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Avatar Cal-PM 2022 Update 66

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Avatar Cal-PM 2022 Update 29

Product Update Form Description

The following issues are resolved: 1) Claims not associated to the selected interim batch is displayed in the 'Re-print Bill' and 'Delete Claim' forms. 2) The 'Eligibility Inquiry (270) Submission' form prevents processing of any option except "Compile" with missing 'File From Date' and 'File Through Date' error even though they are filled in the form.

Included Updates

29

Required Updates

Avatar Cal-PM 2022 Update 29
Details
NEW0 CHANGED1 FIXED1
Changed (1)
Claim Support - Create Interim Billing Batch File
The functionality for supporting claims created from an 'Interim Billing Batch File' has been updated to ensure that a claim created by the interim batch is only displayed in the interim batch it was claimed it. It will not erroneously display in other interim batches throughout the system, such as in ‘Re-Print Bill’ or ‘Delete Claim’.
Value Added: Prevents claims from showing in an interim batch where they do not exist.
Topics
• Print Bill
 
Fixed (1)
Eligibility Inquiry (270) Submission
An issue has been resolved where processing any of the 'Options' would output an error message indicating that the 'File From Date' and the 'File Through Date' fields were missing when they contained data. KB0070958 v0.01
Topics
• Eligibility Inquiry (270) Submission
 
