Skip to main content

Avatar Cal-PM 2023 Monthly Release 2023.00.01 Acceptance Tests

  1. Last updated
  2. Save as PDF
Update 3 Summary | Details
Avatar Cal-PM 'Cal-OMS Admission' Form
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • System Code Definition
  • Program Maintenance
  • Cal-OMS Admission
Scenario 1: 'Cal-OMS Admission' - Form Verification
Specific Setup:
  • One or more client(s) with episode eligible for Cal-OMS Admission entry/filing
Steps
  1. Open 'Cal-OMS Admission' form.
  2. Select client/episode for record entry and click 'OK' button.
  3. Enter value for 'Admission Date' field.
  4. Click to expand the 'Location of Admission' drop-down selection field.
  5. Ensure that Programs available for selection in 'Location of Admission' field are limited to Cal-OMS enabled Programs allowed/available for the current system code (according to 'Associated Programs' field in 'System Code Definition' for current system code, where user is logged into sub-system code).
  6. Note - In case where user is logged into Avatar Cal-PM root system code, all Cal-OMS enabled Programs will be available for selection in the 'Location of Admission' field
  7. Select value for 'Location of Admission' and 'Level of Care Admitted' fields.
  8. Complete other fields in form as required/desired.
  9. Click 'Submit' button in 'Cal-OMS Admission' form to file record/data.
Avatar Cal-PM 'Program Maintenance' Form
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Registry Settings (PM)
  • File Import
  • File Import Report
  • Program Maintenance
  • Admission (Outpatient)
  • Back Dated Admission/Discharge
Scenario 1: 'File Import' - Verification of 'Program Maintenance' Import (Avatar Cal-PM)
Specific Setup:
  • Avatar Cal-PM Registry Setting 'Enable Default Guarantor Assignment' may optionally be enabled/disabled
  • Avatar Cal-PM 'Program Maintenance' File Import file containing one or valid rows, including one or more of the following fields/segments:
  • 'Default The Guarantor During' (field/segment 78)
  • 'Default The Guarantor Only If' (field/segment 79)
  • 'Guarantor Order' (field/segment 80)
  • 'Require Source Of Admission' (field/segment 81)
  • 'Require Attending Practitioner' (field/segment 82)
  • Updated import file layout document 'Avatar_Cal-PM_File_Import_Record_Layouts.xls' included with update package
  • Crystal Reports or other SQL reporting tool
Steps
  1. Open Avatar Cal-PM 'File Import' form.
  2. Select File Type 'Program Maintenance'.
  3. Select 'Upload New File' in 'Action' field and Click 'Process Action' button.
  4. Select Avatar Cal-PM 'Program Maintenance' import file and click 'Open' button.
  5. Select 'Compile/Validate File' in 'Action' field.
  6. Select loaded import file and click 'Process Action' button.
  7. Ensure that 'Compile/Validate File' action completes, and message 'Compiled' or '(File Name) contains one or more errors. These errors can be reviewed using 'Print Errors' action' is displayed.
  8. Click 'OK' button.
  9. Select 'Print Errors' in 'Action' field if errors encountered in compile; Select compiled import file with errors and click 'Process Action' button.
  10. In 'Program Maintenance' File Import Error Report, ensure that all invalid/errored import row(s) are included in report with segment/value reference and error message detail.
  11. Select 'Print File' in 'Action' field to view successfully compiled import data; Select compiled import file and click 'Process Action' button.
  12. In 'Program Maintenance' File Import Report, ensure that all valid import row(s) are included in report with segment/value details, including the following fields/segments where included:
  13. 'Selected Guarantors to Default' ('Guarantor Order')
  14. 'Default The Guarantor During'
  15. 'Default The Guarantor Only If'
  16. 'Require Source Of Admission'
  17. 'Require Attending Practitioner'
  18. Select 'Post File' in 'Action' field to post successfully compiled import data; Select compiled import file and click 'Process Action' button.
  19. Ensure that 'Compile/Validate File' action completes, and message 'Posted' and/or 'The selected file contains one or more lines with compilation errors. Only those lines without compilation errors will be posted' is displayed.
  20. Open Crystal Reports or other SQL reporting tool.
  21. In new Avatar Cal-PM SQL table 'SYSTEM.file_import_prog_maint', ensure that all 'Program Maintenance' File Import rows are included in table with values from import data file.
  22. Open Avatar Cal-PM 'Program Maintenance' form.
  23. Select 'Edit' in 'Add or Edit Program' field and select existing Program filed via import.
  24. Ensure values for 'Require Source Of Admission' and 'Require Attending Practitioner' fields are present as filed via import.
  25. Navigate to 'Default Guarantor Assignment' section of 'Program Maintenance' form (where enabled/present).
  26. Ensure values for 'Guarantor Order', 'Default the Guarantor During' and 'Default the Guarantor Only If' fields are present as filed via import (where enabled/present).
