Quick Billing
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- Admission (Outpatient)
- App Dashboard
- Client Charge Input
- Diagnosis
- Dictionary Update (PM)
- Dynamic Form - Admission - Client
- Financial Eligibility
- Guarantors/Payors
- Practitioner Numbers By Guarantor and Program
- Quick Billing
- Quick Billing Rule Definition
- Registry Settings (PM)
- User Definition
- Client Charge Input With Diagnosis Entry
- Client Ledger
Scenario 1: 'Quick Billing' - Verification of workscreen row deletion
Specific Setup:
- Avatar Cal-PM Registry Setting 'Enable New Quick Billing Format' must be enabled
- One or more Quick Billing batch(es) must be present for edit via 'Quick Billing' form workscreen
Steps
- Open 'Quick Billing' form.
- In the 'Add New Or Edit Existing Quick Billing Batch' field, select 'Edit Existing'
- In the 'File' drop-down selection field, select existing Quick Billing batch for edit.
- Click the 'Launch Workscreen' button.
- In 'Quick Billing' form workscreen, select one or more rows for deletion, and click 'Delete Row' button.
- Ensure that 'Confirm Delete' dialog is presented; click 'Yes' button to confirm workscreen row deletion.
- Repeat row selection and 'Delete Row' action for any further rows as desired in the 'Quick Billing' form workscreen.
- When edits/deletions are complete, click the 'Save' button to save workscreen data for selected Quick Billing batch.
- Ensure that 'Exit Grid' dialog is presented, noting 'Save Successful'.
- In 'Quick Billing' form, select same batch for edit and click 'Launch Workscreen' button.
- Ensure that any row(s) previously deleted from Quick Billing batch are not present in workscreen grid on re-entry of workscreen for same batch (evidence of correct prior deletion).
- Ensure that any row(s) previously deleted from Quick Billing batch are not re-added to same batch on re-run/submission of 'Quick Billing' form for existing batch.
- Ensure that in case where all rows are deleted from Quick Billing batch, the Quick Billing/Interim Billing batch is deleted from system on saving of workscreen data/submission of 'Quick Billing' form.
Scenario 2: Cal-PM - Quick Billing Rule Definition - HCFA-1500/837-P Billing Options
Specific Setup:
- Client:
- Is admitted to an outpatient program. Note the program.
- Has an active ‘Financial Eligibility’ record. Note the ‘Guarantor’ and ‘Financial Class’ for the guarantor.
- Has an active ‘Diagnosis’ record. Note the diagnosis code.
- Two charges, in the same month, have been entered in ‘Client Charge Input’. Note the last service date.
- Two charges, in the same month as above, have been entered in ‘Client Charge Input With Diagnosis Entry. Enter a code in ‘Diagnosis 1’ that is not the same diagnosis code as in the ‘Diagnosis’ record. The last date of service is before the last date of service entered in ‘Client Charge Input’.
- Use ‘Close Charges’ to close the charges.
- The 'Guarantor/Program Billing Defaults' template for the guarantor and program combination has a value of '1' in '837 Professional', 'Maximum Service Information Per Claim Information (Maximum LX Per CLM)'.
- Form Designer' has been used to revert the 'Quick Billing Rule Definition' section of the 'Quick Billing Rule Definition' form to 'Netsmart Produced Changes'.
- A ‘Quick Billing Rule Definition’ for the guarantor and program combination has the following:
- Billing Form = 837 Professional.
- HCFA-1500/837-P Billing Options = 'Include Services With and Without Diagnosis Entry'.
- Send Generated Bill To = File.
- File Description = 837Ptest.
- File Location = a local directory, noting the value. This is where the 837 Professional will be created.
Steps
- Open 'Quick Billing'.
- Create the bill for the services created above.
- Navigate to the local directory and open the file with '837Ptest' in the name with the current date.
- Validate that four services are output for the Client.
- Validate that for the two services created in 'Client Charge Input', that the 'HI*ABK' segment is present and includes the diagnosis code from the 'Diagnosis' record.
- Validate that for the two services created in 'Client Charge Input With Diagnosis Entry', that the 'HI*ABK' segment is present and includes the diagnosis code entered in 'Client Charge Input With Diagnosis Entry'.
- Close the report.
- Close the form.
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Topics
• Quick Billing
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