Avatar Cal-PM 2023 Quarterly Release 2023.04 Acceptance Tests

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Update 1 Summary \| Details Avatar Cal-PM 2023 is Installed Scenario 1: Validate Upgrading Avatar Cal-PM 2022 to 2023 is successful when 2022.04.00 is loaded Specific Setup: Latest Monthly Release is installed. Steps Open the "Product Updates" form. Select the appropriate [Namespace] from the Application dropdown list Click [Select Update/Customization Pack]. Browse to the location for the updates and select the Update 1. Click [OK] on the "File Upload Complete" window. Click [Review Update/Customization Pack Contents]. Verify Update 1 is included. Click [Install Update/Customization Pack]. Click [OK] when the install completes. Click [Close Form].	Topics • Upgrade
Update 2 Summary \| Details Diagnosis - Show Active Only Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Treatment Plan Dictionary Update (CWS) Scenario 1: Diagnosis form: Validating 'Problem Classification' - Registry Setting "Problem Classification Required" set to "Y" Specific Setup: Registry Setting "Problem Classification Required" is set to "Y". Dictionary Codes are defined for "(16250) Problem Classification". Steps Open "Diagnosis" form for any client and episode. Select any value in the "Type Of Diagnosis" field. Set the "Date Of Diagnosis" to any date (this field will not accept future dates). Set the "Time Of Diagnosis" to any time. Click [New Row]. Select any diagnosis from the "Diagnosis Search" drop down search field. Select any value in the "Status" field. Select any staff member in the "Diagnosing Practitioner" search field. Select "Yes" in the "Add To Problem List" field. Verify the "Problem Classification" field is enabled and not required. Select any value from the "Problem Classification" drop down list field. Complete other fields as required. Click [Submit]. Click [No] n the "Pre-Display Confirmation" "Do you want to return to Pre-Display?" prompt. Open the "Problem List" form for the same client. Click [View/Enter Problems]. Verify the data entered in the "Diagnosis" form is displayed in the "Problem List" grid. Verify the "Problem Classification" field is populated as entered in the "Diagnosis" form. Click [Close/Cancel] to return to the diagnosis home page. Click [Close Form]. Open the "Treatment Plan" for the same client. Click [Add] to add a new treatment plan. Complete the required fields. Navigate to the "Problems" grid. Verify the "Problem Classification" displays for the diagnosis entered in the "Diagnosis" form record. Click "Include in this plan?" on the diagnosis. Click [Launch Plan]. Verify the "Problem Classification" displays successfully. Complete the plan and click [Back to Plan Page]. Finalize the treatment plan. Verify the plan files successfully. Scenario 2: Diagnosis form: "Problem Classification" enabled with Registry Setting "Problem Classification Required" set to "R" Specific Setup: Registry Setting "Problem Classification Required" is set to "R" to require the "Problem Classification". Dictionary Codes are defined for "(16250) Problem Classification". Steps Open "Diagnosis" form for any client and episode. Select any value in the "Type of Diagnosis" field. Set the "Date of Diagnosis" to any date (this field will not accept future dates). Set the "Time of Diagnosis" to any time. Click [New Row]. Select any diagnosis from the "Diagnosis Search" drop down search field. Select any value in the "Status" field. Select any staff member in the "Diagnosing Practitioner" search field. Select "Yes" in the "Add To Problem List" field. Verify the "Problem Classification" field is enabled and required. Select any value from the "Problem Classification" drop down list field. Complete other fields as required. Click [Submit]. Click [No] n the "Pre-Display Confirmation" dialog "Do you want to return to Pre-Display?". Open the "Problem List" form for the same client. Click [View/Enter Problems]. Verify the data entered in the "Diagnosis" form is displayed in the "Problem List" grid. Verify the "Problem Classification" field is required and populated as entered in the "Diagnosis" form. Click [Close/Cancel] to return to the diagnosis home page. Click [Close Form]. Open the "Treatment Plan" for the same client. Click [Add] to add a new treatment plan. Complete the required fields. Navigate to the "Problems" grid. Verify the "Problem Classification" displays for the diagnosis entered in the "Diagnosis" form record. Click "Include" on the diagnosis. Click [Launch Plan]. Verify the "Problem Classification" displays successfully. Complete the plan and click [Back to Plan Page]. Finalize the treatment plan. Click [Submit]. Verify the plan files successfully. Scenario 3: Diagnosis - Editing diagnosis record to change the status - Show Active Only Specific Setup: Set the registry setting 'Problem Classification Required' to 'Y'. Steps Open the form 'Diagnosis' for any patient. Click 'New Row' and fill out the required fields. Verify the Status field is set to 'Active'. Select 'Yes' to 'Add To Problem List'. This will enable the 'Problem Classification' dropdown menu. Select 'No Classification'. Click [Submit]. Re-open the form for the same client and episode. Select the diagnosis record that is added in above steps. Click [Edit]. Verify the diagnosis displays in the table as entered. Click on the row to edit it. Change the Status from 'Active' to 'Resolved'. Verify that the 'Add to Problem List' and 'Problem Classification' fields are disabled. Click [Submit]. Re-open the form for the same client and episode. Select the diagnosis record that is updated in previous step. Click [Edit]. Verify the diagnoses table is blank since the “Show Active Only” box is set to 'Yes'. Set the 'Show Active Only' field to 'No'. Verify the diagnoses table populates correctly with the non-active diagnosis record.	Topics • Diagnosis • NX
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 Scenario 1: 'Cal-OMS Admission' - Form Verification Specific Setup: One or more client(s) with episode eligible for Cal-OMS Admission entry/filing Steps Open 'Cal-OMS Admission' form. Select client/episode for record entry and click 'OK' button. Enter value for 'Admission Date' field. Click to expand the 'Location of Admission' drop-down selection field. 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). 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 Select value for 'Location of Admission' and 'Level of Care Admitted' fields. Complete other fields in form as required/desired. 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: File Import File Import Report 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 Open Avatar Cal-PM 'File Import' form. Select File Type 'Program Maintenance'. Select 'Upload New File' in 'Action' field and Click 'Process Action' button. Select Avatar Cal-PM 'Program Maintenance' import file and click 'Open' button. Select 'Compile/Validate File' in 'Action' field. Select loaded import file and click 'Process Action' button. 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. Click 'OK' button. Select 'Print Errors' in 'Action' field if errors encountered in compile; Select compiled import file with errors and click 'Process Action' button. 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. Select 'Print File' in 'Action' field to view successfully compiled import data; Select compiled import file and click 'Process Action' button. 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: 'Selected Guarantors to Default' ('Guarantor Order') 'Default The Guarantor During' 'Default The Guarantor Only If' 'Require Source Of Admission' 'Require Attending Practitioner' Select 'Post File' in 'Action' field to post successfully compiled import data; Select compiled import file and click 'Process Action' button. 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. Open Crystal Reports or other SQL reporting tool. 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. Open Avatar Cal-PM 'Program Maintenance' form. Select 'Edit' in 'Add or Edit Program' field and select existing Program filed via import. Ensure values for 'Require Source Of Admission' and 'Require Attending Practitioner' fields are present as filed via import. Navigate to 'Default Guarantor Assignment' section of 'Program Maintenance' form (where enabled/present). 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 Open Avatar Cal-PM 'Admission' form. 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 In 'Select Client' dialog, enter values for search criteria and click 'Search' button. Select existing client record to enter Admission record, or click 'New Client' button to create new client record via Admission record entry. 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. 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). 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). 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 Open the Avatar Cal-PM 'Program Maintenance' form. 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). Ensure that 'EVV Provider Organization ID' field is present in form; enter value for 'EVV Provider Organization ID' if desired. 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. 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 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. 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 Enter/select values for all other Program Maintenance fields as required/desired. Click 'File Program' button to save Program Maintenance information. Click 'Print All Programs' button to display Program Maintenance information. In Program Maintenance report, ensure 'Require Source Of Admission' and 'Require Attending Practitioner' fields are present and reflect values filed via 'Program Maintenance' form. Open Crystal Reports or other SQL reporting tool. 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: File Import File Import Report Financial Eligibility 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 Open Avatar Cal-PM 'File Import' form. Select File Type 'Program Maintenance'. Select 'Upload New File' in 'Action' field and Click 'Process Action' button. Select Avatar Cal-PM 'Program Maintenance' import file and click 'Open' button. Select 'Compile/Validate File' in 'Action' field. Select loaded import file and click 'Process Action' button. 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. Click 'OK' button. Select 'Print Errors' in 'Action' field if errors encountered in compile; Select compiled import file with errors and click 'Process Action' button. 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. Select 'Print File' in 'Action' field to view successfully compiled import data; Select compiled import file and click 'Process Action' button. 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: 'Selected Guarantors to Default' ('Guarantor Order') 'Default The Guarantor During' 'Default The Guarantor Only If' 'Require Source Of Admission' 'Require Attending Practitioner' Select 'Post File' in 'Action' field to post successfully compiled import data; Select compiled import file and click 'Process Action' button. 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. Open Crystal Reports or other SQL reporting tool. 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. Open Avatar Cal-PM 'Program Maintenance' form. Select 'Edit' in 'Add or Edit Program' field and select existing Program filed via import. Ensure values for 'Require Source Of Admission' and 'Require Attending Practitioner' fields are present as filed via import. Navigate to 'Default Guarantor Assignment' section of 'Program Maintenance' form (where enabled/present). 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 Open 'Registry Settings' form. Enter search value 'Enable Default Guarantor Assignment' and click 'View Registry Settings' button. Ensure Registry Setting 'Enable Default Guarantor Assignment' is returned (under 'Avatar PM -> Billing -> Financial Eligibility' path). 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 Open the Avatar Cal-PM 'Program Maintenance' form. 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). Enter/select values for all fields in main/first section of 'Program Maintenance' form as required/desired. Navigate to 'Default Guarantor Assignment' section of 'Program Maintenance' form. Ensure the following fields are present in 'Default Guarantor Assignment' section: 'Select Guarantor To Default' 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 A default Benefit Plan should be configured for the selected Guarantor(s) 'Guarantor Order' List of included/selected Guarantor(s) for Financial Eligibility record defaulting in order added/specified A default Benefit Plan should be configured for the selected Guarantor(s) 'Clear Guarantor Order' button Clears 'Guarantor Order' field for Guarantor re-selection/re-ordering 'Default the Guarantor During' 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' 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 'Default the Guarantor Only If' Only enabled/applicable where 'Entry To Financial Eligibility Options' is selected for 'Default The Guarantor During' field 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' 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. Select one or more Guarantor(s) in the 'Select Guarantor To Default' field, populating the 'Guarantor Order' field/list as desired. Select value for 'Default The Guarantor During' field. Where 'Entry To Financial Eligibility Options' is selected for 'Default The Guarantor During' field, select value for 'Default The Guarantor Only If' field. Navigate to main/first section of 'Program Maintenance' form. Click 'File Program' button to save Program Maintenance information. Click 'Print All Programs' button to display Program Maintenance information. 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. Open Crystal Reports or other SQL reporting tool. 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 Open Avatar Cal-PM 'Admission' form. 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 In 'Select Client' dialog, enter values for search criteria and click 'Search' button. Select existing client record to enter new Admission record, or click 'New Client' button to create new client record via Admission record entry. 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). Enter/select values for 'Type of Admission', 'Admitting Practitioner' and any other required/desired fields in 'Admission' form. Click 'Submit' button to file new Admission/episode for existing client/new client creation. Open 'Financial Eligibility' form, selecting client/episode filed via 'Admission' form above. Note, Acceptance Testing Guarantor Default Assignment may also be confirmed via 'Fast Financial Eligibility' form Navigate to 'Guarantor Selection' section of 'Financial Eligibility' form. 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). For each assigned Guarantor row, ensure value for 'Guarantor Plan' is assigned (according to 'Guarantor Plan' field in 'Guarantors/Payors' form). 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 For each assigned Guarantor row, ensure value for 'Client's Relationship To Subscriber ' is set to 'Self'. For each assigned Guarantor row, ensure value for 'Coverage Effective Date ' is set to Admission date for episode. 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 Open Avatar Cal-PM 'Financial Eligibility' form. 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). Navigate to 'Guarantor Selection' section of 'Financial Eligibility' form. 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'). 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'). For each defaulted/assigned Guarantor row, ensure value for 'Guarantor Plan' is assigned (according to 'Guarantor Plan' field in 'Guarantors/Payors' form). For each defaulted/assigned Guarantor row, ensure value for 'Client's Relationship To Subscriber ' is set to 'Self'. For each defaulted/assigned Guarantor row, ensure value for 'Coverage Effective Date ' is set to Admission date for episode. Add/update/remove Guarantor row(s) from 'Guarantor Selection' following Assigned Guarantor Defaulting for Program if desired. 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). 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 Click 'Submit' button to file 'Financial Eligibility' form/record for client episode. Avatar Cal-PM 'Program Maintenance' Form Scenario 1: 'Program Maintenance' - Form Verification (Avatar Cal-PM) Specific Setup: Crystal Reports or other SQL reporting tool Steps Open the Avatar Cal-PM 'Program Maintenance' form. 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). Ensure that 'EVV Provider Organization ID' field is present in form; enter value for 'EVV Provider Organization ID' if desired. 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. 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 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. 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 Enter/select values for all other Program Maintenance fields as required/desired. Click 'File Program' button to save Program Maintenance information. Click 'Print All Programs' button to display Program Maintenance information. In Program Maintenance report, ensure 'Require Source Of Admission' and 'Require Attending Practitioner' fields are present and reflect values filed via 'Program Maintenance' form. Open Crystal Reports or other SQL reporting tool. 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 4 Summary \| Details Select reports are modified to prevent overlapping data displays. Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Claim Follow-Up Productivity Report Unbilled Services Report Scenario 1: 'Claim Follow-Up Productivity' Report Steps Access the 'Claim Follow-Up Productivity Report' form. Select "Detail Report" in the 'Summary or Detail Report' field. Leave the "User" field blank. This will pick up all rows for the report. Enter the desired dates in the 'Start Date' and 'End Date' fields. Process the report. Validate the 'Guarantor' name field does not overlap with the 'Follow-Up Note Entry Date' field. Validate the 'Follow-Up Note' field displays text as entered in the 'AR Console'. Close the report and the form. Scenario 2: 'Client Ledger' report - validate fields have no overlaps Specific Setup: Client with a Guarantor and Services filed (Client A). Steps Access the 'Client Ledger' form. Select "Client A" in the 'Client ID' field. Select "All Episodes" in the 'Claim/Episode/All Episodes' field. Select "Crystal" in the 'Ledger Type' field. Click [Process]. Review the report and verify the following: 'Service Description' field does not overlap with 'Units' field. 'Guarantor' field does not overlap with 'Guarantor Liability' field. Close the report. Scenario 3: 'Unbilled Services Report' - validate fields have no overlaps Steps Access the 'Unbilled Services Report' form. Set 'Service Start Date' to any date where services were rendered. Set 'Service End Date' to any date to include services. Select "All" in the 'Financial Class(es)' field. Select "All" in the 'Program(s)' field. Select "All" in the 'Service Status' field. Select "No" in the 'Include 0 Liability' field. Click [Process]. Review the report and note the following: 'Guarantor' field data does not overlap with the 'FE Expired?' field. A long Guarantor name wraps to prevent overlapping other fields. Close the report. Close the form.	Topics • NX • Client Ledger