Scenario 2: 'Admission' - Form Verification (Avatar Cal-PM)
Specific Setup:
  • Program where 'Require Source Of Admission' and/or 'Require Attending Practitioner' is defined as 'Yes' (via Avatar Cal-PM 'Program Maintenance' form)
Steps
  1. Open Avatar Cal-PM 'Admission' form.
  2. Note - Acceptance Testing Scenario 'Source of Admission'/'Attending Practitioner' field requirements also apply to 'Admission (Outpatient)' and 'Back Dated Admission/Discharge' forms, as well as the Avatar Cal-PM Client Admission web service
  3. In 'Select Client' dialog, enter values for search criteria and click 'Search' button.
  4. Select existing client record to enter Admission record, or click 'New Client' button to create new client record via Admission record entry.
  5. In 'Admission' form, enter/select values for 'Preadmit/Admission Date', 'Preadmit/Admission Time', 'Program', 'Type of Admission', 'Admitting Practitioner' and any other required/desired fields.
  6. Where selected Program value is defined with 'Require Source of Admission' set to 'Yes', ensure that 'Source Of Admission' field is required in 'Admission' form (field marked in red and disallows form filing if value not specified).
  7. Where selected Program value is defined with 'Require Attending Practitioner' set to 'Yes', ensure that 'Attending Practitioner' field is required in 'Admission' form (field marked in red and disallows form filing if value not specified).
  8. Click 'Submit' button to file new Admission/episode for existing client/new client creation.
Scenario 3: 'Program Maintenance' - Form Verification (Avatar Cal-PM)
Specific Setup:
  • Crystal Reports or other SQL reporting tool
Steps
  1. Open the Avatar Cal-PM 'Program Maintenance' form.
  2. Select 'Add' in 'Add or Edit Program' field and enter Program Code (or select 'Edit' in 'Add or Edit Program' field and select existing Program).
  3. Ensure that 'EVV Provider Organization ID' field is present in form; enter value for 'EVV Provider Organization ID' if desired.
  4. Ensure that 'Require Source Of Admission' field is present in form (Yes/No radio button selection field); select value for 'Require Source Of Admission' if desired.
  5. If 'Require Source Of Admission' is set to 'Yes', the 'Source Of Admission' field will be required in the Avatar Cal-PM 'Admission', 'Admission (Outpatient)' and 'Back Dated Admission/Discharge' forms (as well as the Avatar Cal-PM Client Admission Web Service) for the selected Program
  6. Ensure that 'Require Attending Practitioner' field is present in form (Yes/No radio button selection field); select value for 'Require Source Of Admission' if desired.
  7. If 'Require Attending Practitioner' is set to 'Yes', the 'Attending Practitioner' field will be required in the Avatar Cal-PM 'Admission', 'Admission (Outpatient)' and 'Back Dated Admission/Discharge' forms (as well as the Avatar Cal-PM Client Admission Web Service) for the selected Program
  8. Enter/select values for all other Program Maintenance fields as required/desired.
  9. Click 'File Program' button to save Program Maintenance information.
  10. Click 'Print All Programs' button to display Program Maintenance information.
  11. In Program Maintenance report, ensure 'Require Source Of Admission' and 'Require Attending Practitioner' fields are present and reflect values filed via 'Program Maintenance' form.
  12. Open Crystal Reports or other SQL reporting tool.
  13. In Avatar Cal-PM SQL table 'SYSTEM.table_program_definition' - ensure all Program Maintenance information filed is present, including values for 'req_src_adm_code'/'req_src_adm_value' and 'req_attn_pract_code'/'req_attn_pract_value'.
Avatar Cal-PM 'Enable Default Guarantor Assignment' Registry Setting
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Registry Settings (PM)
  • File Import
  • File Import Report
  • Program Maintenance
  • Financial Eligibility
  • Admission (Outpatient)
  • Back Dated Admission/Discharge
Scenario 1: 'File Import' - Verification of 'Program Maintenance' Import (Avatar Cal-PM)
Specific Setup:
  • Avatar Cal-PM Registry Setting 'Enable Default Guarantor Assignment' may optionally be enabled/disabled
  • Avatar Cal-PM 'Program Maintenance' File Import file containing one or valid rows, including one or more of the following fields/segments:
  • 'Default The Guarantor During' (field/segment 78)
  • 'Default The Guarantor Only If' (field/segment 79)
  • 'Guarantor Order' (field/segment 80)
  • 'Require Source Of Admission' (field/segment 81)
  • 'Require Attending Practitioner' (field/segment 82)
  • Updated import file layout document 'Avatar_Cal-PM_File_Import_Record_Layouts.xls' included with update package
  • Crystal Reports or other SQL reporting tool
Steps
  1. Open Avatar Cal-PM 'File Import' form.
  2. Select File Type 'Program Maintenance'.
  3. Select 'Upload New File' in 'Action' field and Click 'Process Action' button.
  4. Select Avatar Cal-PM 'Program Maintenance' import file and click 'Open' button.
  5. Select 'Compile/Validate File' in 'Action' field.
  6. Select loaded import file and click 'Process Action' button.
  7. Ensure that 'Compile/Validate File' action completes, and message 'Compiled' or '(File Name) contains one or more errors. These errors can be reviewed using 'Print Errors' action' is displayed.
