been updated to correctly process inactive providers, including providers that are inactive at one site, but active at a different site.
Included Updates
None
Product Update Form Description
An issue is resolved where providers marked as inactive were not being excluded from the 274 submission file.
Topics
• 274 - Provider Directory
  • 'Electronic Billing' Support for Services Originating in Avatar MSO
    An issue is resolved to ensure that 837 5010 Professional and Institutional files produced via the Avatar Cal-PM 'Electronic Billing' form correctly produce 2320-AMT(D) Coordination Of Benefits (COB) Payer Paid Amount and 2320-AMT(EAF) Remaining Patient Liability Amount segments/values for services originating in Avatar MSO when the Avatar Cal-PM 'Support MSO Other Healthcare Coverage' Registry Setting is enabled.
Included Updates
None
Product Update Form Description
The issue is resolved where the 837 5010 Professional and Institutional files produced via the 'Electronic Billing' form is always producing 0 in 2320-AMT(D)-02, and not producing the 2320-AMT(EAF) segment for MSO OHC services.
Topics
• Electronic Billing
  • Admission - "ProviderConnect Enterprise" section
    The "ProviderConnect Enterprise" section of the 'Admission' form is updated to prevent editing/deleting previously filed client mappings.
Included Updates
None
Additional Requirements
Avatar CareFabric 2022 Update 21
Product Update Form Description
The "ProviderConnect Enterprise" section of the 'Admission' form is updated to prevent deleting or editing mappings that have previously been filed.
Topics
• Admission • ProviderConnect Enterprise • Admission (Outpatient)
  • 'Client Ledger' Re-Billed Service Display
    An issue is resolved to ensure that services for re-billed claims are correctly displayed in the 'Client Ledger' form 'Simple' Ledger Type.
Included Updates
None
Product Update Form Description
The issue is resolved where services for re-billed claims are not showing in the client ledger.
Topics
• Client Ledger
2021 Update 22 Summary | User Acceptance Tests
  • Electronic Billing - SBR segment
    The ability to force claims as primary payer when it was originally submitted to a different payor has been added to the system.
    This is accomplished by adding a field to the 'Posting/Adjustment Codes Definition' form. The field is: 'Bill Charge Created from this Transfer Code as Primary'.
Included Updates
10, 11, 15
Product Update Form Description
The 'Posting/Adjustment Codes Definition' form is updated to include the 'Bill Charge Created from this Transfer Code as Primary' field. This allows for an 837 Professional or 837 Institutional claim to be submitted as a primary payer for the transfer code.
Topics
• myAvatar/myAvatar NX • Posting/Adjustment Codes
2021 Update 47 Summary | User Acceptance Tests
  • Eligibility Inquiry (270) Request - exclude client with expired coverage
    The new field, ‘Exclude Clients With Expired Coverage For Selected Guarantor(s)’, has been added to the 'Batch Eligibility Inquiry (270) Request' and the 'Batch Eligibility Scheduler Options' sections of the 'Eligibility Inquiry (270) Request' form.
  • Eligibility Inquiry (270) - Request and Submission
    The 'Eligibility Inquiry (270) Request' form is updated to clear the value of the 'Guarantor' field when switching between sections of the form. The 'Eligibility Inquiry (270) Submission' report will not report duplicate data if the form is submitted again without changing the submission data.
  • 270 - Segments to Suppress
    The ability to suppress segments of the 270 file has been added.
    To enable: 1. Update the 'Avatar PM->Billing->Electronic Submissions->Eligibility Inquiry & Response (270/271)->->Specify Segments To Suppress' registry setting to 'Y'. 2. Add desired values to Dictionary Update> Other Tabled Files > # 270175 - Select Segments to Suppress.
