Avatar Cal-PM 2023 Monthly Release 2023.03.02 Acceptance Tests
- Last updated
-
-
Save as PDF
Purge Billing Files - Billing List to Purge
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- Purge Billing Files
- Quick Billing
Scenario 1: Validate 'Purge Billing Files' when '271 Batch' is selected to purge.
Specific Setup:
- At least two 271 batch(es) are identified. Note the batch numbers.
Steps
- Open 'Purge Billing Files'.
- Select '271 Batch' in 'Billing List to Purge'.
- Enter a date in 'Date Created Start Date'.
- Enter a date in 'Date Created End Date'.
- Select 'None' in 'File Selection Default'.
- Click [Select File(s) to Purge].
- Verify that the file list contains both the 'Posted' batches along with the 'Compiled' batches.
- Select the first row, noting the 'Date Created' and 'Batch Name'.
- Click [OK].
- Click [Submit].
- Click [OK].
- Repeat steps 1 - 7.
- Verify that the batch that was deleted is not present by confirming that the deleted 'Date Created' and 'Batch Name' are not included in the grid.
- Run the SQL query and verify that the purged files are only removed from the file lists and not from the system.
Scenario 2: Validate 'Purge Billing Files' when '835 Batch' is selected to purge.
Specific Setup:
- At least two 835 batch(es) are identified for this test.
- Note down the batch numbers.
Steps
- Open 'Purge Billing Files'.
- Select '835 Batch' in 'Billing List to Purge'.
- Enter a date in 'Date Created Start Date'.
- Enter a date in 'Date Created End Date'.
- Select 'None' in 'File Selection Default'.
- Click [Select File(s) to Purge].
- Verify that the file list contains both the 'Posted' batches along with the 'Compiled' batches.
- Select the first row, noting the 'Date Created' and 'Batch Name'.
- Click [OK].
- Click [Submit].
- Click [OK].
- Repeat steps 1 - 7.
- Verify that the batch that was deleted is not present by confirming that the deleted 'Date Created' and 'Batch Name' are not included in the grid.
- Run the SQL query and verify that the purged files are only removed from the file lists and not from the system.
Scenario 3: Validate 'Purge Billing Files' when 'Quick Billing Batch' is selected to purge.
Specific Setup:
- At least two Quick Billing batches are identified. Note the batch numbers.
Steps
- Open 'Purge Billing Files'.
- Select 'Quick Billing Batch' in 'Billing List to Purge'.
- Enter a date in 'Date Created Start Date'.
- Enter a date in 'Date Created End Date'.
- Select 'None' in 'File Selection Default'.
- Click [Select File(s) to Purge].
- Select the first row, noting the 'Date Created' and 'Batch Number'.
- Click [OK].
- Click [Submit].
- Click [OK].
- Repeat steps 1 - 7.
- Verify that the batch that was deleted is not present by confirming that the deleted 'Date Created' and 'Batch Number' are not included in the list.
- If desired, SQL query the 'SYSTEM.billing_quick_batch' table specific to the purged batch, and verify that the associated 837 compiles do not display.
|
Topics
• Eligibility Response (271)
• Purge Billing Files
• 835 Health Care Claim Payment/Advice
• Quick Billing
|
Avatar PM 'Cal-PM Admission' form
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- Dictionary Update (PM)
- Cal-OMS Admission
- Cal-OMS File Import
Scenario 1: Avatar Cal-PM 'Dictionary Update' - Verification of 'Level Of Care Admitted' Dictionary
Steps
- Open Avatar Cal-PM 'Dictionary Update' form.
- Navigate to 'Input Dictionary Code(s)' section of form.
- Select 'Client' file.
- Select Data Element/Dictionary '(70710) Level of Care Admitted'.
- Enter/select value for Dictionary Code/Value, and select Extended Dictionary Data Element '(70913) Opioid Treatment Program - Override Concurrent Admissions Error Checking'.