  8. Click 'OK' button.
  9. Select 'Print Errors' in 'Action' field if errors encountered in compile; Select compiled import file with errors and click 'Process Action' button.
  10. In 'Program Maintenance' File Import Error Report, ensure that all invalid/errored import row(s) are included in report with segment/value reference and error message detail.
  11. Select 'Print File' in 'Action' field to view successfully compiled import data; Select compiled import file and click 'Process Action' button.
  12. In 'Program Maintenance' File Import Report, ensure that all valid import row(s) are included in report with segment/value details, including the following fields/segments where included:
  13. 'Selected Guarantors to Default' ('Guarantor Order')
  14. 'Default The Guarantor During'
  15. 'Default The Guarantor Only If'
  16. 'Require Source Of Admission'
  17. 'Require Attending Practitioner'
  18. Select 'Post File' in 'Action' field to post successfully compiled import data; Select compiled import file and click 'Process Action' button.
  19. Ensure that 'Compile/Validate File' action completes, and message 'Posted' and/or 'The selected file contains one or more lines with compilation errors. Only those lines without compilation errors will be posted' is displayed.
  20. Open Crystal Reports or other SQL reporting tool.
  21. In new Avatar Cal-PM SQL table 'SYSTEM.file_import_prog_maint', ensure that all 'Program Maintenance' File Import rows are included in table with values from import data file.
  22. Open Avatar Cal-PM 'Program Maintenance' form.
  23. Select 'Edit' in 'Add or Edit Program' field and select existing Program filed via import.
  24. Ensure values for 'Require Source Of Admission' and 'Require Attending Practitioner' fields are present as filed via import.
  25. Navigate to 'Default Guarantor Assignment' section of 'Program Maintenance' form (where enabled/present).
  26. Ensure values for 'Guarantor Order', 'Default the Guarantor During' and 'Default the Guarantor Only If' fields are present as filed via import (where enabled/present).
Scenario 2: Avatar Cal-PM Registry Settings - Verification of 'Enable Default Guarantor Assignment' Registry Setting
Steps
  1. Open 'Registry Settings' form.
  2. Enter search value 'Enable Default Guarantor Assignment' and click 'View Registry Settings' button.
  3. Ensure Registry Setting 'Enable Default Guarantor Assignment' is returned (under 'Avatar PM -> Billing -> Financial Eligibility' path).
  4. Ensure 'Registry Setting Details' field contains the following explanation text:

"Selecting 'Y' adds the 'Default Guarantor Assignment' section to the 'Program Maintenance' form. This will allow users to assign default guarantor in the 'Financial Eligibility' form either 1) upon filing a new admission through the 'Admission', 'Admission(Outpatient)', 'Pre-Admit' or 'Back Dated Admission\Discharge' forms or 2) automatically add a 'Guarantor Selection' row in the 'Financial Eligibility' upon form entry. The guarantor information will automatically be defaulted in the row with the selected guarantor but edits will be allowed.


Selecting 'N' will remove the form from the menu.


Please Note: The default guarantor must have a default guarantor plan setup in the 'Guarantors/Payors' form to automatically file a 'Financial Eligibility' record upon filing a new admission. If no default guarantor plan exists, only the admission will be filed."

Scenario 3: 'Program Maintenance' - Form Verification, 'Default Guarantor Assignment' Section (Avatar Cal-PM)
Specific Setup:
  • Avatar Cal-PM Registry Setting 'Enable Default Guarantor Assignment' must be enabled
  • Crystal Reports or other SQL reporting tool
Steps
  1. Open the Avatar Cal-PM 'Program Maintenance' form.
  2. Select 'Add' in 'Add or Edit Program' field and enter Program Code (or select 'Edit' in 'Add or Edit Program' field and select existing Program).