Acceptance Tests
AV-82913 Summary | Details
Claim Support - Create Interim Billing Batch File
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Admission (Outpatient)
  • Client Charge Input
  • Client Ledger
  • Create Interim Billing Batch File
  • Delete Claim
  • Diagnosis
  • Financial Eligibility
  • Guarantors/Payors
  • Print Bill
  • Program Maintenance
  • Re-Print Bill
Scenario 1: Re-Print Bill/Delete Claim - Interim Billing Batch File.
Specific Setup:
  • Note: Full testing will require waiting until the next day after an additional charge is added during UAT testing steps.
  • Clients: Select or create two clients that are in the same program and are assigned the same guarantor in Financial Eligibility. (Client 1 & Client 2).
  • Client 1: Create one service. Note the date of service. Note the data entry date.
  • Client 2: Create one service using the same date of service. Note the data entry date.
  • ‘Create Interim Billing Batch File’ is used to create a batch for both services. Set the ‘From Date’ and ‘Through Date’ to the date of service. Set the ‘Data Entry From Date’ and the ‘Data Entry Through Date’ to the current date. Note the batch number.
  • ‘Close Charges’ is used to close charges for the interim batch.
  • ‘Print Bill’ is used to create claims for the interim batch. Use a claim date that is a few days after the date of service. Note the date of claim and the claim form.
  • ‘Client Ledger’ is used to verify that the services contain a claim number.
Steps
  1. Open ‘Re-Print Bill’.
  2. Enter the ‘Date Of Claim’ from Setup.
  3. Select ‘Interim Batch’ in ‘Reprint Claims By’.
  4. Select the interim batch used above in ‘Interim Batch Number’.
  5. Select desired value in ‘Unpaid Claims Only’.
  6. Select the claim form from Setup in ‘Print On What Form’.
  7. Click [Select Claims To Reprint].
  8. Select the claim for both clients.
  9. Click [OK].
  10. Click [Process].
  11. Validate that the report contains both client/claims and the information is correct.
  12. Close the report.
  13. Close the form.
  14. Open ‘Delete Claim’.
  15. Enter the ‘Date Of Claim’ from Setup.
  16. Select ‘Interim Batch’ in ‘Delete Claim By’.
  17. Select the interim batch from Setup in ‘Interim Batch Number/837 File’.
  18. Select ‘None’ in ‘Default All Or None’.
  19. Click [Select Claim To Delete].
  20. Validate that both claims are displayed.
  21. Click [Cancel].
  22. Close the form.
  23. Open ‘Client Charge Input’.
  24. Create a service for Client 1. Note the date of service. Note the data entry date.
  25. Close the form.
  26. Stop testing and resume the next day.
  27. Open ‘Client Charge Input’.
  28. Create a service for Client 2, using the same date of service used four steps above.
  29. Close the form.
  30. Open ‘Create Interim Billing Batch File’ and create a batch for the two services. Set the ‘From Date’ and ‘Through Date’ to the date of service. Set the ‘Data Entry From Date’ and the ‘Data Entry Through Date’ to the current date.
  31. Click [Process].
  32. Validate that the report only contains the service for Client 2.
  33. Close the report.
  34. Close the form.
  35. Open ‘‘Print Bill’ and create a claim for the interim batch using the same date of claim from ‘Setup’. Note the claim form.
  36. Validate that only Client 2 is contained in the report.
  37. Close the report.
  38. Close the form.
  39. Open ‘Re-Print Bill’.
  40. Enter the ‘Date Of Claim’.
  41. Select ‘Interim Batch’ in ‘Reprint Claims By’.
  42. Select the interim batch created in UAT in ‘Interim Batch Number’.
  43. Select desired value in ‘Unpaid Claims Only’.
  44. Select the claim form used above in ‘Print On What Form’.
  45. Click [Select Claims To Reprint].
  46. Validate that only the claim for Client 2 is included.
  47. Select the claim.
  48. Click [OK].
  49. Click [Process].
  50. Validate that the report contains Client 2, and the information is correct.
  51. Close the report.
  52. Close the form.
  53. Open ‘Delete Claim’.
  54. Enter the ‘Date Of Claim’.
  55. Select ‘Interim Batch’ in ‘Delete Claim By’.
  56. Select the interim batch used above in ‘Interim Batch Number/837 File’.
  57. Select ‘None’ in ‘Default All Or None’.
  58. Click [Select Claim To Delete].
  59. Validate that only the claim for Client 2 is displayed.
  60. Click [Cancel].
  61. Close the form.
Topics
• Print Bill
AV-83117 Summary | Details
Eligibility Inquiry (270) Submission
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Admission (Outpatient)
  • Client Charge Input
  • Dictionary Update (PM)
  • Eligibility Inquiry (270) Request
  • Eligibility Inquiry (270) Submission
  • Fast Financial Eligibility
  • Guarantors/Payors
  • Registry Settings (PM)
  • SQL Query/Reporting
Scenario 1: Eligibility Inquiry (270) Submission - compiling 270 request for the client when minimum search options are defined
Specific Setup:
  • Registry Settings:
  • The 'Avatar PM->Client Information->Client Demographics->>>Client Demographics - Additional Fields' registry setting doesn't contain a value of '3'.
  • The 'Avatar PM->Billing->Fast Financial Eligibility->->->Additional Fields To Add' registry setting contains all selections.
  • Dictionary Update:
  • File=Client
  • Data Element = Client's Relationship To Subscriber
  • Dictionary Code/Value = desired code/value. Note the dictionary code/value
  • Extended Dictionary Data Element is not set to "Yes"
  • Guarantors/Payors
  • Edit/Add a guarantor that is configured for the 270 eligibility submission. Note the guarantor id and name for further testing.
  • Set the 'Minimum Search Options' field in the '270 / 271 / 834' section to "Last Name", "First Name" and "Date Of Birth".
  • Admission (Outpatient):
  • An outpatient client is admitted. Note the client ID, admission date and admission program.
  • Fast Financial Eligibility:
  • The guarantor configured in 'Guarantors/Payors' form is assigned to the client.
  • Select the dictionary code/value in the 'Client Relationship' field that is configured in the 'Dictionary Update' form.
  • Make sure to populate the Subscriber Name #1, Subscriber's Birth Date # 1 and Subscriber Social Security # 1 fields.
Steps
  1. Open the 'Eligibility Inquiry (270) Request' form.
  2. Add an inquiry for the desired client/guarantor. Note the date range.
  3. Close the form.
  4. Open the 'Eligibility Inquiry (270) Submission' form.
  5. Select 'Compile File' in 'Options'.
  6. Select the desired 'Guarantor'.
  7. Click 'T' button in 'Through Date'.
  8. Click [Process].
  9. Verify that the compile process completed successfully.
  10. Review the 'Eligibility Inquiry (270)' report.
  11. Click 'Submission Data' link.
  12. Verify the report displays client and service included in the eligibility inquiry (270) request/submission correctly.
  13. Close the report.
  14. Select 'Dump File' in 'Options'.
  15. Click the 'T' button in 'File From Date'.
  16. Click the 'T' button in 'File Through Date'.
  17. Select the desired file in 'Select File'
  18. Click [Process].
  19. Verify the report displays client and service included in the eligibility inquiry (270) request/submission correctly.
  20. Close the report.
  21. Change the 'File From Date' to any valid date
  22. Click [Process].
  23. Verify the report displays client and service included in the eligibility inquiry (270) request/submission correctly.
  24. Close the report.
  25. As desired, repeat steps 14 - 24 for 'Create File On Server For Submission' and 'Run Report' in 'Options'.
  26. If desired, select 'Delete File' in 'Options'.
  27. Close the form.
Topics
• Eligibility Inquiry (270) Submission