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Avatar Cal-PM 2022 Update 3

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Product Requirements / Recommendations

Avatar Cal-PM required
RADplus required

Recommended Update Level

Avatar Cal-PM 2021 Update 35

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.

Included Updates

None

Required Updates

None

Details
NEW0 CHANGED0 FIXED1
Fixed (1)
'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. KB0068757 v0.01
Topics
• Electronic Billing • NX • Service Fee/Cross Reference Maintenance
 
Acceptance Tests
AV-78105 Summary | Details
'Electronic Billing' - 837 Professional 2400-SV1 Service Information
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Electronic Billing
Scenario 1: 'Electronic Billing' - Verification of 837 Professional 2400-SV1 Service Information
Specific Setup:
  • One or more 837 Professional /HCFA1500 service(s) eligible for Electronic Billing inclusion where applicable Guarantor Definition Override exists with 'Service Unit Of Measurement Code' and 'Quantity' values defined (via Avatar Cal-PM 'Service Fee/Cross Reference Maintenance' form, 'Guarantor Definition' section)
Steps
  1. Open Avatar Cal-PM 'Electronic Billing' form. (Note, acceptance testing may also be confirmed via Avatar 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), and click 'Process' button to display 837 Professional outbound file data.
  9. In Avatar PM 837 Professional format outbound electronic billing file data - If applicable Guarantor Definition Override exists with 'Service Unit Of Measurement Code' and 'Quantity' values defined, ensure that values for Unit of Measurement and Quantity are reflected in 2400-SV1 Service Line Number service information (2400-SV1-03 and 2400-SV1-04 segments/values, respectively).
  10. Examples:
  11. SV1*HC:90804*125.50*UN*10*11**1~
  12. SV1*HC:90804*125.50*MJ*60*11**1~
  13. SV1*HC:90804*125.50*DA*1*11**1~
Topics
• Electronic Billing • NX • Service Fee/Cross Reference Maintenance

 

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