  3. Enter/select values for all fields in main/first section of 'Program Maintenance' form as required/desired.
  4. Navigate to 'Default Guarantor Assignment' section of 'Program Maintenance' form.
  5. Ensure the following fields are present in 'Default Guarantor Assignment' section:
  6. 'Select Guarantor To Default'
  7. Dropdown selection field; populated with all Guarantors defined in Avatar Cal-PM system. Selection of Guarantor will add it to 'Guarantor Order' list and include the selected Guarantor(s) in Financial Eligibility record defaulting in order added/specified in 'Guarantor Order' field
  8. A default Benefit Plan should be configured for the selected Guarantor(s)
  9. 'Guarantor Order'
  10. List of included/selected Guarantor(s) for Financial Eligibility record defaulting in order added/specified
  11. A default Benefit Plan should be configured for the selected Guarantor(s)
  12. 'Clear Guarantor Order' button
  13. Clears 'Guarantor Order' field for Guarantor re-selection/re-ordering
  14. 'Default the Guarantor During'
  15. If 'Filing Of Admission' is selected, a 'Financial Eligibility' record will be automatically filed upon filing a new admission through the 'Admission', 'Admission(Outpatient)', 'Pre-Admit' or 'Back Dated Admission\Discharge' forms (where selected Program is used) only if there is no existing 'Financial Eligibility' record for that episode. The 'Coverage Effective Date' field is set to the episode's admission date and the 'Client's Relationship To Subscriber' field is set to 'Self'
  16. If 'Entry To Financial Eligibility Options' is selected, 'Guarantor Selection' row(s) will be automatically defaulted/added upon entry of the 'Financial Eligibility' form (where selected Program is used for episode) with behavior according to 'Default The Guarantor Only If' field setting
  17. 'Default the Guarantor Only If'
  18. Only enabled/applicable where 'Entry To Financial Eligibility Options' is selected for 'Default The Guarantor During' field
  19. If 'None Exists' is selected, a 'Guarantor Selection' row(s) for the selected Guarantor(s) will be added upon entry to the 'Financial Eligibility' form only if there is no existing 'Financial Eligibility' record for that episode. The 'Coverage Effective Date' field will be set to the episode's admission date and the 'Client's Relationship To Subscriber' field will be set to 'Self'
  20. If 'Not A Part Of Financial Eligibility' is selected, a 'Guarantor Selection' row for the selected Guarantor(s) will be added upon entry to the 'Financial Eligibility' form if there is no existing 'Financial Eligibility' record for that episode or the existing record does not contain the selected Guarantor(s). The 'Coverage Effective Date' field will be set to the episode's admission date and the 'Client's Relationship To Subscriber' field will be set to 'Self'. The selected Guarantor(s) will be added to the end of the previous Guarantor order.
  21. Select one or more Guarantor(s) in the 'Select Guarantor To Default' field, populating the 'Guarantor Order' field/list as desired.
  22. Select value for 'Default The Guarantor During' field.
  23. Where 'Entry To Financial Eligibility Options' is selected for 'Default The Guarantor During' field, select value for 'Default The Guarantor Only If' field.
  24. Navigate to main/first section of 'Program Maintenance' form.
  25. Click 'File Program' button to save Program Maintenance information.
  26. Click 'Print All Programs' button to display Program Maintenance information.
  27. In Program Maintenance report, ensure 'Selected Guarantors to Default', 'Default the Guarantor During' and 'Default the Guarantor Only If' fields are present and reflect Default Guarantor Assignment values filed via 'Program Maintenance' form.
  28. Open Crystal Reports or other SQL reporting tool.
  29. In Avatar Cal-PM SQL table 'SYSTEM.default_guarantors' - ensure all 'Default Guarantor Assignment' Program Maintenance information filed is present.
Scenario 4: 'Admission' Form - Verification of Financial Eligibility Guarantor Defaulting (Avatar Cal-PM)
Specific Setup:
  • Avatar Cal-PM Registry Setting 'Enable Default Guarantor Assignment' must be enabled
  • Program where 'Guarantor Order' is defined with one or more Guarantor(s) for default assignment, and where 'Filing Of Admission' is selected for 'Default The Guarantor During' field (via Avatar Cal-PM 'Program Maintenance' form, 'Default Guarantor Assignment' section)
Steps
  1. Open Avatar Cal-PM 'Admission' form.
  2. Note - Acceptance Testing Scenario Guarantor Defaulting also applies to 'Admission (Outpatient)', 'Pre Admit' and 'Back Dated Admission/Discharge' forms, as well as 'Admission' records/episodes filed via the Avatar Cal-PM Client Admission web service
  3. In 'Select Client' dialog, enter values for search criteria and click 'Search' button.
  4. Select existing client record to enter new Admission record, or click 'New Client' button to create new client record via Admission record entry.
  5. In 'Admission' form, enter/select values for 'Preadmit/Admission Date', 'Preadmit/Admission Time', 'Program' - using 'Program' where 'Default The Guarantor During' is set to 'Filing Of Admission' (via Avatar Cal-PM 'Program Maintenance' form 'Default Guarantor Assignment' section).
  6. Enter/select values for 'Type of Admission', 'Admitting Practitioner' and any other required/desired fields in 'Admission' form.
  7. Click 'Submit' button to file new Admission/episode for existing client/new client creation.
  8. Open 'Financial Eligibility' form, selecting client/episode filed via 'Admission' form above.
  9. Note, Acceptance Testing Guarantor Default Assignment may also be confirmed via 'Fast Financial Eligibility' form
  10. Navigate to 'Guarantor Selection' section of 'Financial Eligibility' form.
  11. Ensure Guarantor row is present in Financial Eligibility record for each/all Guarantors assigned for defaulting (via the 'Select Guarantor To Default'/'Guarantor Order' fields in 'Program Maintenance' form 'Default Guarantor Assignment' section).
  12. For each assigned Guarantor row, ensure value for 'Guarantor Plan' is assigned (according to 'Guarantor Plan' field in 'Guarantors/Payors' form).