Update 5 Summary \| Details Avatar Cal-PM Location/Place Of Service and 'Enable Alternative Service Location Fields' Registry Setting Scenario 1: 'Electronic Billing' (Avatar Cal-PM) - Verification of 'Enable Alternative Service Location Fields' Registry Setting For 'Location' Values Specific Setup: Avatar Cal-PM Registry Setting 'Enable Alternative Service Location Fields' must be enabled Avatar Cal-PM Registry Setting 'Service Facility Location 2310D/2420C' must be enabled 'Client's Information (Name/Address) Only If Place Of Service Is '12-Home' or '10-Telehealth-Patient in Home' for 2310C/2310D' and/or 'Client's Information (Name/Address) Only If Place Of Service Is '12-Home' or '10-Telehealth-Patient in Home' for 2420C' must be selected for 'Select Type Of Information To Include In Service Facility Location (2310D/2420C)' field in applicable 837 Professional Guarantor/Program Billing Defaults Template (via Avatar Cal-PM 'Guarantor/Program Billing Defaults' form '837 Professional' section) 'Program Maintenance' and/or 'Guarantor/Program Billing Defaults' value may be selected for 'Facility Identification Code information to display in 2310C-NM1-09 and 2420-NM1-09' field in applicable 837 Professional Guarantor/Program Billing Defaults Template (via Avatar Cal-PM 'Guarantor/Program Billing Defaults' form '837 Professional' section) 'Program Maintenance' and/or 'Guarantor/Program Billing Defaults' value may be selected for 'Facility Identification Code information to display in 2310E-NM1-09' field in applicable 837 Institutional Guarantor/Program Billing Defaults Template (via Avatar Cal-PM 'Guarantor/Program Billing Defaults' form '837 Institutional' section) One or more unclaimed services available for 837 file inclusion, where 'Location' Dictionary Code/value for service has 'Place of Service (837 Professional)' Extended Dictionary Code/value 'Telehealth - Patient in Home (10)' or 'Home (12)' Steps Open Avatar Cal-PM 'Electronic Billing' form. Note, 'Quick Billing' form/functions may also be used for 837 generation/validation. Select 837 Professional or 837 Institutional in 'Billing Form' field. Select values for 837 bill generation in the 'Type of Bill', 'Individual or All Guarantors' and 'Billing Type' fields. Select 'Sort File' in the 'Billing Options' field. Select/enter values for service inclusion in 'All Clients or Interim Billing Batch' and 'Program(s)' fields. Select/enter values for 'Create Claims' (and 'Date of Claim' if 'Yes'), 'First Date of Service to Include' and 'Last Date of Service to Include' fields. Select/enter values for any other bill sorting criteria fields as required/desired. Click 'Process' button in form to sort bill. Following 837 bill generation, select 'Dump File' in the 'Billing Options' field. Select 837 file generated, and click 'Process' button in form to view 837 file output data. For 837 Professional format file(s) generated - ensure that for claims including service(s) where 'Location' value for service has 'Place of Service (837 Professional)' value 'Telehealth - Patient in Home (10)' or 'Home (12)', 'Patient's Home' and patient demographic address information values are included in Loop 2310C / 2420C Service Facility Location segments for claim. Example: NM1772PATIENT'S HOME~N31234 CLIENTADDRESS STREET~N4HERMOSA BEACHCA902540000~* For 837 Institutional format file(s) generated - ensure that for claims including service(s) where 'Location' value for service has 'Place of Service (837 Professional)' value 'Telehealth - Patient in Home (10)' or 'Home (12)', 'Patient's Home' and patient demographic address information values are included in Loop 2310E Service Facility Location segments for claim. Example: NM1772PATIENT'S HOME~N31234 CLIENTADDRESS STREET~N4HERMOSA BEACHCA902540000~* For 837 Professional and/or 837 Institutional format file(s) generated - ensure that for claims including service(s) where 'Location' value for service does not have 'Place of Service (837 Professional)' value 'Telehealth - Patient in Home (10)' or 'Home (12)', Loop 2310C / 2310E / 2420C Service Facility Location segments contain information from associated Program Maintenance and/or Guarantor/Program Billing Defaults Template and do not include 'Patient's Home' information/values as detailed above. Scenario 2: Avatar Cal-PM 'Dictionary Update' - Verification of 'Place of Service (837 Professional)' Dictionary Steps Open Avatar Cal-PM 'Dictionary Update' form. Navigate to 'Print Dictionary' section of form. Select 'Client' File. Select 'Individual Data Element' and select Data Element/Dictionary '(579) Place Of Service (837 Professional)'. Click 'Print Dictionary' button to display dictionary fields/values for Data Element. Confirm Avatar Cal-PM 'Client' File Data Element/Dictionary 'Place Of Service (837 Professional)' includes Code '10' with Dictionary Value 'Telehealth - Patient in Home'. Navigate to 'Input Dictionary Code(s)' section of form. Select 'Client' file. Select Data Element/Dictionary '(10006) Location'. Enter/select value for Dictionary Code/Value, and select Extended Dictionary Data Element '(579) Place Of Service (837 Professional)'. Ensure Dictionary Code/Value 'Telehealth - Patient in Home' is available for assignment/selection as Extended Dictionary Data Element for 'Place Of Service (837 Professional)' under 'Location' Dictionary Data Element. Scenario 3: Avatar Cal-PM 'Registry Settings' - Verification of 'Enable Alternative Service Location Fields' Registry Setting Steps Open 'Registry Settings' form. Enter search value 'Enable Alternative Service Location'. Select 'Yes' for 'Include Hidden Registry Settings' field. Click 'View Registry Settings' button. Ensure Registry Setting 'Enable Alternative Service Location Fields' is returned (under 'Avatar PM -> Billing -> Client Charge Input' path). Ensure 'Registry Setting Details' field contains the following explanation text: "If 'Y' is selected the following fields will be added to the 'Edit Service Information' and 'Edit Service Information (Charge Fee Access) forms: Facility Location Name Facility Location Code Qualifier Facility Location Code Identifier Facility Location Address - Street Facility Location Zip Code Facility Location City Facility Location State These fields will allow a user to define a facility location other than the address associated with the program of service. If the service being edited has come into the system via an 837 in Avatar MSO these fields will display the service facility location information from the 837 and will not be editable. When this registry setting is enabled and there is data in the fields, they will be used in place of the address associated with the program of service when defining the 'Service Facility Location' in the 837 Professional loops (2310C/2420C) and the 837 Institutional loop 2310E when creating an 837 in the 'Electronic Billing' form. Additionally, FL-32 field on the HCFA-1500 bill is impacted in the following ways: 1. If the 'Place Of Service (837 Professional)' extended attribute off of location of service is set to '11 - Office', then FL-32 will be populated based on the 'Facility Name To Print In Form Locator 32' field on the 'Guarantor/Program Billing Defaults' form (Paper CMS 1500 section). 2. If the 'Place Of Service (837 Professional)' extended attribute off of location of service is set to '12 - Home' or '10-Telehealth - Patient in Home', then FL-32 will be populated from the client's home address information stored in the 'patient_name', 'patient_add_street_1', 'patient_add_city', 'patient_add_state_code' and 'patient_add_zipcode' fields in the SYSTEM.patient_current_demographics table. 3. Otherwise, if the 'Place Of Service (837 Professional)' extended attribute off of location of service is set to any other value, then FL-32 will be populated from the address information filed in the SYSTEM.billing_tx_address table. If 'N' is selected, the fields will be removed from the forms."	Topics • Registry Settings • Electronic Billing • NX • Dictionary
Update 6 Summary \| Details Avatar Cal-PM 'Women's Health History' Web Service Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Women's Health History Scenario 1: ProviderConnect 'Women's Health History' - Form Verification Specific Setup: Avatar Cal-PM Registry Setting 'Require Client's Episode Number' must be enabled (set to '1') Netsmart ProviderConnect or other application utilizing the Avatar Cal-PM 'Women's Health History'/'WSAPI.PM.Client.ClientCalls' web service 'Add Women's Health History', 'Edit Women's Health History' and 'View Women's Health History' permissions must be assigned to ProviderConnect user/access group Steps In ProviderConnect Main Menu, open 'Lookup Client' form. Enter lookup criteria for client and click 'Search by Criteria' button. In 'Client Lookup' results, select/open client record. Click 'Women's Health History' sidebar menu tab, and ensure that 'Women's Health History' pre-display is opened. In 'Women's Health History pre-display, ensure that display of existing records for view/edit selection includes only those where Program of associated episode is allowed/valid for user's Contracting Provider agency; ensure that any existing records where Program of related episode is disallowed/invalid for user's Contracting Provider agency are not included/available for selection. In 'Women's Health History' pre-display, ensure that 'Add Health History Record' button is present (where 'Add Women's Health History' permission is assigned to user/access group). In 'Women's Health History pre-display, ensure that 'Edit' button is present for view/edit of existing records for valid episodes (where 'Edit Women's Health History' and/or 'View Women's Health History' permissions are assigned to user/access group). Ensure that episodes/records available for edit selection include only those where Program of episode is allowed/valid for user's Contracting Provider agency. Click 'Add Health History Record' button to enter new record, or 'Edit' button to view/edit existing record. In 'Episode Number' field for new 'Women's Health History' record entry, ensure that episodes available for selection include only those where Program of episode is allowed/valid for user's Contracting Provider agency; ensure that episodes where Program of episode is disallowed/invalid for user's Contracting Provider agency are not included/available for selection in the 'Episode Number' field. Ensure that 'Episode Number' and 'Date of Assessment' fields are required (and that same fields cannot be edited when viewing/updating existing record). In ProviderConnect 'Women's Health History' form/record detail, ensure that the following fields are displayed and available for entry (including existing field values where present when viewing/editing): Episode Number Date of Assessment Date of Last Menstrual Period (2300-DTP-03) Frequency LMP/LMP Unknown Premenstrual Symptoms Menarche Age Menopause/Onset Age Date of Last Mammogram/Results/Performing Provider/Site Date of Last PAP/Results/Performing Provider/Site Start Date of Pregnancy End Date of Pregnancy Initial Treatment Date (2300-DTP-03) Have you ever been pregnant? Pregnancy Status Expected Due Date Living Children Lactating Status Have you started prenatal care at another facility? Date of Prenatal Care (at other facility) Have you ever had an ectopic pregnancy? Have you ever had an abortion? Number of Abortion(s) Have you ever had a miscarriage? Number of Miscarriage(s) Contraception Have you ever been treated for a sexually transmitted disease? Received HPV Vaccine? Sexually Active Notes Enter/select values for all required/desired fields, and click 'Save Changes' to save/file 'Women's Health History' record. Ensure user is automatically redirected to 'Women's Health History' pre-display on saving/filing form, and that new or edited record is present in pre-display.	Topics • Client Management
Update 7 Summary \| Details Avatar Cal-PM 'Cal-OMS Discharge' and 'Cal-OMS Annual Update' Forms Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Cal-OMS File Import Cal-OMS Annual Update Cal-OMS Discharge Web Service Scenario 1: 'Cal-OMS File Import' - Verification of Import File Processing Specific Setup: Avatar Cal-PM Registry Setting 'Enable LA County Reporting Requirements' must be enabled (set to 'YC' or 'Y') One or more client(s) with episodes eligible for 'Cal-OMS Annual Update'/'Cal-OMS Discharge' record filing via import 'Cal-OMS File Import' file containing one or more valid Cal-OMS Annual Update and/or Cal-OMS Discharge import data rows including information/values for the following fields/segments: 'Has the client been linked to a stable housing during treatment?' 'If no, explain' 'If yes, what is the permanent housing arrangement?' 'Specify Other' 'Zip Code' Steps Open Avatar Cal-PM 'Cal-OMS File Import' form. Select 'Upload New File' action and click 'Process Action' button. Load import file containing one or more valid Cal-OMS Annual Update and/or Cal-OMS Discharge import data row(s). Select 'Compile File' action and click 'Process Action' button. Click 'OK' button in file compilation confirmation dialog. Select 'Print Compilation Error(s)' action and click 'Process Action' button. Ensure that valid Cal-OMS Annual Update/Cal-OMS Discharge import data row(s) are successfully compiled. Click 'OK' button in file compilation confirmation dialog. Select 'Post File' action and click 'Process Action' button. Click 'OK' button in file compilation confirmation dialog. Open 'Cal-OMS Annual Update' or 'Cal-OMS Discharge' form for client with posted import row. In 'Cal-OMS Annual Update' or 'Cal-OMS Discharge' pre-display, select record posted via 'Cal-OMS File Import'. Click 'Edit' button. In 'Cal-OMS Annual Update' or 'Cal-OMS Discharge' form, ensure values are correct/expected value from import file data for the following stable/permanent housing information fields: 'Has the client been linked to a stable housing during treatment?' 'If no, explain' 'If yes, what is the permanent housing arrangement?' 