Included Updates
4, 10, 11, 15, 22, 23, 25, 26, 28, 35, 42, 44, 46
Required Updates
Avatar Cal-PM 2021 Update 26
Product Update Form Description
The Eligibility Inquiry (270) process is updated as follows: 1) New field 'Exclude Clients With Expired Coverage For Selected Guarantor(s)' is added to the 'Batch Eligibility (270) Request' and 'Batch Inquiry Scheduler Options' tabs of the 'Eligibility Inquiry (270) Request' form. 2) Dictionary field 'Select Segments To Suppress' is added to the 'Eligibility Inquiry (270)' tab of the 'Guarantor/Program Billing Defaults' form. This user-defined dictionary allows facilities to specify the suppression of non-required loops, segments and/or fields. 3) An issue is resolved where the 'Submission Data' sub-report of the 'Eligibility Inquiry (270) Submission' report shows duplicate entries. This could occur when multiple compiles are performed using the same parameters without ever choosing to create a submission file on the server. 4) An issue is resolved where field 'Guarantor' remains enabled and populated when switching from a non-batch request to a batch request.
Topics
• Eligibility Inquiry (270) Request • Eligibility Inquiry (270) Submission • NX
2021 Update 54 Summary | User Acceptance Tests
  • File Import - Client Charge Input - Inhibit Billing By Service
    Resolves an issue to ensure that the service rendered to the client through 'File Import' client charge input file with the 'Billable (Inhibit Billing)' field set to "N" is inhibited from the billing correctly.
Included Updates
None
Product Update Form Description
The issue with the "Client Charge Input" 'File Type' in the 'File Import' form where services with the "Billable (Inhibit Billing)" field set to "N" are not inhibited from billing is resolved.
Topics
• Inhibit Billing • NX • Client Charge Input • File Import
2021 Update 73 Summary | User Acceptance Tests
  • "SYSTEM.billing_plan_table_levels" table - field length's
    A data truncation issue that could occur when displaying SQL table data in the "covered_charge_cat_all" and "pract_cat_for_cov_all" fields of the "SYSTEM.billing_plan_table_levels" table is resolved by expanding the "MAXLEN" value for the fields to "255"
Included Updates
None
Product Update Form Description
An issue is resolved where the fields 'covered_charge_cat_all' and 'pract_cat_for_cov_all' are truncated in the SQL table 'SYSTEM.billing_plan_table_levels'
Topics
• Data Warehouse • Database Management • NX
2021 Update 77 Summary | User Acceptance Tests
  • CSI Assessment - Site Specific fields
    The CSI Assessment site specific fields below will not output the both the code and value to the 'assessment_ca_csi_ss_data' table.
    73018.1 - SS CSI Assessment Single Select Dictionary 1 73018.2 - SS CSI Assessment Single Select Dictionary 2 73018.3 - SS CSI Assessment Single Select Dictionary 3 73018.4 - SS CSI Assessment Single Select Dictionary 4 73018.5 - SS CSI Assessment Single Select Dictionary 5 73019.1 - SS CSI Assessment Multiple Select Dictionary 1 73019.2 - SS CSI Assessment Multiple Select Dictionary 2 73019.3 - SS CSI Assessment Multiple Select Dictionary 3 73019.4 - SS CSI Assessment Multiple Select Dictionary 4 73019.5 - SS CSI Assessment Multiple Select Dictionary 5
Included Updates
None
Product Update Form Description
An issue is resolved where value fields for site specific dictionaries would not populate in the 'SYSTEM.assessment_ca_csi_ss_data' table
Topics
• CSI Assessment
2021 Update 79 Summary | User Acceptance Tests
  • Share of Cost - Quick Billing
    Quick Billing functionality has been updated to prevent Share of Cost with an unmet Share of Cost from being closed.
Included Updates
3, 4, 5, 10, 11, 15, 23, 25, 26, 28, 35, 42, 44, 46, 51, 52, 53, 55, 61, 63, 67, 69, 70
Required Updates
Avatar Cal-PM 2021 Update 23
Product Update Form Description
The issue is resolved where services with un-met Share of Cost amount are being closed thru the 'Quick Billing' form.
Topics
• Quick Billing • Share of Cost Management
2021 Update 80 Summary | User Acceptance Tests
  • 'Client Admission' web service
    Ensure the ability to file the 'Client Admission' web service for new and existing clients.
Included Updates
7
Product Update Form Description
An issue where the Client Admission web service incorrectly fails with the error "Client Name field and Client First Name are not the same" is resolved.
Topics
• Admission • NX • Web Services