  13. Any Guarantor(s) selected/included in Default Guarantor Assignment 'Guarantor Order' where default 'Guarantor Plan' is not defied will not be included in Financial Eligibility record Guarantor filing
  14. For each assigned Guarantor row, ensure value for 'Client's Relationship To Subscriber ' is set to 'Self'.
  15. For each assigned Guarantor row, ensure value for 'Coverage Effective Date ' is set to Admission date for episode.
  16. In main/first section of 'Financial Eligibility' form, ensure Guarantor order is set as defined for Program where more than one Guarantor is assigned (according to the 'Guarantor Order' field in 'Program Maintenance' form 'Default Guarantor Assignment' section).
Scenario 5: 'Financial Eligibility' Form - Verification of Financial Eligibility Guarantor Defaulting (Avatar Cal-PM)
Specific Setup:
  • Avatar Cal-PM Registry Setting 'Enable Default Guarantor Assignment' must be enabled
  • Client with Admission/Episode(s) under Program where 'Guarantor Order' is defined with one or more Guarantor(s) for default assignment, and where 'Entry To Financial Eligibility Options' is selected for 'Default The Guarantor During' field (via Avatar Cal-PM 'Program Maintenance' form, 'Default Guarantor Assignment' section)
Steps
  1. Open Avatar Cal-PM 'Financial Eligibility' form.
  2. Select client/episode under 'Program' where 'Default The Guarantor During' is set to 'Entry To Financial Eligibility Options' (via Avatar Cal-PM 'Program Maintenance' form 'Default Guarantor Assignment' section).
  3. Navigate to 'Guarantor Selection' section of 'Financial Eligibility' form.
  4. In case where no Financial Eligibility record exists prior to form entry for selected episode/Program - Ensure Guarantor row is defaulted/present on entry of Financial Eligibility form for each/all Guarantors assigned for defaulting (via the 'Select Guarantor To Default'/'Guarantor Order' fields in 'Program Maintenance' form 'Default Guarantor Assignment' section, where 'Default The Guarantor Only If' is set to 'None Exists').
  5. In case where Financial Eligibility record exists prior to form entry for selected episode/Program but where not all Guarantor(s) set for Default Assignment are assigned - Ensure Guarantor row is defaulted/present on entry of Financial Eligibility form for each/all Guarantors assigned for defaulting and not already present (via the 'Select Guarantor To Default'/'Guarantor Order' fields in 'Program Maintenance' form 'Default Guarantor Assignment' section, where 'Default The Guarantor Only If' is set to 'Not A Part Of Financial Eligibility').
  6. For each defaulted/assigned Guarantor row, ensure value for 'Guarantor Plan' is assigned (according to 'Guarantor Plan' field in 'Guarantors/Payors' form).
  7. For each defaulted/assigned Guarantor row, ensure value for 'Client's Relationship To Subscriber ' is set to 'Self'.
  8. For each defaulted/assigned Guarantor row, ensure value for 'Coverage Effective Date ' is set to Admission date for episode.
  9. Add/update/remove Guarantor row(s) from 'Guarantor Selection' following Assigned Guarantor Defaulting for Program if desired.
  10. In main/first section of 'Financial Eligibility' form, ensure Guarantor order is set as defined for Program where more than one Guarantor is assigned (according to the 'Guarantor Order' field in 'Program Maintenance' form 'Default Guarantor Assignment' section).
  11. Note - In case where Financial Eligibility record exists prior to form entry for selected episode/Program but where not all Guarantor(s) set for Default Assignment are assigned, newly defaulted Guarantor row(s) will be added to the end of the previous Guarantor order
  12. Click 'Submit' button to file 'Financial Eligibility' form/record for client episode.
Avatar Cal-PM 'Program Maintenance' Form
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Program Maintenance
Scenario 1: 'Program Maintenance' - Form Verification (Avatar Cal-PM)
Specific Setup:
  • Crystal Reports or other SQL reporting tool
Steps
  1. Open the Avatar Cal-PM 'Program Maintenance' form.
  2. Select 'Add' in 'Add or Edit Program' field and enter Program Code (or select 'Edit' in 'Add or Edit Program' field and select existing Program).
  3. Ensure that 'EVV Provider Organization ID' field is present in form; enter value for 'EVV Provider Organization ID' if desired.
  4. Ensure that 'Require Source Of Admission' field is present in form (Yes/No radio button selection field); select value for 'Require Source Of Admission' if desired.
  5. If 'Require Source Of Admission' is set to 'Yes', the 'Source Of Admission' field will be required in the Avatar Cal-PM 'Admission', 'Admission (Outpatient)' and 'Back Dated Admission/Discharge' forms (as well as the Avatar Cal-PM Client Admission Web Service) for the selected Program
  6. Ensure that 'Require Attending Practitioner' field is present in form (Yes/No radio button selection field); select value for 'Require Source Of Admission' if desired.