'Specify Other' 'Zip Code' Scenario 2: 'Cal-OMS Discharge' - Form Verification Specific Setup: Avatar Cal-PM Registry Setting 'Enable LA County Reporting Requirements' must be enabled (set to 'YC' or 'Y') One or more client(s) with episodes eligible for 'Cal-OMS Discharge' record filing Crystal Reports or other SQL reporting tool Steps Open Avatar Cal-PM 'Cal-OMS Discharge' form. Select client record/Cal-OMS Admission episode for Cal-OMS Discharge entry/edit. Click 'Add' button to enter new Cal-OMS Discharge record, or select existing Cal-OMS Discharge record for view/edit in pre-display and click 'Edit' button. Navigate to the 'Family/Social Data' section of form. Ensure the following fields are present in form (related to the 'Has the client been linked to a stable housing during treatment?' field/question): 'If yes, what is the permanent housing arrangement?' Selections/values available: 'Rental by client, no ongoing housing subsidy' 'Rental by client, with ongoing housing subsidy' 'Staying or living with family, permanent tenure' 'Staying or living with friends, permanent tenure' 'Other: specify' 'Specify Other' 'Zip Code' Ensure that if 'No' is selected in the 'Has the client been linked to a stable housing during treatment?' field, stable/permanent housing information fields noted above are disabled (and 'If no, explain' field is enabled for entry). Ensure that if 'Yes' is selected in the 'Has the client been linked to a stable housing during treatment?' field, stable/permanent housing information fields noted above are enabled for entry. Ensure that if 'Other: specify' is selected in the 'If yes, what is the permanent housing arrangement?' field, 'Specify Other' field is enabled for entry. Enter/select values for stable/permanent housing information fields noted above. Enter/select values for all other 'Cal-OMS Discharge' form fields as required/desired. Click 'Submit' button to file 'Cal-OMS Discharge' form/record. Open Crystal Reports or other SQL reporting tool. In Avatar Cal-PM SQL table 'SYSTEM.cal_oms_discharge', ensure that the following fields are present and reflect data filed via 'Cal-OMS Discharge' form: 'permanent_housing_code' 'permanent_housing_value' 'permanent_housing_zip' 'permanent_housing_other' Scenario 3: 'Cal-OMS Annual Update' - Form Verification Specific Setup: Avatar Cal-PM Registry Setting 'Enable LA County Reporting Requirements' must be enabled (set to 'YC' or 'Y') One or more client(s) with episodes eligible for 'Cal-OMS Annual Update' record filing Crystal Reports or other SQL reporting tool Steps Open Avatar Cal-PM 'Cal-OMS Annual Update' form. Select client record/Cal-OMS Admission episode for Cal-OMS Annual Update entry/edit. Click 'Add' button to enter new Cal-OMS Annual Update record, or select existing Cal-OMS Annual Update record for view/edit in pre-display and click 'Edit' button. Navigate to the 'Family/Social Data' section of form. Ensure the following fields are present in form (related to the 'Has the client been linked to a stable housing during treatment?' field/question): 'If yes, what is the permanent housing arrangement?' Selections/values available: 'Rental by client, no ongoing housing subsidy' 'Rental by client, with ongoing housing subsidy' 'Staying or living with family, permanent tenure' 'Staying or living with friends, permanent tenure' 'Other: specify' 'Specify Other' 'Zip Code' Ensure that if 'No' is selected in the 'Has the client been linked to a stable housing during treatment?' field, stable/permanent housing information fields noted above are disabled (and 'If no, explain' field is enabled for entry). Ensure that if 'Yes' is selected in the 'Has the client been linked to a stable housing during treatment?' field, stable/permanent housing information fields noted above are enabled for entry. Ensure that if 'Other: specify' is selected in the 'If yes, what is the permanent housing arrangement?' field, 'Specify Other' field is enabled for entry. Enter/select values for stable/permanent housing information fields noted above. Enter/select values for all other 'Cal-OMS Annual Update' form fields as required/desired. Click 'Submit' button to file 'Cal-OMS Annual Update' form/record. Open Crystal Reports or other SQL reporting tool. In Avatar Cal-PM SQL table 'SYSTEM.cal_oms_annual_update', ensure that the following fields are present and reflect data filed via 'Cal-OMS Annual Update' form: 'permanent_housing_code' 'permanent_housing_value' 'permanent_housing_zip' 'permanent_housing_other' Scenario 4: Cal-OMS Discharge Web Service - Verification of Web Service Filing Specific Setup: Avatar Cal-PM Registry Setting 'Enable LA County Reporting Requirements' must be enabled (set to 'YC' or 'Y') Application utilizing the Avatar Cal-PM 'Cal-OMS Discharge' web service One or more client(s) with episodes eligible for 'Cal-OMS Discharge' record filing Steps Using the 'Cal-OMS Discharge' web service (and/or 'Cal-OMS Discharge V2' web service), submit request to 'FileCalOMSDischarge' method to create or update Cal-OMS Discharge record. Confirm 'Cal-OMS Discharge' web service responds with confirmation data/ID on successful filing of 'FileCalOMSDischarge' method. Example:"<Confirmation>ClientID:111\|\|EP:1\|\|UniqueID:OMD.001</Confirmation>" Confirm 'Cal-OMS Discharge' web service responds with confirmation message on successful filing of 'FileCalOMSDischarge' method. Example:"<Message>Cal-OMS Discharge web service has been filed successfully.</Message>" Confirm 'Cal-OMS Discharge' web service responds with successful status value on successful filing of 'FileCalOMSDischarge' method. Example:"<Status>1</Status>" Open Avatar Cal-PM 'Cal-OMS Discharge' form and select client/episode/Cal-OMS Discharge record filed via web service for view/update. Confirm Cal-OMS Discharge record is created/updated in Avatar Cal-PM, with values/data submitted via web service, including the following fields: 'Has the client been linked to a stable housing during treatment?' ('LinkedToStableHousing') 'If yes, what is the permanent housing arrangement?' ('PermanentHousingArrange') 'Specify Other' ('PermanentHousingOther') 'Zip Code' ('PermanentHousingArrZip')	Topics • Cal-OMS • NX • Registry Settings • Web Services
Update 8 Summary \| Details Discharge - OSHPD Reporting Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: OSHPD Other Information Flag Client for OSHPD Submission (report) OSHPD Submission Scenario 1: Validate OSHPD workflow: Admission, Discharge, OSHPD Other Information, Flag Client For OSHPD Submission, Submission Specific Setup: OSHPD enabled. Program Maintenance: A program is identified that has a value of 'Yes' in 'OSHPD Program'. Facility Defaults: Note the value of 'Output Path On Server for State Reporting Files' because this is where created files will be placed. If needed, review the state specifications for OSHPD reporting. Steps Open ‘Admission’. Admit a client into the ‘OSHPD’ program. Note the date of admission. Submit the form. Open ‘Discharge’ for the client and add data to a minimum of the required fields. Select the ‘OSHPD’ section. Validate that the new fields display: ‘OSHPD Address Number and Street Name’ – data will default from the address record. ‘OSHPD City’ – data will default from the address record. ‘OSHPD State’ – data will default from the address record. ‘OSHPD Country Code’- this input box is ready for data entry ‘OSHPD Homeless Indicator’ - this is a radio group is ready for selection. Enter/select all other desired data. Submit the form. Open ‘OSHPD Other Information’ for the client. Select the ‘OSHPD Diagnosis Code(s)’ section. Click ‘Add New Item’. Select desired value in ‘Diagnosis Code Present At Admission’. Enter/select the desired ‘Diagnosis Code’. Select the ‘OSHPD Procedure Code(s)’ section. Click ‘Add New Item’. Enter/select the desired ‘Procedure Code’. Select the ‘OSHPD Other Information’ section. Select the ‘ Principal Diagnosis Code’. Submit the form. Open ‘Flag Client For OSHPD Submission’ for the client. Select the desired episode. Submit the form. Open ‘OSHPD Submission’. Select ‘Compile’ in ‘Option’. Validate that ‘From Date’ is disabled and auto filled. Enter desired value in ‘Through Date’. Enter other desired data. Click [Submit]. Click [Yes]. Select ‘Submit (Create File)’ in ‘ Options’. Select desired value in ‘’Create File’. Click [Submit]. Click [OK]. Select the compiled file in ‘Select File To Print/Submit’. Click [Submit]. Click [OK]. Select desired value in form return prompt. Navigate to the directory where the file was created and review the file. If desired, and if it was a review file, return to the form and select ‘Final’ in ‘Create File’ and submit. Click [OK]. Select the compiled file in ‘Select File To Print/Submit’. Click [Submit]. Click [OK]. Select desired value in form return prompt. OSHPD Reporting - Submission Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: OSHPD Other Information Flag Client for OSHPD Submission (report) OSHPD Submission Scenario 1: Validate OSHPD workflow: Admission, Discharge, OSHPD Other Information, Flag Client For OSHPD Submission, Submission Specific Setup: OSHPD enabled. Program Maintenance: A program is identified that has a value of 'Yes' in 'OSHPD Program'. Facility Defaults: Note the value of 'Output Path On Server for State Reporting Files' because this is where created files will be placed. If needed, review the state specifications for OSHPD reporting. Steps Open ‘Admission’. Admit a client into the ‘OSHPD’ program. Note the date of admission. Submit the form. Open ‘Discharge’ for the client and add data to a minimum of the required fields. Select the ‘OSHPD’ section. Validate that the new fields display: ‘OSHPD Address Number and Street Name’ – data will default from the address record. ‘OSHPD City’ – data will default from the address record. ‘OSHPD State’ – data will default from the address record. ‘OSHPD Country Code’- this input box is ready for data entry ‘OSHPD Homeless Indicator’ - this is a radio group is ready for selection. Enter/select all other desired data. Submit the form. Open ‘OSHPD Other Information’ for the client. Select the ‘OSHPD Diagnosis Code(s)’ section. Click ‘Add New Item’. Select desired value in ‘Diagnosis Code Present At Admission’. Enter/select the desired ‘Diagnosis Code’. Select the ‘OSHPD Procedure Code(s)’ section. Click ‘Add New Item’. Enter/select the desired ‘Procedure Code’. Select the ‘OSHPD Other Information’ section. Select the ‘ Principal Diagnosis Code’. Submit the form. Open ‘Flag Client For OSHPD Submission’ for the client. Select the desired episode. Submit the form. Open ‘OSHPD Submission’. Select ‘Compile’ in ‘Option’. Validate that ‘From Date’ is disabled and auto filled. Enter desired value in ‘Through Date’. Enter other desired data. Click [Submit]. Click [Yes]. Select ‘Submit (Create File)’ in ‘ Options’. Select desired value in ‘’Create File’. Click [Submit]. Click [OK]. Select the compiled file in ‘Select File To Print/Submit’. Click [Submit]. Click [OK]. Select desired value in form return prompt. Navigate to the directory where the file was created and review the file. If desired, and if it was a review file, return to the form and select ‘Final’ in ‘Create File’ and submit. Click [OK]. Select the compiled file in ‘Select File To Print/Submit’. Click [Submit]. Click [OK]. Select desired value in form return prompt.	Topics • State Forms • OSHPD • NX
Update 10 Summary \| Details Site Specific Section Modeling - Add-On Service fields Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Site Specific Section Modeling (CWS) Service Codes Progress Notes (Group and Individual) Clinical Document Viewer Scenario 1: Progress Note (Group and Individual) - Validating Add-On fields in the 'Site Specific Section Modeling' form when the 'Enable Multiple Add-On Code Per Primary Code Functionality' registry setting="Y". Specific Setup: The 'Enable Multiple Add-On Code Per Primary' registry setting is set to "Y". Using the "Service Codes" form, create 3 group service codes. Two of them must be primary add on codes and one of them must be a primary code. Admit a client into an outpatient episode. Steps Open the 'Site Specific Section Modeling (CWS)' form. Select 'CWSPN22000 (Progress Notes (Group and Individual)) Individual Progress Notes' in 'Site Specific Section'. Select the 'Prompt Definition' section. Select the 'Add-On Service' field. Click [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "Yes". Select the 'Add-On Duration' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "Yes". Select the 'Save Add-On Service' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "Yes". Select the 'Selected Add-On Services' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "Yes". Select the 'Select Add-On Service Entry to Edit/Remove' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "Yes". Select the 'Remove Add-On Service' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "Yes". Submit the form. Open the 'Progress Notes (Group and Individual)' form. Validate the 'Add-On Service' field doesn't exist. Validate the 'Add-On Duration' field doesn't exist. Validate the 'Remove Add-On Service Entry to Edit/Remove' field doesn't exist. Validate the 'Remove Add-On Service' field doesn't exist. Validate the 'Selected Add-On Services' field doesn't exist. Validate the 'Save Add-On Service' field doesn't exist. Open the 'Site Specific Section Modeling (CWS)' form. Select the 'Prompt Definition' section. Select the 'Add-On Service' field. Click [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "No". Select the 'Add-On Duration' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "No". Select the 'Save Add-On Service' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "No". Select the 'Selected Add-On Services' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "No". Select the 'Select Add-On Service Entry to Edit/Remove' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "No". Select the 'Remove Add-On Service' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "No". Submit the form. Open the 'Progress Notes (Group and Individual)' form. Generate a "Group Default Note". Add the test client to the group using the Add Client fields on the form. File the Group Default Note. Select the test client from the "Select Group Note to Edit" field. Verify the 'Add-On Service' field exists. Verify the 'Add-On Duration' field exists. Verify the 'Select Add-On Service Entry to Edit/Remove' exists. Verify the 'Remove Add-On Service' button exists. Verify the 'Selected Add-On Services' field exists. Verify the 'Save Add-On Service' button exists. Individualize the progress note for the test client and populate the Add on service fields. Finalize and sign the document. Open the 'Progress Notes (Group and Individual)' form. Select the test client from the "Select Group Note to Edit" field. Verify the 'Add-On Service' field exists. Verify the 'Add-On Duration' field exists. Verify the 'Select Add-On Service Entry to Edit/Remove' exists. Verify the 'Remove Add-On Service' button exists. Verify the 'Selected Add-On Services' field exists. Verify the 'Save Add-On Service' button exists. Create the progress note for the test client and populate the Add on service fields. Finalize and sign the document. Using the "Client Ledger" form, validate the primary and add on services are on the client's ledger. Using the "Clinical Document Viewer" form, validate the documents display. Scenario 2: Progress Note (Group and Individual) - Validating Add-On fields in the 'Site Specific Section Modeling' form when the 'Enable Multiple Add-On Code Per Primary Code Functionality' registry setting="N" Specific Setup: The 'Enable Multiple Add-On Code Per Primary' registry setting is set to "N". Steps Open the 'Site Specific Section Modeling (CWS)' form. Select 'CWSPN22000 (Progress Notes (Group and Individual)) Individual Progress Notes' in 'Site Specific Section'. Select the 'Prompt Definition' section. Select the 'Add-On Service' field. Click [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is set to 'Yes' and disabled. Select the 'Add-On Duration' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is set to 'Yes' and disabled. Select the 'Save Add-On Service' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is set to 'Yes' and disabled. Select the 'Selected Add-On Services' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is set to 'Yes' and disabled. Select the 'Select Add-On Service Entry to Edit/Remove' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is set to 'Yes' and disabled. Select the 'Remove Add-On Service' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is set to 'Yes' and disabled. Submit the form. Open the 'Progress Notes (Group and Individual)' form. Verify the 'Add-On Service' field does not exist. Verify the 'Add-On Duration' field does not exist. Verify the 'Select Add-On Service Entry to Edit/Remove' does not exist. Verify the 'Remove Add-On Service' button does not exist. Verify the 'Selected Add-On Services' field does not exist. Verify the 'Save Add-On Service' button does not exist. Create and finalize the progress note. Using the "Clinical Document Viewer" to validate the document was stored and can be retrieved.	Topics • Site Specific Section Modeling • Progress Notes
Update 11 Summary \| Details The 'BedAssignment' web service Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Bed Availability Report SOAPUI - BedAssignment SOAPUI - BedAssignment - AddBedAssignment SOAPUI - BedAssignment - DeleteBedAssignment SOAPUI - BedAssignment - EditBedAssignment SOAPUI - BedAssignment - GetDictionaryItems Delete Bed Assignment Scenario 1: Validate the 'BedAssignment' - 'AddBedAssignment' web service Specific Setup: A client is enrolled in an existing inpatient episode (Client A). Steps Access SoapUI for the 'BedAssignment' - 'AddBedAssignment' web service. Enter the system code that will be used to log into Avatar in the 'SystemCode' field. Enter the user name that will be used to log into Avatar in the 'UserName' field. Enter the password that will be used to log into Avatar in the 'Password' field. Enter the desired date in the 'DateOfAssignment' field. Enter the desired time in the 'TimeOfAssignment' field. Enter the desired unit in the 'Unit' field. Enter the desired room in the 'Room' field. Enter the desired bed in the 'Bed' field. Enter the desired value in the 'RoomAndBoardBillingCode' field. Enter the desired value in the 'AdmissionChargeCode' field. Enter the desired value in the 'DailyChargeCode' field. Enter "Client A" in the 'ClientID' field. Enter the existing episode in the 'EpisodeNumber' field. Click [Run]. Validate the 'AddBedAssignmentResult' field contains the following: 'Confirmation' field containing a unique ID for the record. 'Message' field containing: Bed Assignment web service has been filed successfully. Select "Client A" and access the 'Bed Assignment' form. Validate the 'Date Of Bed Assignment' field contains the date filed in the previous steps. Validate the 'Time Of Bed Assignment' field contains the time filed in the previous steps. Validate the 'Unit' field contains the unit filed in the previous steps. Validate the 'Room' field contains the room filed in the previous steps. Validate the 'Bed' field contains the bed filed in the previous steps. Validate the 'Room And Board Billing Code' field contains the value filed in the previous steps. Validate the 'Admission Charge Code' field contains the value filed in the previous steps. Validate the 'Daily Charge Code' field contains the value filed in the previous steps. Close the form. Scenario 2: Validate the 'BedAssignment' - 'DeleteBedAssignment' web service Specific Setup: A client has an existing inpatient episode with a current & previous bed assignment record. The previous bed assignment must be available (Client A). Steps Select "Client A" and access the 'Bed Assignment' form. Validate the 'Unit' field contains the unit for the current bed assignment. Validate the 'Room' field contains the room for the current bed assignment. Validate the 'Bed' field contains the bed for the current bed assignment. Validate all other fields contain the values for the current bed assignment. Close the form. Access SoapUI for the 'BedAssignment' - 'DeleteBedAssignment' web service. Enter the system code that will be used to log into Avatar in the 'SystemCode' field. Enter the user name that will be used to log into Avatar in the 'UserName' field. Enter the password that will be used to log into Avatar in the 'Password' field. Enter "Client A" in the 'ClientID' field. Enter the existing episode number in the 'EpisodeNumber' field. Enter the unique ID for the current bed assignment record in the 'UniqueID' field. Click [Run]. Validate the 'DeleteBedAssignmentResult' field contains the following: 'Confirmation' field containing the unique ID for the deleted record. 