- Ensure Dictionary Codes/Values 'Yes' and 'No' are available for assignment/selection as Extended Dictionary Data Element for 'Opioid Treatment Program - Override Concurrent Admissions Error Checking' under 'Level of Care Admitted' Dictionary Data Element.
- This Extended Dictionary Data Element will determine whether the Avatar Cal-PM 'Cal-OMS Admission' form allows overlapping/concurrent Cal-OMS Admission episodes (Cal-OMS 'Admission Date' through 'Discharge Date' if discharged otherwise current date) for the same 'Level of Care Admitted'/'Cal-OMS Type of Service'.
- Selecting 'Yes' will override system validation/error checking and allow overlapping/concurrent entries under this 'Level of Care Admitted' for new and existing Cal-OMS Admission records/episodes where one or more overlapping Cal-OMS Admissions exist with same 'Cal-OMS Type of Service' based on 'Level of Care Admitted' values
- Selecting 'No' (or no value) will enforce validation/error checking to disallow overlapping/concurrent Cal-OMS Admission episode entries under same 'Cal-OMS Type of Service' based on 'Level of Care Admitted' values (system default behavior)
- Select value for Extended Dictionary Data Element for 'Opioid Treatment Program - Override Concurrent Admissions Error Checking' (and any other Extended Dictionary Data Elements as desired).
- Click 'Apply Changes' button to file Data Element/Dictionary.
- Enter/select previously entered value for Dictionary Code/Value, and select Extended Dictionary Data Element '(70913) Opioid Treatment Program - Override Concurrent Admissions Error Checking'.
- Ensure that previously selected/filed value is present in 'Extended Dictionary Value (Single Dictionary)' field.
Scenario 2: 'Cal-OMS Admission' - Verification of 'Level of Care Admitted' Concurrent Admission Validation
Specific Setup:
- Avatar Cal-PM Registry Setting 'Allow Multiple Cal-OMS Admissions Per Avatar Episode' must be enabled
- 'Level of Care Admitted' Dictionary Data Element where 'Opioid Treatment Program - Override Concurrent Admissions Error Checking' Extended Dictionary Data Element is set to 'Yes' (via Avatar Cal-PM 'Dictionary Update' form)
- One or more client(s) with episode eligible for Cal-OMS Admission entry/filing
Steps
- Open 'Cal-OMS Admission' form.
- Note - Acceptance testing may also be confirmed via 'Cal-OMS File Import' form and/or Avatar Cal-PM 'Cal-OMS Admission' web service
- Select client/episode for record entry and click 'OK' button.
- Enter value for 'Admission Date' field, using date which overlaps/is concurrent with a different/existing Cal-OMS Admission episode for same client (Cal-OMS 'Admission Date' through 'Discharge Date' if discharged otherwise current date).
- Select value for 'Location of Admission' and 'Level of Care Admitted' fields.
- Note - 'Cal-OMS Type of Service' value is determined by 'Level of Care Admitted' selection/linked value
- In case where 'Opioid Treatment Program - Override Concurrent Admissions Error Checking' Extended Dictionary Element is set to 'No' (or no value/not defined) for the selected 'Level of Care Admitted':
- If the 'Cal-OMS Type of Service' for selected 'Level of Care Admitted' value is same as that of existing overlapping/concurrent Cal-OMS Admission episode for the same client - ensure that 'Level of Care Admitted'/'Cal-OMS Type of Service' validation/error checking is failed, user is presented with error dialog noting 'There is an active Cal-OMS admission for this 'Cal-OMS Type of Service'' or 'There is a later Cal-OMS admission for this 'Cal-OMS Type of Service'' and the entry/selection is disallowed.
- If the 'Cal-OMS Type of Service' for selected 'Level of Care Admitted' value is not the same as that of any existing overlapping/concurrent Cal-OMS Admission episode for the same client - ensure that 'Level of Care Admitted'/'Cal-OMS Type of Service' validation/error checking is passed, error dialog is not displayed and entry/selection is allowed.