  7. If 'Require Attending Practitioner' is set to 'Yes', the 'Attending Practitioner' field will be required in the Avatar Cal-PM 'Admission', 'Admission (Outpatient)' and 'Back Dated Admission/Discharge' forms (as well as the Avatar Cal-PM Client Admission Web Service) for the selected Program
  8. Enter/select values for all other Program Maintenance fields as required/desired.
  9. Click 'File Program' button to save Program Maintenance information.
  10. Click 'Print All Programs' button to display Program Maintenance information.
  11. In Program Maintenance report, ensure 'Require Source Of Admission' and 'Require Attending Practitioner' fields are present and reflect values filed via 'Program Maintenance' form.
  12. Open Crystal Reports or other SQL reporting tool.
  13. In Avatar Cal-PM SQL table 'SYSTEM.table_program_definition' - ensure all Program Maintenance information filed is present, including values for 'req_src_adm_code'/'req_src_adm_value' and 'req_attn_pract_code'/'req_attn_pract_value'.
Topics
• Cal-Oms Admission • NX • Registry Settings • Program Maintenance • File Import • Admission • Admission (Outpatient) • Financial Eligibility
Update 16 Summary | Details
File Import - Service Fee/Cross Reference
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Registry Settings (PM)
  • CPT Code Definition (PM)
  • Revenue Code Definition (PM)
  • File Import
Scenario 1: Cal-PM: File Import - Service Fee/Cross Reference
Specific Setup:
  • Service Codes: Create two new service codes (Service Code 1 & Service Code 2).
  • Registry Setting: Note the value of 'Avatar PM->System Maintenance->File Import->->->Import File Delimiter' to determine the delimiter in the import file.
  • Create a 'File Import' file for 'Service Fee/Cross Reference' for both service codes. Note the information that will be imported.
  • The 'File Import' spreadsheet will be included in the update zip file.
Steps
  1. Open' File Import'.
  2. Select 'Service Fee/Cross Reference' in 'File Type'.
  3. Validate that 'Action' contains 'Upload New File'.
  4. Load the file created in setup.
  5. Compile the file.
  6. If necessary correct errors, delete the existing file, load, and compile again.
  7. Post the compiled file.
  8. Open 'Service Fee/Cross Reference Maintenance'.
  9. Select 'Edit Existing' in 'Enter New Or Edit Existing Fee/Cross Reference'.
  10. Enter 'Service Code 1'.
  11. Enter the 'From Date'.
  12. Click [Select Fee/Cross Ref To Edit/Default From Existing].
  13. Select the desired row in the 'Edit Service Fee Definition' grid.
  14. Click [OK].
  15. Validate the data that was submitted in 'File Import' displays correctly.
  16. Select 'Edit Existing' in 'Enter New Or Edit Existing Fee/Cross Reference'.
  17. Enter 'Service Code 2'.
  18. Enter the 'From Date'.
  19. Click [Select Fee/Cross Ref To Edit/Default From Existing].
  20. Select the desired row in the 'Edit Service Fee Definition' grid,
  21. Click [OK].
  22. Validate the data that was submitted in 'File Import' displays correctly.
Topics
• Service Fee/Cross Reference Maintenance • File Import • NX
2022 Update 64 Summary | Details
'Payor Based Authorizations' Form 'Service Code' Field
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Payor Based Authorizations
  • Payor Based Authorizations Report
  • Registry Settings (PM)
Scenario 1: 'Payor Based Authorizations' - Form Verification
Specific Setup:
  • Avatar Cal-PM Registry Setting 'Enable Payor Based Authorizations' must be enabled
  • Avatar Cal-PM Registry Setting 'Require Authorizations At Guarantors/Payors Level' may optionally be enabled/disabled
  • Avatar Cal-PM Registry Setting 'Enable CPT Based Payor Authorizations' may optionally be enabled/disabled
  • Avatar Cal-PM Registry Setting 'Enable Program/Service Code Filter' may optionally be enabled/disabled
  • Crystal Reports or other SQL reporting tool
Steps
  1. Open Avatar Cal-PM 'Payor Based Authorizations' form (under 'Avatar PM / System Maintenance / System Definition' menu).
  2. Select 'Add' action in 'Add/Edit/Delete' field (or select 'Edit' action and click 'Select Authorizations To Edit/Delete' button to view/update existing Payor Based Authorization record/entry).