'Message' field containing: Bed Assignment web service has been filed successfully. Select "Client A" and access the 'Bed Assignment' form. Validate the 'Unit' field contains the unit from the previous bed assignment. Validate the 'Room' field contains the room from the previous bed assignment. Validate the 'Bed' field contains the bed from the previous bed assignment. Validate all other fields contain the values from the previous bed assignment. Close the form. Scenario 3: Validate the 'BedAssignment' - 'EditBedAssignment' web service Specific Setup: A client is enrolled in an existing inpatient episode (Client A). Steps Access SoapUI for the 'BedAssignment' - 'EditBedAssignment' web service. Enter the system code that will be used to log into Avatar in the 'SystemCode' field. Enter the user name that will be used to log into Avatar in the 'UserName' field. Enter the password that will be used to log into Avatar in the 'Password' field. Enter the desired time in the 'TimeOfAssignment' field. Enter the desired value in the 'RoomAndBoardBillingCode' field. Enter the desired value in the 'AdmissionChargeCode' field. Enter the desired value in the 'DailyChargeCode' field. Enter "Client A" in the 'ClientID' field. Enter the existing episode in the 'EpisodeNumber' field. Enter the unique ID for the existing record in the 'UniqueID' field. Click [Run]. Validate the 'EditBedAssignmentResult' field contains the following: 'Confirmation' field containing the unique ID for the record. 'Message' field containing: Bed Assignment web service has been filed successfully. Select "Client A" and access the 'Bed Assignment' form. Validate the 'Time Of Bed Assignment' field contains the time filed in the previous steps. Validate the 'Room And Board Billing Code' field contains the value filed in the previous steps. Validate the 'Admission Charge Code' field contains the value filed in the previous steps. Validate the 'Daily Charge Code' field contains the value filed in the previous steps. Close the form. Scenario 4: Validate the 'BedAssignment' - 'GetDictionaryItems' web service Steps Access SoapUI for the 'BedAssignment' - 'GetDictionaryItems' web service. Enter the system code that will be used to log into Avatar in the 'SystemCode' field. Enter the user name that will be used to log into Avatar in the 'UserName' field. Enter the password that will be used to log into Avatar in the 'Password' field. Click [Run]. Validate the 'GetDictionaryItemsResponse' field is populated with the defined dictionary values for the 'Bed Assignment' form.	Topics • Bed Assignment
Update 12 Summary \| Details Payment/Adjustment Posting and Avatar MSO 'Retro Claim Adjudication' Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Retro Claim Adjudication Scenario 1: Avatar PM Service Payment/Adjustment Posting - Verification of Retro Claim Adjudication filing in Avatar MSO Specific Setup: One or more services which have been filed/pushed to Avatar PM parent system via Avatar MSO (and eligible for Retro Claim Adjudication entry in Avatar MSO) 'Trigger Retro Claim Adjudication Entry in MSO' must be set to 'Yes' for one or more posting/adjustment codes (via Avatar PM 'Posting/Adjustment Codes Definition' form) Extended Dictionary Data Element 'Payment/Adjustment And Transfer Codes (920)' may be defined with a PM posting/adjustment code in Avatar MSO 'Other Tabled Files' Indirect Dictionary Code 'Adjustment Code (351)' if default adjustment code not desired (via Avatar MSO 'Dictionary Update' form) 'Default Retro Claim Adjudication Adjustment Code For Adjustments In PM' must be defined in Avatar MSO (via Avatar MSO 'Set System Defaults' form) Avatar MSO 2021 Update 2 is required for 'Original Duration', 'Updated Duration' and 'Take Back Duration' fields to be present in Avatar MSO 'Retro Claim Adjudication' form/SQL table Steps Open Avatar PM 'Individual Cash Posting' form. Note - functionality may also be confirmed via 'Spreadsheet Remittance Posting' and/or 'Batch Cash Posting' forms. Enter/select value for 'Client and 'Post By Claim Or Episode' fields (and 'Claim'/'Episode' fields if enabled). Click 'Select Item(s) To Post Against' button to open service selection grid. Select service for payment/adjustment posting and click 'OK' button to close service selection grid. Enter/select values for 'Posting Date', 'Date Of Receipt', and 'Guarantor' fields. Enter/select values for 'Dollar Amount To Be Posted' and 'Posting Code' fields. Enter/select value for 'Action For Remaining Balance If Applicable' (if required), and any other fields as required/desired. Click 'Update Temporary' file button to save payment/adjustment entry. Click 'Submit' button to file 'Individual Cash Posting' form and finalize temporary file posting/adjustment entries. Open Avatar MSO 'Retro Claim Adjudication' form. Note, Retro Claim Adjudication entries filed via Avatar PM payment/adjustment posting may also be confirmed directly in Avatar MSO SQL table 'SYSTEM.retro_claim_adjudications' Select 'Edit' in 'Add/Edit/Delete Claim Adjudication' field. In 'Claim' dropdown selection field, ensure that new Retro Claim Adjudication is present for original Avatar MSO claim where payment/adjustment has been filed for service in Avatar PM. In 'Claim' and 'Date of Service/Procedure' dropdown selection fields, select original Avatar MSO claim/service where payment/adjustment has been filed for service in Avatar PM. Confirm Avatar MSO 'Adjustment Code' value for Retro Claim Adjudication entry is value linked to Avatar PM posting/adjustment code by Extended Dictionary Data Element 'Payment/Adjustment And Transfer Codes'; if no MSO value for 'Payment/Adjustment And Transfer Codes' link is defined, confirm 'Adjustment Code' value for Retro Claim Adjudication entry is value defined as 'Default Retro Claim Adjudication Adjustment Code For Adjustments In PM'. Confirm 'Take Back Amount' value for Retro Claim Adjudication entry is value filed for 'Dollar Amount To Be Posted' in Avatar PM. Confirm 'Updated Disbursement Amount' value for Retro Claim Adjudication entry is calculated as 'Original Disbursement Amount minus Take Back Amount'. Confirm 'Take Back Duration' value for Retro Claim Adjudication entry is calculated with same ratio as 'Updated Disbursement' to 'Original Disbursement'. Example 1 'Original Duration' = 120, 'Original Disbursement Amount' = 300 'Dollar Amount To Be Posted'/'Take Back Amount' = 150 'Take Back Duration' will be calculated as 60 (being 1/2 value of 'Original Duration', 1/2 ratio of 'Updated Disbursement Amount' to 'Original Disbursement Amount') Example 2 'Original Duration' = 60, 'Original Disbursement Amount' = 300 'Dollar Amount To Be Posted'/'Take Back Amount' = 300 (full adjustment/payment) 'Take Back Duration' will be calculated as 60 (being full take back 'Original Duration') Confirm 'Updated Duration' value for Retro Claim Adjudication entry is calculated as 'Original Duration minus Take Back Duration'. Close Avatar MSO 'Retro Claim Adjudication' form. Scenario 2: '835 Health Care Claim Payment/Advice' - Verification of Retro Claim Adjudication filing in Avatar MSO for payment/adjustment Specific Setup: One or more claimed services which have been filed/pushed to Avatar PM parent system via Avatar MSO (eligible for Avatar PM 835 inbound posting and Retro Claim Adjudication entry in Avatar MSO) 'Trigger Retro Claim Adjudication Entry in MSO' must be set to 'Yes' for one or more posting/adjustment codes (via Avatar PM 'Posting/Adjustment Codes Definition' form) Extended Dictionary Data Element 'Payment/Adjustment And Transfer Codes (920)' may be defined with a PM posting/adjustment code in Avatar MSO 'Other Tabled Files' Indirect Dictionary Code 'Adjustment Code (351)' if default adjustment code not desired (via Avatar MSO 'Dictionary Update' form) 'Default Retro Claim Adjudication Adjustment Code For Adjustments In PM' must be defined in Avatar MSO (via Avatar MSO 'Set System Defaults' form) Avatar MSO 2021 Update 2 is required for 'Original Duration', 'Updated Duration' and 'Take Back Duration' fields to be present in Avatar MSO Retro Claim Adjudication form/SQL table Inbound 835 Health Care Claim Payment/Advice file containing one or more successfully compiled entries for Avatar PM claims containing services originating in Avatar MSO Steps Open Avatar PM '835 Health Care Claim Payment/Advice' form. Select 'Load File' in the 'Options' field. Enter 'File Path/Name' value for 835 inbound file to be loaded, and click 'Process File' button. Ensure 835 file is successfully loaded. Select 'Compile File' in the 'Options' field. Select loaded inbound 835 file in the 'Select File' field, and click 'Process File' button. In 835 Compile Report - ensure that payments/adjustments are successfully compiled for Avatar PM claims containing services originating in Avatar MSO. Select 'Post File' in the 'Options' field. Select compiled inbound 835 file in the 'Select File' field, enter values for 'Posting Date' and 'Date of Receipt' fields (as well as any other fields as required/desired), and click 'Process File' button. In 835 Posting Report - ensure that payments/adjustments are successfully posted for Avatar PM claims containing services originating in Avatar MSO. Open Avatar MSO 'Retro Claim Adjudication' form. Note, Retro Claim Adjudication entries filed via Avatar PM 835 payment/adjustment posting may also be confirmed directly in Avatar MSO SQL table 'SYSTEM.retro_claim_adjudications' Select 'Edit' in 'Add/Edit/Delete Claim Adjudication' field. In 'Claim' dropdown selection field, ensure that new Retro Claim Adjudication is present for original Avatar MSO claim where payment/adjustment has been filed for service in Avatar PM via inbound 835 Health Care Claim Payment/Advice file posting. In 'Claim' and 'Date of Service/Procedure' dropdown selection fields, select original Avatar MSO claim/service where payment/adjustment has been filed for service in Avatar PM via inbound 835 Health Care Claim Payment/Advice file posting. Confirm Avatar MSO 'Adjustment Code' value for Retro Claim Adjudication entry is value linked to Avatar PM posting/adjustment code by Extended Dictionary Data Element 'Payment/Adjustment And Transfer Codes'; if no MSO value for 'Payment/Adjustment And Transfer Codes' link is defined, confirm 'Adjustment Code' value for Retro Claim Adjudication entry is value defined as 'Default Retro Claim Adjudication Adjustment Code For Adjustments In PM'. Confirm 'Take Back Amount' value for Retro Claim Adjudication entry is value filed for payment/adjustment in Avatar PM via inbound 835 Health Care Claim Payment/Advice file posting. Confirm 'Updated Disbursement Amount' value for Retro Claim Adjudication entry is calculated as 'Original Disbursement Amount minus Take Back Amount'. Confirm 'Take Back Duration' value for Retro Claim Adjudication entry is calculated with same ratio as 'Updated Disbursement' to 'Original Disbursement'. Example 1 'Original Duration' = 120, 'Original Disbursement Amount' = 300 Amount posted from 835 adjustment/payment/'Take Back Amount' = 150 'Take Back Duration' will be calculated as 60 (being 1/2 value of 'Original Duration', 1/2 ratio of 'Updated Disbursement Amount' to 'Original Disbursement Amount') Example 2 'Original Duration' = 60, 'Original Disbursement Amount' = 300 Amount posted from 835 adjustment/payment/'Take Back Amount' = 300 (full adjustment/payment) 'Take Back Duration' will be calculated as 60 (being full take back 'Original Duration') Confirm 'Updated Duration' value for Retro Claim Adjudication entry is calculated as 'Original Duration minus Take Back Duration'. Close Avatar MSO 'Retro Claim Adjudication' form.	Topics • Individual Cash Posting • Spreadsheet Remittance Posting • Spreadsheet Batch Remittance Posting • NX • 835 Health Care Claim Payment/Advice • Posting/Adjustment Codes
Update 13 Summary \| Details Demographics Scenario 1: 'Update Client Data' - Verification of form filing Specific Setup: If custom Form Designer changes are present in 'Update Client Data' form, please use 'Form Designer' to revert to 'Netsmart Produced Changes'. A client is enrolled in an existing episode (Client A). The 'Enable Address Validation' registry setting must be enabled. Steps Select "Client A" and access the 'Update Client Data' form. Enter an invalid address in the 'Client's Address - Street' field and press the 'Tab' key. Validate an 'Address Validation' dialog stating: "The address was invalid for the following reason: Address Not Found. Discard changes?" Click [No]. Enter an invalid address in the 'Client's Address - Street' field and press the 'Tab' key. Validate an 'Address Validation' dialog stating: "The address was invalid for the following reason: Address Not Found. Discard changes?" Click [Yes]. Validate a dialog stating: "Cancelled." and click [OK]. Validate the 'Client's Address - Street' field is cleared. Enter a valid address and populate any desired fields. Enter a 'Place of Birth' value that contains 40 characters. Click [Submit]. Re-enter the form for the client and validate that the data submitted successfully.	Topics • Admission • Update Client Data • NX
Update 14 Summary \| Details Client Charge Input - Duration Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Site Specific Section Modeling (PM) Scenario 1: Client Charge Input - SS Specific Field of SS Treatment Integers Specific Setup: Service Code: Service Required By = Both. Type Of Service = Group. Type Of Fee = Fixed Fee (Per Event). Fixed Fee Units = desired value. Is this an ODS Group Service? = Yes. Program Maintenance: Substance Abuse Program (Cal-OMS) = Yes (Reportable). Site Specific Section Modeling: PATIENT903 (Client Charge Input) Client Charge Input has been used to add prompt definitions for: ‘SS Treatment Integer 1’. If desired, give the prompt a label. Select "Use as first field to calculate duration" in ‘Product Custom Logic’. ‘SS Treatment Integer 2’. If desired, give the prompt a label. Select "Use as second field to calculate duration" in ‘Product Custom Logic’. ‘SS Treatment Integer 7. If desired, give the prompt a label. Select "Use as third field to calculate duration" in ‘Product Custom Logic’. Steps Open ‘Client Charge Input’. Enter the ‘Date Of Service’. Select the ‘Client ID’. Select the ‘Episode Number’. Validate that the ‘Program’ field contains a value. Enter the ‘Service Code’ from setup. Select the practitioner. Validate that Duration (Minutes) is null. Enter a duration in the ‘SS Treatment Integer 1’ field. Validate that Duration (Minutes) contains the duration entered in ‘SS Treatment Integer 1’. Enter a duration in the ‘SS Treatment Integer 2’ field. Validate that Duration (Minutes) contains the total duration entered in ‘SS Treatment Integer 1’ and ‘SS Treatment Integer 2’ fields. Enter a duration in the ‘SS Treatment Integer 3’ field. Validate that Duration (Minutes) contains the total duration entered in ‘SS Treatment Integer 1’, ‘SS Treatment Integer 2’ and ‘SS Treatment Integer 3 fields. Click [Submit]. Close the form. If desired, open Edit service information for the client and 'Date of Service' and validate the duration. Close the form.	Topics • Client Charge Input • Site Specific Section Modeling • NX
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: 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 Open' File Import'. Select 'Service Fee/Cross Reference' in 'File Type'. Validate that 'Action' contains 'Upload New File'. Load the file created in setup. Compile the file. If necessary correct errors, delete the existing file, load, and compile again. Post the compiled file. Open 'Service Fee/Cross Reference Maintenance'. Select 'Edit Existing' in 'Enter New Or Edit Existing Fee/Cross Reference'. Enter 'Service Code 1'. Enter the 'From Date'. Click [Select Fee/Cross Ref To Edit/Default From Existing]. Select the desired row in the 'Edit Service Fee Definition' grid. Click [OK]. Validate the data that was submitted in 'File Import' displays correctly. Select 'Edit Existing' in 'Enter New Or Edit Existing Fee/Cross Reference'. Enter 'Service Code 2'. Enter the 'From Date'. Click [Select Fee/Cross Ref To Edit/Default From Existing]. Select the desired row in the 'Edit Service Fee Definition' grid, Click [OK]. Validate the data that was submitted in 'File Import' displays correctly.	Topics • Service Fee/Cross Reference Maintenance • File Import • NX