- In case where 'Opioid Treatment Program - Override Concurrent Admissions Error Checking' Extended Dictionary Element is set to 'Yes' for the selected 'Level of Care Admitted':
- If the 'Cal-OMS Type of Service' for selected 'Level of Care Admitted' value is same as that of existing overlapping/concurrent Cal-OMS Admission episode for the same client - ensure that failed 'Level of Care Admitted'/'Cal-OMS Type of Service' validation/error checking is overridden, error dialog is not displayed and entry/selection is allowed.
- If the 'Cal-OMS Type of Service' for selected 'Level of Care Admitted' value is not the same as that of any existing overlapping/concurrent Cal-OMS Admission episode for the same client - ensure that 'Level of Care Admitted'/'Cal-OMS Type of Service' validation/error checking is passed, error dialog is not displayed and entry/selection is allowed.
- Enter/select values for other fields in form as required/desired.
- Click 'Submit' button in 'Cal-OMS Admission' form to file record/data.
|
Topics
• Cal-Oms Admission
• Dictionary
|
|
Topics
• Admission
• Update Client Data
• Pre Admit
• Call Intake
• Pre Admit Discharge
• Web Services
• Discharge
• Admission (Outpatient)
|
Payor Based Authorization
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- Payor Based Authorizations
Scenario 1: Payor Based Authorizations - Add/Edit
Specific Setup:
- Registry setting:
- Payor Based Authorizations >> Enable Payor Based Authorizations = Y.
- Payor Based Authorizations >> Enable CPT Based Payor Authorizations Registry Setting Value = N.
- Authorization Group >> Require Authorizations at Guarantors/Payors Level Registry Setting Value = Y.
- Authorization Group Definition:
- Create new Authorization groups.
Steps
- Open 'Payor Based Authorizations’ form.
- Select 'Add'.
- Select 'Guarantor'.
- Select 'Program'.
- Enter 'Effective Date'.
- Enter 'Expiration Date'.
- Select 'Authorization Group'.
- Validate 'Service Codes' selected based on the selected 'Authorization Group'.
- Enter 'Authorization Number'.
- Click on Submit.
- Open 'Payor Based Authorizations’ form.
- Select 'Edit'.
- Select 'Guarantor'.
- Click on 'Select Authorizations To Edit/Delete' button.
- Select above record.
- Click OK.
- Edit desired fields.
- Click Submit.
- Open 'Payor Based Authorizations’ form.
- Select 'Edit'.
- Select 'Guarantor'.
- Click on 'Select Authorizations To Edit/Delete' button.
- Select above record.
- Click OK.
- Validate that the edited field contains the correct data,
- Close the form.
Scenario 2: 'Payor Based Authorizations' - Verification of Authorization Deletion
Specific Setup:
- Registry setting:
- Payor Based Authorizations >> Enable Payor Based Authorizations = Y.
- Payor Based Authorizations >> Enable CPT Based Payor Authorizations Registry Setting Value = N.
- Authorization Group >> Require Authorizations at Guarantors/Payors Level Registry Setting Value = Y.
- Authorization Group Definition:
- Create new Authorization groups.
- Payor Based Authorization:
- Create multiple payor based authorizations.
Steps
- Open ‘Payor Based Authorizations’ ' form.
- Select 'Delete'.
- Select 'Guarantor'.
- Click on 'Select Authorizations To Edit/Delete' button.
- Select any record.
- Click OK.
- Click Submit.
- Open ‘Payor Based Authorizations’ ' form.
- Select 'Edit'.
- Validate that the deleted authorization does not display in the list.
- Close the form.
|
Topics
• Payor Based Authorization
|
|
|
Topics
• Registry Settings
• Service Codes
• Site Registration
• NX
|
| |
Avatar_Cal-PM_2023_Monthly_Release_2023.03.02_Details.csv