  3. Ensure the following fields are present in the 'Payor Based Authorizations' form:
  4. 'Guarantor'
  5. 'Program'
  6. Available only where Avatar Cal-PM Registry Setting 'Require Authorizations At Guarantors/Payors Level' is enabled
  7. 'Practitioner Category'
  8. Available only where Avatar Cal-PM Registry Setting 'Require Authorizations At Guarantors/Payors Level' is enabled
  9. 'Effective Date'
  10. 'Expiration Date'
  11. Not a required field where Avatar Cal-PM Registry Setting 'Require Authorizations At Guarantors/Payors Level' is enabled
  12. 'Authorization Number'
  13. 'Service Code' / 'Service Code(s)'
  14. All service codes will be available for search/selection regardless of whether Avatar Cal-PM Registry Setting 'Enable Program/Service Code Filter' is enabled
  15. Not available where Avatar Cal-PM Registry Setting 'Enable CPT Based Payor Authorizations' is enabled
  16. 'Service Code' is a single code search/select field where Avatar Cal-PM Registry Setting 'Require Authorizations At Guarantors/Payors Level' is disabled
  17. 'Service Code(s)' is a multiple selection field (including 'All Service Codes' selection) where Avatar Cal-PM Registry Setting 'Require Authorizations At Guarantors/Payors Level' is enabled
  18. 'Authorization Group'
  19. Available only where Avatar Cal-PM Registry Setting 'Require Authorizations At Guarantors/Payors Level' is enabled
  20. 'Select CPT ® Codes' button
  21. Available only where Avatar Cal-PM Registry Setting 'Enable CPT Based Payor Authorizations' is enabled
  22. 'All CPT Codes'
  23. Available only where Avatar Cal-PM Registry Setting 'Enable CPT Based Payor Authorizations' is enabled
  24. 'Display Authorizations' button
  25. 'Select Authorizations To Edit/Delete' button
  26. Enter/select values in 'Effective Date' and 'Expiration Date' fields.
  27. Where Avatar Cal-PM Registry Setting 'Require Authorizations At Guarantors/Payors Level' is enabled - select one or more values in 'Program' and/or 'Practitioner Category' multiple selection fields if desired.
  28. Where Avatar Cal-PM Registry Setting 'Require Authorizations At Guarantors/Payors Level' is enabled - select one or more codes or 'All Service Codes' in 'Service Code(s)' multiple selection field, or select grouping in 'Authorization Group' field and ensure that codes in group are selected in 'Service Codes' field (and limited to only codes specified for group).
  29. Where Avatar Cal-PM Registry Setting 'Enable CPT Based Payor Authorizations' is enabled - Click 'Select CPT Codes' button and enter one or more code selections in the multi-iteration grid displayed (or set 'All CPT Codes' field to 'Yes').
  30. Enter 'Authorization Number' field value.
  31. Click 'Submit' button to file 'Payor Based Authorizations' form/record.
  32. Select 'Edit' action in 'Add/Edit/Delete' field and click 'Select Authorizations To Edit/Delete' button to view/update previously entered Payor Based Authorization record/entry.
  33. Ensure all field values are present in 'Payor Based Authorizations' form/record as previously entered/filed.
  34. Click 'Display Authorizations' button to display the Payor Based Authorizations report/information.
  35. In Payor Based Authorizations report display/results, ensure that all Payor Based Authorization entries/records for selected 'Guarantor' value are displayed, including the following fields:
  36. 'Guarantor'
  37. 'Service Code' or 'CPT Code'
  38. Dependent on Avatar Cal-PM Registry Setting 'Enable CPT Based Payor Authorizations'
  39. 'Program'
  40. 'Practitioner Category'
  41. 'Effective Date'
  42. Expiration Date'
  43. 'Authorization Number'
  44. Open Crystal Reports or other SQL reporting tool.
  45. Where Avatar Cal-PM Registry Setting 'Enable CPT Based Payor Authorizations' is disabled - In Avatar Cal-PM SQL table 'SYSTEM.table_payor_auths', ensure that data row(s) are added/updated on filing of 'Payor Based Authorizations' form and contain values/information filed via form for all applicable fields (including 'Program' and 'Practitioner Category' values where entered).
  46. Where Avatar Cal-PM Registry Setting 'Enable CPT Based Payor Authorizations' is enabled - In Avatar Cal-PM SQL table 'SYSTEM.table_payor_auths_cpt', ensure that data row(s) are added/updated on filing of 'Payor Based Authorizations' form and contain values/information filed via form for all applicable fields (including 'Program' and 'Practitioner Category' values where entered).
Topics
• Registry Settings • Service Authorizations
2022 Update 67 Summary | Details
CSI Submission - The merged client with CSI assessment record
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • CSI Submission
  • Program Maintenance
  • Admission (Outpatient)
  • CSI Admission
  • CSI Assessment
  • Crystal Report Viewer
  • Change MR#
Scenario 1: CSI Submission - Validate CSI data for the clients with 'CSI Assessment' occurrences after 'Client Merge' and 'Change MR #' functionality
Specific Setup:
  • Program Maintenance:
  • Create a new program or identify an existing admit program set up as a ‘Mental Health Program (CSI)’. Note the program code/value.
  • Create a new program or identify an existing admit program that is not set up as a ‘Mental Health Program (CSI)’. Note the program code/value.
  • Admission:
  • Three clients are admitted:
  • First client with two episodes:
  • First episode - A client is admitted in the CSI program. A CSI Admission and CSI Assessment records are created for the client.
  • Second episode - A client is admitted in the non CSI program.
  • Note the client ID/ name.
  • Second client with one episode:
  • A client is admitted in the non CSI program. Note the client ID/ name.
  • Third client with one episode:
  • Client valid for 'CSI Submission' form reporting with a 'CSI Assessment' record to be renumbered using the "Change MR#" form.
  • Note the client ID/ name.