Update 17 Summary \| Details Avatar Cal-PM 'Service Fee/Cross Reference Maintenance' Form Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: File Import File Import - Error Report File Import - Compile/Post Report Service Fee/Cross Reference Maintenance Report Client Charge Input (Charge Fee Access) Client Charge Input With Diagnosis Entry Client Charge Input (Charge Fee Access and Diagnosis Entry) Recurring Client Charge Input (Charge Fee Access) Recurring Client Charge Input (Diagnosis Entry) Recurring Client Charge Input (Charge Fee Access and Diagnosis Entry) Edit Service Information (Charge Fee Access) Spreadsheet Edit Service Information Verify Staff Member Appointments Post Staff Member Schedule Scenario 1: 'File Import' - Verification of 'Service Fee/Cross Reference' Import (Avatar Cal-PM) Specific Setup: Avatar Cal-PM 'Service Fee/Cross Reference' File Import file containing one or valid rows, including value for 'User Defined Fee Unit' (Field/Segment 35) 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 Open Avatar Cal-PM 'File Import' form. Select File Type 'Service Fee/Cross Reference'. Select 'Upload New File' in 'Action' field and Click 'Process Action' button. Select Avatar Cal-PM 'Service Fee/Cross Reference' import file and click 'Open' button. Select 'Compile/Validate File' in 'Action' field. Select loaded import file and click 'Process Action' button. 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. Click 'OK' button. Select 'Print Errors' in 'Action' field if errors encountered in compile; Select compiled import file with errors and click 'Process Action' button. In 'Service Fee/Cross Reference' File Import Error Report, ensure that all invalid/errored import row(s) are included in report with segment/value reference and error message detail. Ensure that if 'User Defined Fee Unit' value is included in file but no value for 'Duration Range' is included, import row(s) produce error 'Missing required field (Duration Range)' on compile Select 'Print File' in 'Action' field to view successfully compiled import data; Select compiled import file and click 'Process Action' button. In 'Service Fee/Cross Reference' File Import Report, ensure that all valid import row(s) are included in report with segment/value details, including 'User Defined Fee Unit' field/segment where included. Select 'Post File' in 'Action' field to post successfully compiled import data; Select compiled import file and click 'Process Action' button. 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. Open Crystal Reports or other SQL reporting tool. In new Avatar Cal-PM SQL table 'SYSTEM.file_import_svc_fee', ensure that all 'Service Fee/Cross Reference' File Import rows are included in table with values from import data file, including 'user_defined_fee_units' field/segment where included. Open Avatar Cal-PM 'Service Fee/Cross Reference Maintenance' form. Select 'Edit Existing' in the 'Enter New Or Edit Existing Fee/Cross Reference' field. Enter/select 'Service Code' and 'From Date' field values for Service Fee/Cross Reference entry posted via File Import, and select imported Service Fee/Cross Reference entry for view/edit. Ensure values for all fields are present as filed via import, including values for 'Fixed Fee Unit' and 'User Defined Fee Unit' fields where applicable. Scenario 2: 'Service Fee/Cross Reference Maintenance' - Form Validation (Avatar Cal-PM) Specific Setup: Crystal Reports or other SQL reporting tool Steps Open Avatar Cal-PM 'Service Fee/Cross Reference Maintenance' form. Select 'Enter New' or 'Edit Existing' in the 'Enter New Or Edit Existing Fee/Cross Reference' field. Enter/select values for 'Service Code' and 'From Date' fields (and select Service Fee/Cross Reference entry for edit if applicable). Enter/select values for 'Practitioner Category', 'Location', 'Practitioner' and/or 'Program' Service Fee/Cross Reference entry criteria if desired. Ensure that 'Fixed Fee Unit' and 'User Defined Fee Unit' fields are present in form. In case where selected Service Code is defined as 'User Defined' (via Avatar Cal-PM 'Service Codes' form 'Type Of Fee' field) - ensure that the 'Fixed Fee Unit' field is disabled (as field only applies to Fixed Fee Service Codes). In case where selected Service Code is defined as 'Fixed Fee' (via Avatar Cal-PM 'Service Codes' form 'Type Of Fee' field) - ensure that the 'User Defined Fee Unit' field is disabled (as field only applies to User Defined Fee Service Codes). Ensure user help message is present in form for 'User Defined Fee Unit' field (lightbulb icon), containing the following information: "A value entered in this field will make the 'Duration Range' field required. The Unit Quantity amount and gross charge amount generated for the service will be based on the integer entered in this field." Ensure that if value is entered for 'User Defined Fee Unit' field, the 'Duration Range' fee criteria field is required. Enter/select values for 'Duration Range', 'Fee', 'Fixed Fee Unit' and/or 'User Defined Fee Unit' fields (and any other Service Fee/Cross Reference definition fields as desired/required). Click 'Submit' button to file 'Service Fee/Cross Reference Maintenance' form/entry; ensure user is presented with filing confirmation dialog noting 'Service Fee/Cross Reference Maintenance has completed. Do you wish to return to form?'; Click 'Yes' button to return to form. Select 'Edit Existing' in the 'Enter New Or Edit Existing Fee/Cross Reference' field. Enter/select values for 'Service Code' and 'From Date' fields, using same code/date as previously filed Service Fee/Cross Reference entry, and select previously entered/filed Service Fee/Cross Reference entry for view/edit. Ensure previously entered/filed values are present in all form fields for selected Service Fee/Cross Reference entry (including values for 'Fixed Fee Unit' and 'User Defined Fee Unit' fields where applicable). Click 'Service Fee/Cross Reference Definition Report' button to launch report displaying all defined Service Fee/Cross Reference entries. In Service Fee/Cross Reference Definition Report, ensure that existing Service Fee/Cross Reference entries are present, including values for 'Units' field where value defined. Note, 'Units' field in Service Fee/Cross Reference Definition Report will display value of 'Fixed Fee Unit' if present for Fixed Fee Service Codes, and will display value of 'User Defined Fee Unit' if present for User Defined Fee Service Codes Open Crystal Reports or other SQL reporting tool. In Avatar Cal-PM SQL table 'SYSTEM.billing_tx_master_fee_table' (and 'SYSTEM.billing_tx_master_fee_audit' for deleted entries), ensure that data rows are present for all Service Fee/Cross Reference entries filed/updated in system, including values for 'fixed_fee_units' and 'user_defined_fee_units' fields. Scenario 3: 'Client Charge Input' - Verification of 'User Defined Fee Units' Service Fee Override Calculation Specific Setup: Service Code where 'Type of Fee' is set to 'User Defined' and (via Avatar Cal-PM 'Service Codes' form) Service Fee/Cross Reference entry applicable to Service Code/Date of Service where 'User Defined Fee Unit' value is specified (via Avatar Cal-PM 'Service Fee/Cross Reference Maintenance' form) Client record eligible for 'Client Charge Input' form service entry Steps Open Avatar Cal-PM 'Client Charge Input' form. Note, Acceptance Testing may also be confirmed via one or more of the following Avatar Cal-PM forms: 'Client Charge Input (Charge Fee Access)' 'Client Charge Input With Diagnosis Entry' 'Client Charge Input (Charge Fee Access and Diagnosis Entry)' 'Recurring Client Charge Input' 'Recurring Client Charge Input (Charge Fee Access)' 'Recurring Client Charge Input (Diagnosis Entry)' 'Recurring Client Charge Input (Charge Fee Access and Diagnosis Entry)' 'Edit Service Information' 'Edit Service Information (Charge Fee Access)' 'Spreadsheet Edit Service Information' Enter value for 'Date of Service'. Enter/select values for 'Client ID', 'Episode Number', 'Program', 'Service Code' and 'Practitioner' fields (and any other fields as desired/required). Enter value for 'Duration (Minutes)' field. Where 'User Defined Fee Unit' value is specified for Service Fee/Cross Reference entry - ensure that 'Cost of Service' value in 'Client Charge Input' form is calculated based on 'User Defined Fee Unit' and 'Fee' from Service Fee/Cross Reference entry applicable to Service Code/Date of Service and 'Duration (Minutes)' entry for User Defined Fee Service Code (Service Fee/Cross Reference 'User Defined Fee Unit' value overrides Service Code 'Minutes Per Unit'/service entry 'Duration (Minutes)' values for calculation of 'Cost of Service'). Example, 'User Defined Fee Units' value specified for Service Fee/Cross Reference entry: Service Code 'Minutes Per Unit' = 1 Service Fee/Cross Reference entries as follows: 'Duration Range' 0-59, 'User Defined Fee Unit' = 30 and 'Fee' = 10 'Duration Range' 60-119, 'User Defined Fee Unit' = 90 and 'Fee' = 10 'Duration Range' 120-999, 'User Defined Fee Unit' = 180 and 'Fee' = 10 If 'Duration (Minutes)' entry = 10, 'Cost of Service' = 300 If 'Duration (Minutes)' entry = 30, 'Cost of Service' = 300 If 'Duration (Minutes)' entry = 50, 'Cost of Service' = 300 If 'Duration (Minutes)' entry = 60, 'Cost of Service' = 900 If 'Duration (Minutes)' entry = 90, 'Cost of Service' = 900 If 'Duration (Minutes)' entry = 100, 'Cost of Service' = 900 If 'Duration (Minutes)' entry = 120, 'Cost of Service' = 1800 If 'Duration (Minutes)' entry = 180, 'Cost of Service' = 1800 If 'Duration (Minutes)' entry = 360, 'Cost of Service' = 1800 Where 'User Defined Fee Unit' value is not specified for Service Fee/Cross Reference entry - ensure that 'Cost of Service' value in 'Client Charge Input' form is calculated based on Service Code 'Minutes Per Units' value and 'Fee' from Service Fee/Cross Reference entry applicable to Service Code/Date of Service and 'Duration (Minutes)' entry for User Defined Fee Service Code (Service Code 'Minutes Per Unit' and service entry 'Duration (Minutes)' values used for calculation of 'Cost of Service'). Example, 'User Defined Fee Units' value not specified for Service Fee/Cross Reference entry: Service Code 'Minutes Per Unit' = 1 Service Fee/Cross Reference entries as follows: 'Duration Range' 0-59, 'Fee' = 10 'Duration Range' 60-119, 'Fee' = 10 'Duration Range' 120-999, 'Fee' = 10 If 'Duration (Minutes)' entry = 10, 'Cost of Service' = 100 If 'Duration (Minutes)' entry = 50, 'Cost of Service' = 500 If 'Duration (Minutes)' entry = 60, 'Cost of Service' = 600 If 'Duration (Minutes)' entry = 100, 'Cost of Service' = 1000 If 'Duration (Minutes)' entry = 120, 'Cost of Service' = 1200 If 'Duration (Minutes)' entry = 360, 'Cost of Service' = 3600 Enter/select/edit values for any other client charge/service entry information fields as required/desired. Click 'Submit' button to file 'Client Charge Input' form/service. Where 'User Defined Fee Unit' value is specified for Service Fee/Cross Reference entry - ensure that service(s) is/are added to system with 'Units' and 'Charge'/'Cost of Service' values from 'User Defined Fee Unit' and 'Fee' for applicable Service Fee/Cross Reference entry. 'Units' and 'Charge'/'Cost of Service' values for service(s) may be confirmed via 'Client Ledger' form Scenario 4: Appointment Scheduling Services - Verification of 'User Defined Fee Units' Service Fee Override Calculation Specific Setup: Service Code where 'Type of Fee' is set to 'User Defined' and (via Avatar Cal-PM 'Service Codes' form) Service Fee/Cross Reference entry applicable to Service Code/Date of Service where 'User Defined Fee Unit' value is specified (via Avatar Cal-PM 'Service Fee/Cross Reference Maintenance' form) Client record eligible for Appointment Scheduling appointment/service entry Steps Open Avatar Cal-PM 'Scheduling Calendar' form. Select calendar date and practitioner; right click and select 'Add Appointment' for new Appointment/Service entry. Enter/select values for 'Appointment Start Time'/'Appointment End Time' and/or 'Duration' fields. Enter/select/update values for 'Service Code', 'Appointment Status', 'Recurrence Schedule', 'Client', 'Episode Number', 'Practitioner' and 'Program' fields. Enter/select values for any other Appointment/Service entry fields as required/desired, and click 'Submit' button to save Appointment/Service entry. Repeat Appointment/Service entry process as desired in 'Scheduling Calendar' form for additional services; click 'Dismiss' button to close 'Scheduling Calendar' form when complete. Verify Appointments for Practitioner/Staff Member for Appointment/Service entry dates (via Avatar Cal-PM 'Verify Staff Member Appointments' form). Post Appointment/Service schedule entries for Practitioner/Staff Member to create service(s) in system for entered Appointments (via Avatar Cal-PM 'Post Staff Member Schedule' form). For services created via Appointment Scheduling entries, where 'User Defined Fee Unit' value is specified for applicable Service Fee/Cross Reference entry - ensure that 'Cost of Service'/'Total Charge'/Units' values for service are calculated based on 'User Defined Fee Unit' and 'Fee' from Service Fee/Cross Reference entry applicable to Service Code/Date of Service and Appointment 'Duration' value for User Defined Fee Service Code (Service Fee/Cross Reference 'User Defined Fee Unit' value overrides Service Code 'Minutes Per Unit'/Appointment entry 'Duration' values for calculation of 'Cost of Service'). Example, 'User Defined Fee Units' value specified for Service Fee/Cross Reference entry: Service Code 'Minutes Per Unit' = 1 Service Fee/Cross Reference entries as follows: 'Duration Range' 0-59, 'User Defined Fee Unit' = 30 and 'Fee' = 10 'Duration Range' 60-119, 'User Defined Fee Unit' = 90 and 'Fee' = 10 'Duration Range' 120-999, 'User Defined Fee Unit' = 180 and 'Fee' = 10 If 'Duration' entry for Appointment = 10, 'Cost of Service' = 300 If 'Duration' entry for Appointment = 30, 'Cost of Service' = 300 If 'Duration' entry for Appointment = 50, 'Cost of Service' = 300 If 'Duration' entry for Appointment = 60, 'Cost of Service' = 900 If 'Duration' entry for Appointment = 90, 'Cost of Service' = 900 If 'Duration' entry for Appointment = 100, 'Cost of Service' = 900 If 'Duration' entry for Appointment = 120, 'Cost of Service' = 1800 If 'Duration' entry for Appointment = 180, 'Cost of Service' = 1800 If 'Duration' entry for Appointment = 360, 'Cost of Service' = 1800 'Units' and 'Charge'/'Cost of Service' values for service(s) may be confirmed via 'Client Ledger' form Scenario 5: 'Electronic Billing' - Verification of 'User Defined Fee Units' Service Fee/Units Override Calculation Specific Setup: Service Code where 'Type of Fee' is set to 'User Defined' and (via Avatar Cal-PM 'Service Codes' form) Service Fee/Cross Reference entry applicable to Service Code/Date of Service where 'User Defined Fee Unit' value is specified (via Avatar Cal-PM 'Service Fee/Cross Reference Maintenance' form) One or more service(s) eligible for Avatar Cal-PM 837 Professional or 837 Institutional file inclusion Steps Open Avatar Cal-PM 'Electronic Billing' form. Note, acceptance testing may also be confirmed via Avatar Cal-PM 'Quick Billing' form/functionality. Select '837 Professional' or '837 Institutional' in the 'Billing Form' field. Select 'Sort File' in the 'Billing Options' field. Enter/select 837 Professional/837 Institutional file sorting criteria. Click 'Process' button to sort/generate 837 Professional/837 Institutional file. Select 'Dump File' in the 'Billing Options' field (or select 'Create File On Server' to review output file directly). Select 'Print' in the 'Print Or Delete Report' field. Select 837 Professional/837 Institutional file sorted which includes services where 'User Defined Fee Unit' value is specified for applicable Service Fee/Cross Reference entry and click 'Process' button to display 837 outbound file data. In Avatar PM 837 Professional/837 Institutional format outbound electronic billing file data including services where 'User Defined Fee Unit' value is specified for applicable Service Fee/Cross Reference entry - ensure 'Cost of Service'/'Total Charge'/Units' values for service in 2400 SV1/SV2 Service Line Number information are reported from/same as calculated values based on 'User Defined Fee Unit' and 'Fee' from Service Fee/Cross Reference entry applicable to Service Code/Date of Service and 'Duration' value for User Defined Fee Service Code (Service Fee/Cross Reference 'User Defined Fee Unit' value overrides Service Code 'Minutes Per Unit'/service entry 'Duration' values for calculation/reporting of 'Cost of Service'). Example, 'User Defined Fee Units' value specified for Service Fee/Cross Reference entry: Service Code 'Minutes Per Unit' = 1 Service Fee/Cross Reference entries as follows: 'Duration Range' 0-59, 'User Defined Fee Unit' = 30 and 'Fee' = 10 'Duration Range' 60-119, 'User Defined Fee Unit' = 90 and 'Fee' = 10 'Duration Range' 120-999, 'User Defined Fee Unit' = 180 and 'Fee' = 10 If 'Duration' entry for service = 0-59, 'Cost of Service' = 300 837 2400 SV1/SV2 example: SV1HC:90806300UN30111~ SV2914*300UN30~ If 'Duration' entry for service = 60-119, 'Cost of Service' = 900 837 2400 SV1/SV2 example: SV1HC:90806900UN9011*1~ SV2914*900UN90~ If 'Duration' entry for service = 120-999, 'Cost of Service' =1800 837 2400 SV1/SV2 example: SV1HC:908061800UN18011*1~ SV2914*1800UN180~ Note - 837 Professional/837 Institutional 2400 SV1/SV2 values are subject to 'Service Unit of Measurement Code' value if defined in Service Fee/Cross Reference entry; if 'Minutes' is selected, 'Duration' entry/value for services will be reported in 2400 SV1/SV2 (including where 'User Defined Fee Unit' override was used in service cost calculation)* Examples: SV1HC:90806300MJ45111~ SV1HC:90806900MJ10011*1~ SV1HC:908061800MJ36011*1~ Note - 837 Professional/837 Institutional 2400 SV1/SV2 values are subject to 'Quantity' override value if defined in Service Fee/Cross Reference entry and will be reported in 2400 SV1/SV2 Examples: SV1HC:90806300UN211*1~ SV1HC:90806900UN211*1~ SV1HC:908061800UN211**1~	Topics • Service Fee/Cross Reference Maintenance • File Import • NX • Client Charge Input • Edit Service Information • Scheduling Calendar • Electronic Billing • 837 Professional • 837 Institutional
Update 18 Summary \| Details CSI Submission - Compile CSI Data Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Product Updates (PM) Scenario 1: Load & Go - Install update and verify successful installation Specific Setup: N/A Steps N/A	Topics • Database Management
