Avatar Cal-PM 2022 Update 50

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.

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.

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.

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.