Steps
  1. Open the ‘Client Merge’ form.
  2. Set ‘Source Client’ to client ID of the first client.
  3. Set ‘Target Client’ to client ID of the second client.
  4. If present, set ‘Merge All Client Data Through Single Filing’ to ‘Yes’.
  5. Set ‘Create New Episode On Merge’ to ‘Yes’.
  6. Click ‘File’ button.
  7. Click ‘Yes’ button.
  8. Click ‘OK’.
  9. Exit the form.
  10. Enter merged client ID in ‘Search Clients’ field to verify client ID is no longer present in system.
  11. Open the ‘CSI Assessment’ form.
  12. Set ‘Selected Client’ to client ID into which data was merged.
  13. Select the most recent episode and verify that the ‘CSI Assessment’ occurrence merged is present.
  14. Exit the form.
  15. Open the ‘Change MR# ‘ form.
  16. Set ‘Client ID’ to client ID to be renumbered.
  17. Click ‘Assign MR#’ button.
  18. Click ‘Yes’ to assign the next available client ID.
  19. Verify the client ID assigned.
  20. Click ‘Submit’ button.
  21. Enter the client ID that was renumbered in ‘Search Clients’ to verify client ID is no longer present in system.
  22. Open the ‘CSI Assessment’ form.
  23. Set ‘Selected Client’ to client ID to which the client was renumbered.
  24. Select most recent episode and verify that the ‘CSI Assessment’ occurrence for the renumbered client is present.
  25. Exit the form.
  26. Open the ‘CSI Submission’ form.
  27. Set ‘Option’ field to ‘Compile’.
  28. Set ‘Through Date: to a month end value greater than or equal to ‘From Date’ and test ‘CSI Assessment’ occurrence assessment dates.
  29. Click ‘Submit’ button.
  30. Click ‘Yes’.
  31. Set ‘Option’ field to ‘Print’.
  32. Click ‘Select File To Print/Submit’ drop down.
  33. Select the compilation file just created.
  34. Click ‘Print Selected File Information - MHSA/DIG Data’ button.
  35. Verify that data output to the ‘CSI Report (MHSA / DIG)’ report contains correct CSI data for the merged client and the client with changed MR#.
  36. Exit the report.
  37. Set ‘Option’ field to ‘Submit (Create File)’.
  38. Click ‘Select File To Print/Submit’ drop down.
  39. Select the compilation file just created.
  40. Set ‘Create File’ to ‘Review’.
  41. Click ‘Submit’ button.
  42. Click ‘OK’.
  43. Click ‘Yes’.
  44. Verify that data output to the sequential file is correct.
  45. Exit the form.
Scenario 2: CSI Assessment - Validating CSI data in the CSI submission report
Specific Setup:
  • Program Maintenance:
  • Create a new program or identify an existing admit program set up as a ‘Mental Health Program (CSI)’. Note the program code/value.
  • Admission:
  • A client is admitted in the CSI program. A CSI Admission and CSI Assessment records are created for the client. Note the client id/ name.
Steps
  1. Open the 'CSI Assessment' form for the client identified in the setup.
  2. Select the desired episode in the Pre-Display
  3. Click [OK].
  4. Set the 'Assessment Appointment First Offer Date' field to the desired date in the future.
  5. Set the 'Assessment Appointment Accepted Date' field to the desired date.
  6. Set the 'Assessment Start Date' to desired value.
  7. Set the 'Treatment Appointment First Offer Date' field to the desired date in the future.
  8. Set the 'Treatment Appointment Accepted Date' field to the desired date.
  9. Select desired value from the 'Closure Reason' list field. Note the entire value.
  10. Set the 'Closed Out Date' field to desired date.
  11. Click [Submit].
  12. Open the 'Crystal Report' or any other SQL data viewer.
  13. Query the 'system.assessment_ca_csi_data' SQL table.
  14. Locate the client from above step.
  15. Verify the entire value selected in the 'Closure Reason' field is displays in the 'closure_reason_value' field.
  16. Open the 'CSI Submission' form.
  17. Select 'Compile' in the 'Option' field. This file includes all clients who have been admitted in the CSI Admission form.
  18. Verify that the 'From Date' displays one of the following:
  19. The through date of the last submitted CSI file.
  20. The date the file was compiled.
  21. The date (From Date field) of the file selected in the Select File to Print/Submit field.
  22. In the 'Through Date' field, enter the last date to include in the compiled file. Note: The through date must be the last date of the month, and must be before today's date.
  23. Submit the file.
  24. Verify that the submitting has been completed successfully.
  25. Select 'Submit' option to create the CSI file.
  26. Select the CSI file in the 'Select File to Print/Submit' field.
  27. Select 'Review' to create a CSI file in the 'Create File' field.
  28. Select 'Submit' to create the CSI file.
  29. The form will be filed and a dialog will display the file name and storage location.
  30. Review the located CSI Submission file.
  31. Verify the CSI Assessment record is 400 bytes.
Topics
• Client Merge • CSI Assessment