Update 21 Summary \| Details Service Codes - 'Clinic Hours' field Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Service Codes Service Code Upload Process Scenario 1: 'Service Codes' - Add a Provider Only Service Code Specific Setup: Must have access to Crystal Reports or other SQL Reporting Tool. Steps Access the 'Service Codes' form. Select "Add" in the 'Add New Or Edit Existing' field. Validate the 'Clinic Hours' field is displayed and disabled. Validate the 'Always Allow Overbooking' field is displayed and disabled. Populate the required and desired fields. Select "Provider" in the 'Service Required By' field. Validate the 'Clinic Hours' field is now enabled. Note: this field will only be enabled when "Provider" is selected in the 'Service Required By' field. Select "Yes" in the 'Clinic Hours' field. Validate the 'Always Allow Overbooking' field is now enabled. Note: this field will only be enabled when "Yes" is selected for 'Clinic Hours'. Select "Yes" in the 'Always Allow Overbooking' field. Click [Submit]. Access Crystal Reports or other SQL reporting tool. Create a report using the 'SYSTEM.billing_tx_master_table' SQL table. Validate a row is displayed for the service code filed in the previous steps. Validate the 'clinic_hours_code' field contains "Y". Validate the 'clinic_hours_value' field contains "Yes". Validate the 'alwoverbook_code' field contains "Y". Validate the 'alwoverbook_value' field contains "Yes". Access the 'Service Codes' form. Select "Edit" in the 'Add New Or Edit Existing' field. Select the service code filed in the previous steps. Validate "Yes" is selected in the 'Clinic Hours' field. Select "No" in the 'Always Allow Overbooking' field. Click [Submit]. Access Crystal Reports or other SQL reporting tool. Refresh the report using the 'SYSTEM.billing_tx_master_table' SQL table. Validate the 'alwoverbook_code' field contains "N". Validate the 'alwoverbook_value' field contains "No". Close the report. Scenario 2: Cal-PM - 'Service Code Upload Process' - Upload Provider Only Service Code Specific Setup: Must have a Cal-PM Service Code Upload file containing a valid row with "Provider" as the value for 'Service Provided By' field and a valid value populated for 'Clinic Hours' and 'Always Allow Overbooking' fields (File A). Steps Access the 'Service Code Upload Process' form. Enter "File A" in the 'Filename' field. Select "Compile" in the 'Compile Or Post' field. Select "No" in the 'Override Existing Service Codes' field. Click [Submit]. Validate a message is displayed stating: Compile Completed. To view results review accepted and rejected reports. Click [OK] and leave the form opened. Select "Post" in the 'Compile Or Post' field. Click [Submit]. Validate a message is displayed stating: Posting completed. Click [OK] and close the form. Access the 'Service Code Upload Accepted Codes' form. Select "File A" in the 'Select Desired Service Code Import File Name' field. Click [Process]. Validate "File A" contents are displayed in the report. Validate the 'Clinic Hours' field is populated with the value defined in the file. Validate the 'Always Allow Overbooking' field is populated with the value defined in the file. Close the report and the form. Access the 'Service Codes' form. Select "Edit" in the 'Add New Or Edit Existing' field. Select the service code uploaded in the previous steps in the 'Service Code' field. Validate 'Clinic Hours' field contains the uploaded value. Validate 'Always Allow Overbooking' field contains the uploaded value. Validate all other information displays as expected. Close the form Access Crystal Reports or other SQL reporting tool. Create a report using the 'SYSTEM.batchload_tx_accepted' SQL table. Validate a row is displayed for the service code uploaded in the previous steps. Validate the 'clinic_hours_code' field contains the uploaded value. Validate the 'clinic_hours_value' field contains the uploaded value. Validate the 'alwoverbook_code' field contains the uploaded value. Validate the 'alwoverbook_value' field contains the uploaded value. Close the report. CSI Submission - Service Codes Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Financial Eligibility CSI Admission CSI Assessment CSI Submission Service Code Upload Process Scenario 1: 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. Service Codes: Service Code 1 has a value of 'Yes' in 'Report to CSI'. Service Code 1 has a value of 'No' in 'Report to CSI'. 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. Client Charge Input has been used to provide both services to the client. Close Charges has been used to close the charges. Steps Open the 'CSI Assessment' form for the client identified in the setup. Select the desired episode in the Pre-Display Click [OK]. Set the 'Assessment Appointment First Offer Date' field to the desired date in the future. Set the 'Assessment Appointment Accepted Date' field to the desired date. Set the 'Assessment Start Date' to desired value. Set the 'Treatment Appointment First Offer Date' field to the desired date in the future. Set the 'Treatment Appointment Accepted Date' field to the desired date. Select desired value from the 'Closure Reason' list field. Note the entire value. Set the 'Closed Out Date' field to desired date. Click [Submit]. Open the 'Crystal Report' or any other SQL data viewer. Query the 'system.assessment_ca_csi_data' SQL table. Locate the client from above step. Verify the entire value selected in the 'Closure Reason' field is displays in the 'closure_reason_value' field. Open the 'CSI Submission' form. Select 'Compile' in the 'Option' field. This file includes all clients who have been admitted in the CSI Admission form. Verify that the 'From Date' displays one of the following: The through date of the last submitted CSI file. The date the file was compiled. The date (From Date field) of the file selected in the Select File to Print/Submit field. 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. Submit the file. Verify that the submitting has been completed successfully. Select 'Submit' option to create the CSI file. Select the CSI file in the 'Select File to Print/Submit' field. Select 'Review' to create a CSI file in the 'Create File' field. Select 'Submit' to create the CSI file. The form will be filed, and a dialog will display the file name and storage location. Review the located CSI Submission file. Verify the CSI Assessment record is included. Verify that Service Code 1 is reported. Close the CSI Submission file. Scenario 2: Cal-PM - Service Codes validation Steps Access the 'Service Codes' form. Select "Add" from the 'Add New Or Edit Existing' field. Enter the desired value in the 'New Service Code' field. Fill out all required fields, selecting a value of "Yes" in 'Is this Service A Visit'. Validate a value of "No" defaults in the 'Should This Visit Be Included on the CCD?' field. Set "Is this an ODS Group Service?" to "No". Click [File Service Code]. Select "Edit" in the 'Add - Add New Or Edit Existing' field. Enter the service code added in the previous steps in the 'Service Code' field. Validate all the fields selected in the previous steps are populated. Select "Yes" in the 'Should This Visit Be Included On The CCD?' field. Select "Yes" in the "Is this an ODS Group Service?". Click [File Service Code]. Select the 'Service Code Report' section. Select "Individual" in the 'Individual or All Service Codes' field. Enter the service code added in the previous steps in the 'Service Code' field. Click [Display Service Codes]. Verify the 'Service Code List' report is displayed. Validate the 'Service Code List' report displays all information filed for the service code in the previous steps. Validate the 'Service Code List' report contains "Should This Visit Be Included On The CCD?: Yes". Validate the "Service Code List" report contains "Is this an ODS Group Service?". Click [Dismiss] and close the form. Access Crystal Reports or other SQL Reporting tool. Select the PM namespace. Create a report using the 'billing_tx_master_table' table. Validate a row is displayed for the service code added in the previous steps. Validate the 'SERVICE_CODE' field contains the service code added in the previous steps. Validate the 'incl_visit_in_CCD_code' field contains "Y". Validate the 'incl_visit_in_CCD_value' field contains "Yes". Validate the 'ods_grp_svc_code' field contains "Y". Validate the'ods_grp_svc_value' field contains "Yes". Close the report. Scenario 3: Cal-PM - Service Code Upload - Validate 'Report to CSI' field. Specific Setup: Must have a Cal-PM Service Code Upload file for upload with a value of "Yes" in the ‘Report to CSI’ field. (File A) Must have a Cal-PM Service Code Upload file for upload with a value of "No" in the ‘Report to CSI’ field. (File B) Must have a Cal-PM Service Code Upload file for upload with no value in the ‘Report to CSI’ field. (File C) Steps Access the 'Service Code Upload Process' form. Enter "File A" in the 'Filename' field. Select "Compile" in the 'Compile Or Post' field. Select "No" in the 'Override Existing Service Codes' field. Click [Submit]. Validate a message is displayed stating: Compile Completed. To view results review accepted and rejected reports. Click [OK]. Select "Post" in the 'Compile Or Post' field. Click [Submit]. Validate a message is displayed stating: Posting completed. Click [OK] and close the form. Access the 'Service Codes' form. Select "Edit" in the 'Add New Or Edit Existing' field. Select the service code uploaded in the previous steps in the 'Service Code' field. Validate the 'Report to CSI' field contains "Yes". Validate all other information displays as expected. Close the form Access the 'Service Code Upload Accepted Codes' form. Select "File A" in the 'Select Desired Service Code Import File Name' field. Click [Process]. Validate "File A" contents are displayed in the report. Validate the 'Report to CSI' field contains "Yes". Close the report and the form. Access Crystal Reports or other SQL reporting tool. Create a report using the 'SYSTEM.batchload_tx_accepted' SQL table. Validate a row is displayed for the service code uploaded in the previous steps. Validate the 'report_to_csi_code' field contains "Y" Validate the 'report_to_csi_value' field contains "Yes". Close the report. Access the 'Service Code Upload Process' form. Enter "File B" in the 'Filename' field. Select "Compile" in the 'Compile Or Post' field. Select "No" in the 'Override Existing Service Codes' field. Click [Submit]. Validate a message is displayed stating: Compile Completed. To view results review accepted and rejected reports. Click [OK]. Select "Post" in the 'Compile Or Post' field. Click [Submit]. Validate a message is displayed stating: Posting completed. Click [OK] and close the form. Access the 'Service Codes' form. Select "Edit" in the 'Add New Or Edit Existing' field. Select the service code uploaded in the previous steps in the 'Service Code' field. Validate the 'Report to CSI' field contains "No". Validate all other information displays as expected. Close the form Access the 'Service Code Upload Accepted Codes' form. Select "File B" in the 'Select Desired Service Code Import File Name' field. Click [Process]. Validate "File B" contents are displayed in the report. Validate the 'Report to CSI' field contains "No". Close the report and the form. Access Crystal Reports or other SQL reporting tool. Create a report using the 'SYSTEM.batchload_tx_accepted' SQL table. Validate a row is displayed for the service code uploaded in the previous steps. Validate the 'report_to_csi_code' field contains "N" Validate the 'report_to_csi_value' field contains "No". Close the report. Access the 'Service Code Upload Process' form. Enter "File C" in the 'Filename' field. Select "Compile" in the 'Compile Or Post' field. Select "No" in the 'Override Existing Service Codes' field. Click [Submit]. Validate a message is displayed stating: Compile Completed. To view results review accepted and rejected reports. Click [OK]. Select "Post" in the 'Compile Or Post' field. Click [Submit]. Validate a message is displayed stating: Posting completed. Click [OK] and close the form. Access the 'Service Codes' form. Select "Edit" in the 'Add New Or Edit Existing' field. Select the service code uploaded in the previous steps in the 'Service Code' field. Validate the 'Report to CSI' field does not contain a value. Validate all other information displays as expected. Close the form Access the 'Service Code Upload Accepted Codes' form. Select "File C" in the 'Select Desired Service Code Import File Name' field. Click [Process]. Validate "File C" contents are displayed in the report. Validate the 'Report to CSI' field does not contain a value. Close the report and the form. Access Crystal Reports or other SQL reporting tool. Create a report using the 'SYSTEM.batchload_tx_accepted' SQL table. Validate a row is displayed for the service code uploaded in the previous steps. Validate the 'report_to_csi_code' field contains "NULL" Validate the 'report_to_csi_value' field contains "No Entry". Service Codes - 'Available Electronic Visit Verification Tasks' field Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Service Codes Service Code Upload Process Scenario 1: 'Service Codes' - Add an EVV Service Code Specific Setup: Must have access Crystal Reports or other SQL Reporting Tool. Dictionary values must be defined for the 'Other Tabled Files' - '(424) Available Electronic Visit Verification Tasks' Data Element in 'Dictionary Update (PM)'. Steps Access the 'Service Codes' form. Select "Add" in the 'Add New Or Edit Existing' field. Validate the 'Available Electronic Visit Verification Tasks' field is displayed and disabled. Populate the required and desired fields. Select "Yes" in the 'Does Service Code Require Electronic Visit Verification' field. Validate the 'Available Electronic Visit Verification Tasks' field is now enabled. Select the desired value(s) in the 'Available Electronic Visit Verification Tasks' field. Click [Submit]. Access Crystal Reports or other SQL reporting tool. Create a report using the 'SYSTEM.billing_tx_master_table' SQL table. Validate a row is displayed for the service code filed in the previous steps. Validate the 'evv_tasks_code' field contains the code(s) associated to the task(s) selected in the previous steps. Validate the 'evv_tasks_value' field contains the value(s) selected in the previous steps. Access the 'Service Codes' form. Select "Edit" in the 'Add New Or Edit Existing' field. Select the service code filed in the previous steps. Select any new value(s) in the 'Available Electronic Visit Verification Tasks' field. Click [Submit]. Access Crystal Reports or other SQL reporting tool. Refresh the report using the 'SYSTEM.billing_tx_master_table' SQL table. Validate the 'evv_tasks_code' field contains the updated code(s) associated to the task(s) selected in the previous steps. Validate the 'evv_tasks_value' field contains the updated value(s) selected in the previous steps. Close the report. Scenario 2: Cal-PM - 'Service Code Upload Process' - Upload EVV Service Code Specific Setup: Must have a Cal-PM Service Code Upload file for upload containing a valid row that includes "Yes" as the value for 'Does This Visit Require Electronic Visit Verification' and value(s) for 'Available Electronic Visit Verification Tasks' field (File A). Dictionary values must be defined for the 'Other Tabled Files' - '(424) Available Electronic Visit Verification Tasks' Data Element in 'Dictionary Update (PM)'. Steps Access the 'Service Code Upload Process' form. Enter "File A" in the 'Filename' field. Select "Compile" in the 'Compile Or Post' field. Select "No" in the 'Override Existing Service Codes' field. Click [Submit]. Validate a message is displayed stating: Compile Completed. To view results review accepted and rejected reports. Click [OK]. Select "Post" in the 'Compile Or Post' field. Click [Submit]. Validate a message is displayed stating: Posting completed. Click [OK] and close the form. Access the 'Service Code Upload Accepted Codes' form. Select "File A" in the 'Select Desired Service Code Import File Name' field. Click [Process]. Validate "File A" contents are displayed in the report. Validate the 'Available Electronic Visit Verification Tasks' field is populated with the value(s) defined in the file. Close the report and the form. Access the 'Service Codes' form. Select "Edit" in the 'Add New Or Edit Existing' field. Select the service code uploaded in the previous steps in the 'Service Code' field. Validate the 'Available Electronic Visit Verification Tasks' field contains the uploaded value(s). Validate all other information displays as expected. Close the form Access Crystal Reports or other SQL reporting tool. Create a report using the 'SYSTEM.batchload_tx_accepted' SQL table. Validate a row is displayed for the service code uploaded in the previous steps. Validate the 'evv_tasks_code' field contains the uploaded value(s). Validate the 'evv_tasks_value' field contains the uploaded value(s). Close the report. Service Codes - 'Always Allow Overbooking' field Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Service Codes Service Code Upload Process Scenario 1: 'Service Codes' - Add a Provider Only Service Code Specific Setup: Must have access to Crystal Reports or other SQL Reporting Tool. Steps Access the 'Service Codes' form. Select "Add" in the 'Add New Or Edit Existing' field. Validate the 'Clinic Hours' field is displayed and disabled. Validate the 'Always Allow Overbooking' field is displayed and disabled. Populate the required and desired fields. Select "Provider" in the 'Service Required By' field. Validate the 'Clinic Hours' field is now enabled. Note: this field will only be enabled when "Provider" is selected in the 'Service Required By' field. Select "Yes" in the 'Clinic Hours' field. Validate the 'Always Allow Overbooking' field is now enabled. Note: this field will only be enabled when "Yes" is selected for 'Clinic Hours'. Select "Yes" in the 'Always Allow Overbooking' field. Click [Submit]. Access Crystal Reports or other SQL reporting tool. Create a report using the 'SYSTEM.billing_tx_master_table' SQL table. Validate a row is displayed for the service code filed in the previous steps. Validate the 'clinic_hours_code' field contains "Y". Validate the 'clinic_hours_value' field contains "Yes". Validate the 'alwoverbook_code' field contains "Y". Validate the 'alwoverbook_value' field contains "Yes". Access the 'Service Codes' form. Select "Edit" in the 'Add New Or Edit Existing' field. Select the service code filed in the previous steps. Validate "Yes" is selected in the 'Clinic Hours' field. Select "No" in the 'Always Allow Overbooking' field. Click [Submit]. Access Crystal Reports or other SQL reporting tool. Refresh the report using the 'SYSTEM.billing_tx_master_table' SQL table. Validate the 'alwoverbook_code' field contains "N". Validate the 'alwoverbook_value' field contains "No". Close the report. Scenario 2: Cal-PM - 'Service Code Upload Process' - Upload Provider Only Service Code Specific Setup: Must have a Cal-PM Service Code Upload file containing a valid row with "Provider" as the value for 'Service Provided By' field and a valid value populated for 'Clinic Hours' and 'Always Allow Overbooking' fields (File A). Steps Access the 'Service Code Upload Process' form. Enter "File A" in the 'Filename' field. Select "Compile" in the 'Compile Or Post' field. Select "No" in the 'Override Existing Service Codes' field. Click [Submit]. Validate a message is displayed stating: Compile Completed. To view results review accepted and rejected reports. Click [OK] and leave the form opened. Select "Post" in the 'Compile Or Post' field. Click [Submit]. Validate a message is displayed stating: Posting completed. Click [OK] and close the form. Access the 'Service Code Upload Accepted Codes' form. Select "File A" in the 'Select Desired Service Code Import File Name' field. Click [Process]. Validate "File A" contents are displayed in the report. Validate the 'Clinic Hours' field is populated with the value defined in the file. Validate the 'Always Allow Overbooking' field is populated with the value defined in the file. Close the report and the form. Access the 'Service Codes' form. Select "Edit" in the 'Add New Or Edit Existing' field. Select the service code uploaded in the previous steps in the 'Service Code' field. Validate 'Clinic Hours' field contains the uploaded value. Validate 'Always Allow Overbooking' field contains the uploaded value. Validate all other information displays as expected. Close the form Access Crystal Reports or other SQL reporting tool. Create a report using the 'SYSTEM.batchload_tx_accepted' SQL table. Validate a row is displayed for the service code uploaded in the previous steps. Validate the 'clinic_hours_code' field contains the uploaded value. Validate the 'clinic_hours_value' field contains the uploaded value. Validate the 'alwoverbook_code' field contains the uploaded value. Validate the 'alwoverbook_value' field contains the uploaded value. Close the report.	Topics • Service Codes • CSI Assessment • NX • CSI Submission
Update 24 Summary \| Details 837 Billing - Primary / Add-On Services Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Guarantors/Payors Financial Eligibility Scenario 1: Cal-PM - Electronic Billing - 837 Professional - Include primary and associated add-on services in the same claim Specific Setup: System is set up to allow ‘Add-On’ services to the primary services. Service Codes: Use ‘Service Code Category’ to note the ‘Primary Code’. Note the associated add-on codes. Guarantors/Payors: Guarantor 1: Note the ‘Financial Class’. This will be the client’s primary guarantor. Guarantor 2: Note the ‘Financial Class’. This will be the client’s secondary guarantor. Guarantor/Program Billing Defaults: The ‘Maximum Service Information Per Claim Information (Maximum LX Per CLM)’ = 1. Clients: Client 1: Is enrolled in an outpatient program. Note the program. Client has an active diagnosis record. Client has an active financial eligibility record with the above guarantors. Services have been provided for the above ‘Primary Code’ that include add-on codes. Close Charges was used to close the charges. Client Ledger has been used to verify that the liability distributed to the primary guarantor, and note the dates of service for closed, unclaimed services for the above service codes. Client 2: Is enrolled in an inpatient program. Note the program. Client has an active diagnosis record. Client has an active financial eligibility record with a primary and secondary guarantor. Services have been provided for the above ‘Primary Code’ that include add-on codes. Close Charges was used to close the charges. Client Ledger has been used to verify that the liability distributed to the primary guarantor, and note the dates of service for closed, unclaimed services for the above service codes. Steps Open ‘Electronic Billing’. Select ‘837-Professional’ in ‘Billing Form’. Select the primary guarantor ‘Financial Class in ‘Type Of Bill’. Select ‘Individual’ in ‘Individual Or All Guarantors’. Select the primary guarantor in ‘Guarantor’. Select ‘Outpatient’ in ‘Billing Type’. Select ‘Sort File’ in ‘Billing Options’. Enter the desired value in ‘File Description/Name’. Select ‘All Clients’ in ‘All Clients Or Interim Billing Batch’. Select desired value in ‘Program(s)’. Select ‘No’ in ‘Create Claims’. Enter the desired value in ‘First Date Of Service To Include’. Enter the desired value in ‘Last Date Of Service To Include’. Select ‘All in ‘Include Primary and/or Secondary Billing. Click [Process]. Validate the ‘Processing Report’ message contains ‘Compile Complete’. Click [OK]. Select ‘Dump File’ in ‘Billing Options’. Select ‘Print’ in ‘Print Or Delete Report’. Select the desired report in ‘File’. Click [Process]. Validate that there is one ‘CLM’ segment per service, Close the report. Close the form. If desired, use 'Individual Cash Posting' to transfer the services to the secondary guarantor, transferring an add-on code before the transferring the primary code. If the transfer was performed, process the ‘837-Professional’ again to validate that only one claim is created for the service. Scenario 2: Cal-PM - Electronic Billing - 837 Institutional - Include primary and associated add-on services in the same claim Specific Setup: System is set up to allow ‘Add-On’ services to the primary services. Service Codes: Use ‘Service Code Category’ to note the ‘Primary Code’. Note the associated add-on codes. Guarantors/Payors: Guarantor 1: Note the ‘Financial Class’. This will be the client’s primary guarantor. Guarantor 2: Note the ‘Financial Class’. This will be the client’s secondary guarantor. Guarantor/Program Billing Defaults: The ‘Maximum Service Information Per Claim Information (Maximum LX Per CLM)’ = 1. Clients: Client 1: Is enrolled in an outpatient program. Note the program. Client has an active diagnosis record. Client has an active financial eligibility record with the above guarantors. Services have been provided for the above ‘Primary Code’ that include add-on codes. Close Charges was used to close the charges. Client Ledger has been used to verify that the liability distributed to the primary guarantor, and note the dates of service for closed, unclaimed services for the above service codes. Client 2: Is enrolled in an inpatient program. Note the program. Client has an active diagnosis record. Client has an active financial eligibility record with a primary and secondary guarantor. Services have been provided for the above ‘Primary Code’ that include add-on codes. Close Charges was used to close the charges. Client Ledger has been used to verify that the liability distributed to the primary guarantor, and note the dates of service for closed, unclaimed services for the above service codes. Steps Open ‘Electronic Billing’. Select ‘837-Institutional’ in ‘Billing Form’. Select the primary guarantor ‘Financial Class in ‘Type Of Bill’. Select ‘Individual’ in ‘Individual Or All Guarantors’. Select the primary guarantor in ‘Guarantor’. Select ‘Inpatient’ in ‘Billing Type’. Select ‘Sort File’ in ‘Billing Options’. Enter the desired value in ‘File Description/Name’. Select ‘All Clients’ in ‘All Clients Or Interim Billing Batch’. Select desired value in ‘Program(s)’. Select ‘No’ in ‘Create Claims’. Enter the desired value in ‘First Date Of Service To Include’. Enter the desired value in ‘Last Date Of Service To Include’. Select ‘All in ‘Include Primary and/or Secondary Billing. Click [Process]. Validate the ‘Processing Report’ message contains ‘Compile Complete’. Click [OK]. Select ‘Dump File’ in ‘Billing Options’. Select ‘Print’ in ‘Print Or Delete Report’. Select the desired report in ‘File’. Click [Process]. Validate that there is one ‘CLM’ segment per service, Close the report. Close the form. If desired, use 'Individual Cash Posting' to transfer the services to the secondary guarantor, transferring an add-on code before the transferring the primary code. If the transfer was performed, process the ‘837-Institutional’ again to validate that only one claim is created for the service.	Topics • 837 Professional • NX • 837 Institutional
Update 25 Summary \| Details Daylight Savings - Timestamps Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: CareFabric Monitor Scenario 1: 'Admission' form - Validate the 'ProgramAdmissionCreated' payload Steps Access the 'Admission' form. Verify the 'Select Client' dialog is displayed. Enter any new value in the 'Last Name' and 'First Name' fields. Select any value in the 'Sex' field. Click [Search]. Validate a "Search Results" message is displayed stating: No matches found. Click [New Client]. Validate a "Client" message displays indicating "Auto Assign Next ID Number?" Click [Yes]. Enter a date prior to daylight savings time in the 'Preadmit/Admission Date' field (Ex. 03/10/2023). Enter "10:00 AM" in the 'Preadmit/Admission Time' field. Select the desired program in the 'Program' field. Enter any value in the 'Type Of Admission' field. Enter the desired practitioner in the 'Admitting Practitioner' field. Click [Submit]. Access the 'CareFabric Monitor' form. Enter the current date in the 'From Date' field. Enter the current date in the 'Through Date' field. Enter the client admitted in the previous steps in the 'Client ID' field. Click [View Activity Log]. Validate the 'CareFabric Monitor Report' is displayed. Select the 'ProgramAdmissionCreated' activity type. Click [Click to View Record]. Validate all filed information is populated. Validate the 'admissionDate' field contains the 'Preadmit/Admission Date' and 'Preadmit/Admission Time' populated in the previous steps with the correct time zone offset prior to daylight savings time (Ex: 2023-03-01T10:00:00.000-05:00). Close the report and the form. Scenario 2: 'Discharge' form - Validate the 'ProgramDischargeCreated' payload Specific Setup: A client must be enrolled in an existing episode (Client A). Steps Select "Client A" and access the 'Discharge' form. Enter a date prior to daylight savings time in the 'Date Of Discharge' field (Ex. 03/10/2023). Enter "10:00 AM" in the 'Discharge Time' field. Select any value in the 'Type Of Discharge' field. Enter the desired practitioner in the 'Discharge Practitioner' field. Select the desired value in the 'Discharge Client Living Arrangement' field. Enter the desired value in the 'Hospital Discharge Instructions' field. Click [Submit]. Access the 'CareFabric Monitor' form. Enter the current date in the 'From Date' field. Enter the current date in the 'Through Date' field. Enter "Client A" in the 'Client ID' field. Click [View Activity Log]. Select "ProgramDischargeCreated" in the 'Activity Type' field. Click [Click to View Record]. Validate all filed information is populated. Validate the 'dischargeDate' field contains the 'Date Of Discharge' and 'Discharge Time' populated in the previous steps with the correct time zone offset prior to daylight savings time (Ex: 2023-03-01T10:00:00.000-05:00). Close the report and the form. Scenario 3: Diagnosis - Validate the 'DiagnosisCreated' and 'DiagnosisUpdated' SDK events Specific Setup: A client is enrolled in an existing episode (Client A). Steps Select "Client A" and access the 'Diagnosis' form. Select the desired value in the 'Type Of Diagnosis' field. Enter a date prior to daylight savings time in the 'Date Of Diagnosis' field (Ex. 03/10/2023). Enter "10:00 AM" in the 'Time Of Diagnosis' field. Click [New Row]. Select the desired value in the 'Diagnosis Search' field. Select "Active" in the 'Status' field. Select the desired practitioner in the 'Diagnosing Practitioner' field. Click [Submit]. Access the 'CareFabric Monitor' form. Enter the current date in the 'From Date' and 'Through Date' fields. Select "Client A" in the 'Client ID' field. Select "DiagnosisCreated" in the 'Event/Action Search' field. Click [View Activity Log]. Validate the 'startDate' field contains the 'Date Of Diagnosis' and 'Time Of Diagnosis' populated in the previous steps with the correct time zone offset prior to daylight savings time (Ex: 2023-03-10T10:00:00.000-05:00). Close the report and the form. Select "Client A" and access the 'Diagnosis' form. Select the diagnosis record filed in the previous steps and click [Edit]. Select "Resolved" in the 'Status' field. Enter the desired date in the 'Resolved Date' field. Click [Submit]. Access the 'CareFabric Monitor' form. Enter the current date in the 'From Date' and 'Through Date' fields. Select "Client A" in the 'Client ID' field. Select "DiagnosisUpdated" in the 'Event/Action Search' field. Click [View Activity Log]. Validate the 'endDate' field contains the 'Resolved Date' populated in the previous steps. Validate the 'statusCode' - 'code' field contains "04". Validate the 'statusCode' - 'displayName' field contains "Resolved". Close the report and the form.	Topics • Admission • CareFabric Monitor • Discharge • Diagnosis
Update 26 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 Scenario 1: 'Cal-OMS Admission' - Form Verification Specific Setup: One or more client(s) with episode eligible for Cal-OMS Admission entry/filing Steps Open 'Cal-OMS Admission' form. Select client/episode for record entry and click 'OK' button. Enter value for 'Admission Date' field. Click to expand the 'Location of Admission' drop-down selection field. 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). Note - In case where user is logged into Avatar Cal-PM root system code (or where multiple/sub-system codes are not enabled), all Cal-OMS enabled Programs will be available for selection in the 'Location of Admission' field Select value for 'Location of Admission' and 'Level of Care Admitted' fields. Complete other fields in form as required/desired. Click 'Submit' button in 'Cal-OMS Admission' form to file record/data.	Topics • Cal-Oms Admission • NX
Update 27 Summary \| Details Client display in 'Recent Clients' list, 'Search Clients' list, and 'Client Header' Scenario 1: Validate the 'Recent Clients' list, 'Search Clients' list, and 'Client Header' for clients imported via HL7 interface Specific Setup: A client exists that was imported via HL7 interface (Client A). Steps Search for "Client A" in the 'Search Clients' field. Validate the name for "Client A" is correctly displayed. Select "Client A" in the 'Search Clients' field. Validate the 'Recent Clients' field contains "Client A" and the name is correctly displayed. Access the 'Update Client Data' form. Validate the name for "Client A" is correctly displayed in the 'Client Header'. Enter new values in the 'Client Last Name' and 'Client First Name' fields. Click [Submit]. Search for "Client A" in the 'Search Clients' field. Validate the updated name for "Client A" is correctly displayed. Select "Client A" in the 'Search Clients' field. Validate the 'Recent Clients' field contains "Client A" and the updated name is correctly displayed. Access the 'Update Client Data' form. Validate the updated name for "Client A" is correctly displayed in the 'Client Header'. Close the form.	Topics • Update Client Data • Client Header
Update 28 Summary \| Details Program Maintenance - Assignment of Subscriber MEDS ID# Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: File Import California MEDS File Load (report) Financial Eligibility Program Maintenance Web Service Scenario 1: 'Program Maintenance' - Form Verification (Avatar Cal-PM) Specific Setup: Crystal Reports or other SQL reporting tool Steps Open the Avatar Cal-PM 'Program Maintenance' form. 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). Ensure that 'EVV Provider Organization ID' field is present in form; enter value for 'EVV Provider Organization ID' if desired. 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. 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 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. 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 Enter/select values for all other Program Maintenance fields as required/desired. Click 'File Program' button to save Program Maintenance information. Click 'Print All Programs' button to display Program Maintenance information. In Program Maintenance report, ensure 'Require Source Of Admission' and 'Require Attending Practitioner' fields are present and reflect values filed via 'Program Maintenance' form. Open Crystal Reports or other SQL reporting tool. 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'. Scenario 2: Cal-PM - File Import - Validate 'Program Maintenance' Import Specific Setup: Have a valid 'Program Maintenance' import file (File A) created that contains a data row for a program with the following: A value populated in the 'EVV Provider Organization ID' field Value(s) in the 'Associated Service Programs' field Steps Access the 'File Import' form. Select "Program Maintenance" in the 'File Type' field. Select "Upload New File" in the 'Action' field. Click [Process Action]. Navigate to the location of "File A" and click [Open]. Select "Compile/Validate File" in the 'Action' field. Select "File A" in the 'File(s)' field. Click [Process Action]. Validate a message is displayed stating "Compiled" and click [OK]. Select "Print File" in the 'Action' field. Select "File A" in the 'File(s)' field. Click [Process Action]. Validate a report is displayed for the program data in "File A". Close the report. Select "Post File" in the 'Action' field. Select "File A" in the 'File(s)' field. Click [Process Action]. Validate a message is displayed stating "Posted" and click [OK]. Close the form. Access the 'Program Maintenance' form. Select "Edit" in the 'Add Or Edit Program' field. Select the program imported via 'File Import' in the 'Program' field. Validate all imported data is populated as expected. Validate the 'Associated Service Programs' field contains the programs imported in the previous steps. Validate the 'EVV Provider Organization ID' field contains the value imported in the previous steps. Close the form. Scenario 3: Cal-PM - Financial Eligibility - Program Maintenance - Assign Subscriber Meds ID# Specific Setup: Registry setting: 'Subscriber MEDS ID#' Assignment' has a value of 'Y'. 'Subscriber Client Index Number' has a value of 'N'. Program Maintenance: 'Assign Subscriber MEDS ID#'' has a value of 'Yes'. Note the Guarantors assigned to the program. California MEDS File Load: Client A will be assigned a guarantor from the above program in Financial Eligibility'. Note the value of the Subscriber MEDS ID#. The Meds file had been loaded and submitted. Steps Open ‘Financial Eligibility’ for the client. Select the ‘Guarantor’ section. Select the ‘Guarantor’ from ‘Program Maintenance’. Validate that there is no value in ‘Subscriber MEDS ID#’. Close the form. Open ‘Registry Settings’ Change the values of 'Subscriber Client Index Number' to ‘Y’ and submit the form. Open ‘California MEDS File Load’. Load and submit the file. Close the form. Open ‘Financial Eligibility’ for the client. Select the ‘Guarantor’ section. Select the ‘Guarantor’ from ‘Program Maintenance’. Validate that the ‘Subscriber MEDS ID#’ contains the correct value. Close the form. Scenario 4: Cal - PM Program Maintenance Web Service Specific Setup: Registry setting 'Avatar PM->System Maintenance->System Definition->California MEDS File Load->->Enable 'Subscriber MEDS ID#' Assignment' has a value of 'P'. Application utilizing the Avatar Cal-PM 'Program Maintenance' web service: Program Maintenance: Select a program to edit or add a new program. Steps Using the Avatar Cal-PM 'Program Maintenance' web service, add a value of 'Y' or 'N' to '<tem:AssignSubscriberMEDSID></tem:AssignSubscriberMEDSID>. Using the Avatar Cal-PM 'Program Maintenance' web service, ensure that if value submitted for one or more fields exceeds the maximum allowed length of entry for this field, the web service request is rejected and error message noting the field length validation failure is returned. Examples: 'The following fields are invalid: Program Code : Length exceeded 10 characters limit'. 'The following fields are invalid: Description : Length exceeded 40 characters limit'. After correcting the field length issues, please resubmit and verify a successful filing. Open 'Program Maintenance' to review the program that was added or edit to validate that the data filed correctly. Close the form.	Topics • Registry Settings • Program Maintenance • NX • File Import • Financial Eligibility • Web Services
Update 30 Summary \| Details Web Service - WEBSVC.AppointmentScheduling.CLS Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: SOAPUI - AppointmentSchedulingV2 SOAPUI - AddAppointment Scenario 1: Client Charge Input - Validate the 'FileClientChargeInputICD10' web service for the quoted character Specific Setup: Guarantors/Payors: An existing guarantor is identified to be used. Note the guarantor code/name. Service codes: An existing service code is identified to be used. Note the service code/description. Service Fee/ Cross Reference Maintenance: A fee definition is created for the service code identified in the ' Service Codes' form. Admission: An existing client is identified or a new client is admitted. Note client id, admission program, admission date. Financial Eligibility: A guarantor identified in the 'Guarantors/Payors' form is assigned to the client as a primary guarantor. Steps Open SoapUI or any other web service tool. Set up the 'FileClientChargeInputICD10' method of the 'ClientChargeInput' web service. Create a new Client Charge Input request for a desired client by specifying the Date of Service, ClientID, Episode Number, diagnosis information and service code within quotes. Verify the web service displays error message: The following fields are invalid : Service Code : Invalid Service code : "[SERVICE CODE]". Remove the quotes from the 'ServiceCode' item of the web service request. File the request again. Verify the web service files successfully and displays confirmation message: "Client Charge Input web service has been filed successfully." Login to Avatar. Open the 'Client Ledger' form. Select desired client. Select desired episode. Select desired ledger type. Click [Process] Verify the service details are correct as filed via web service request. Click [Submit]. Click [No]. Scenario 2: Appointment Scheduling Web Services - Validating 'AddAppointment' method for the quoted characters Specific Setup: Practitioner Enrollment: An existing practitioner is identified. Note practitioner code/name. Staff Members Hours and Exceptions: The practitioner identified above is defined with hours and exception. Note the hours and exception. Note the site code/name for the practitioner. Service codes: An existing service code is identified to be used. Note the service code/description. Service Fee/ Cross Reference Maintenance: A fee definition is created for the service code identified in the 'Service Codes' form. Admission: An existing client is identified or a new client is admitted. Note client id, admission program, admission date. Steps Access SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by entering desired value to the 'Date of appointment', 'ClientID', 'Episode Number','Start/End time','service code' and 'ApptNotes' fields. Please note: The value in the 'ApptNote' field is within quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Go back to SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by specifying the different Appointment Date or different Start/End time, ClientID, Episode Number, service code and 'ApptNotes' fields. Please note: The value in the 'ApptNote' field is without quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Go back to SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by specifying the different Appointment Date or different Start/End time, ClientID, Episode Number, service code and 'ApptNotes' fields. Please note: The value in the 'ServiceCode' field is within quotes. Verify the webservice returns error about invalid service code. Go back to 'AddAppointment' request for of the Appointment Scheduling web service. Enter desired value in the 'ServiceCode' field without quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Go back to SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by specifying the different Appointment Date or different Start/End time, ClientID, Episode Number, service code and 'ApptNotes' fields. Please note: The value in the 'Location' field is within quotes. Verify the webservice returns error about invalid Location. Go back to 'AddAppointment' request for of the Appointment Scheduling web service. Enter desired value in the 'Location' field without quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Go back to SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by specifying the different Appointment Date or different Start/End time, ClientID, Episode Number, service code and 'ApptNotes' fields. Please note: The value from the 'ClientID' field is within quotes. Verify the webservice returns error about invalid ClientID. Go back to 'AddAppointment' request for of the Appointment Scheduling web service. Enter desired value in the 'ClientID' field without quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Go back to SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by specifying the different Appointment Date or different Start/End time, ClientID, Episode Number, service code and 'ApptNotes' fields. Please note: The value in the 'Program' field is within quotes. Verify the webservice returns error about invalid Program. Go back to 'AddAppointment' request for of the Appointment Scheduling web service. Enter desired value in the 'Program' field without quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Go back to SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by specifying the different Appointment Date or different Start/End time, ClientID, Episode Number, service code and 'ApptNotes' fields. Please note: The value in the 'Episode' field is within quotes. Verify the webservice returns error about invalid Episode. Go back to 'AddAppointment' request for of the Appointment Scheduling web service. Enter desired value in the 'Episode' field without quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Go back to SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by specifying the different Appointment Date or different Start/End time, ClientID, Episode Number, service code and 'ApptNotes' fields. Please note: The value in the 'Site' field is within quotes. Verify the webservice returns error about invalid Site. Go back to 'AddAppointment' request for of the Appointment Scheduling web service. Enter desired value in the 'Site' field without quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Go back to SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by specifying the different Appointment Date or different Start/End time, ClientID, Episode Number, service code and 'ApptNotes' fields. Please note: The value in the 'ApptStartTime' field is within quotes. Verify the webservice returns error about invalid ApptStartTime. Go back to 'AddAppointment' request for of the Appointment Scheduling web service. Enter desired value in the 'ApptStartTime' field without quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Go back to SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by specifying the different Appointment Date or different Start/End time, ClientID, Episode Number, service code and 'ApptNotes' fields. Please note: The value in the 'ApptEndTime' field is within quotes. Verify the webservice returns error about invalid ApptEndTime. Go back to 'AddAppointment' request for of the Appointment Scheduling web service. Enter desired value in the 'ApptEndTime' field without quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Scenario 3: Client Charge Input - Validate the 'FileClientChargeInputICD10' web service for the quoted character Specific Setup: Guarantors/Payors: An existing guarantor is identified to be used. Note the guarantor code/name. Service codes: An existing service code is identified to be used. Note the service code/description. Service Fee/ Cross Reference Maintenance: A fee definition is created for the service code identified in the ' Service Codes' form. Admission: An existing client is identified or a new client is admitted. Note client id, admission program, admission date. Financial Eligibility: A guarantor identified in the 'Guarantors/Payors' form is assigned to the client as a primary guarantor. Steps Open SoapUI or any other web service tool. Set up the 'FileClientChargeInputICD10' method of the 'ClientChargeInput' web service. Create a new Client Charge Input request for a desired client by specifying the Date of Service, ClientID, Episode Number, diagnosis information and service code within quotes. Verify the web service displays error message: The following fields are invalid : Service Code : Invalid Service code : "[SERVICE CODE]". Remove the quotes from the 'ServiceCode' item of the web service request. File the request again. Verify the web service files successfully and displays confirmation message: "Client Charge Input web service has been filed successfully." Login to Avatar. Open the 'Client Ledger' form. Select desired client. Select desired episode. Select desired ledger type. Click [Process] Verify the service details are correct as filed via web service request. Click [Submit]. Click [No]. Scenario 4: Appointment Scheduling Web Services - Validating 'AddAppointment' method for the quoted characters Specific Setup: Practitioner Enrollment: An existing practitioner is identified. Note practitioner code/name. Staff Members Hours and Exceptions: The practitioner identified above is defined with hours and exception. Note the hours and exception. Note the site code/name for the practitioner. Service codes: An existing service code is identified to be used. Note the service code/description. Service Fee/ Cross Reference Maintenance: A fee definition is created for the service code identified in the 'Service Codes' form. Admission: An existing client is identified or a new client is admitted. Note client id, admission program, admission date. Steps Access SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by entering desired value to the 'Date of appointment', 'ClientID', 'Episode Number','Start/End time','service code' and 'ApptNotes' fields. Please note: The value in the 'ApptNote' field is within quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Go back to SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by specifying the different Appointment Date or different Start/End time, ClientID, Episode Number, service code and 'ApptNotes' fields. Please note: The value in the 'ApptNote' field is without quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Go back to SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by specifying the different Appointment Date or different Start/End time, ClientID, Episode Number, service code and 'ApptNotes' fields. Please note: The value in the 'ServiceCode' field is within quotes. Verify the webservice returns error about invalid service code. Go back to 'AddAppointment' request for of the Appointment Scheduling web service. Enter desired value in the 'ServiceCode' field without quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Go back to SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by specifying the different Appointment Date or different Start/End time, ClientID, Episode Number, service code and 'ApptNotes' fields. Please note: The value in the 'Location' field is within quotes. Verify the webservice returns error about invalid Location. Go back to 'AddAppointment' request for of the Appointment Scheduling web service. Enter desired value in the 'Location' field without quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Go back to SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by specifying the different Appointment Date or different Start/End time, ClientID, Episode Number, service code and 'ApptNotes' fields. Please note: The value from the 'ClientID' field is within quotes. Verify the webservice returns error about invalid ClientID. Go back to 'AddAppointment' request for of the Appointment Scheduling web service. Enter desired value in the 'ClientID' field without quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Go back to SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by specifying the different Appointment Date or different Start/End time, ClientID, Episode Number, service code and 'ApptNotes' fields. Please note: The value in the 'Program' field is within quotes. Verify the webservice returns error about invalid Program. Go back to 'AddAppointment' request for of the Appointment Scheduling web service. Enter desired value in the 'Program' field without quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Go back to SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by specifying the different Appointment Date or different Start/End time, ClientID, Episode Number, service code and 'ApptNotes' fields. Please note: The value in the 'Episode' field is within quotes. Verify the webservice returns error about invalid Episode. Go back to 'AddAppointment' request for of the Appointment Scheduling web service. Enter desired value in the 'Episode' field without quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Go back to SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by specifying the different Appointment Date or different Start/End time, ClientID, Episode Number, service code and 'ApptNotes' fields. Please note: The value in the 'Site' field is within quotes. Verify the webservice returns error about invalid Site. Go back to 'AddAppointment' request for of the Appointment Scheduling web service. Enter desired value in the 'Site' field without quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Go back to SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by specifying the different Appointment Date or different Start/End time, ClientID, Episode Number, service code and 'ApptNotes' fields. Please note: The value in the 'ApptStartTime' field is within quotes. Verify the webservice returns error about invalid ApptStartTime. Go back to 'AddAppointment' request for of the Appointment Scheduling web service. Enter desired value in the 'ApptStartTime' field without quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service. Go back to SOAPUI or any other web service tool. File the 'AddAppointment' method of the Appointment Scheduling web service for a desired client by specifying the different Appointment Date or different Start/End time, ClientID, Episode Number, service code and 'ApptNotes' fields. Please note: The value in the 'ApptEndTime' field is within quotes. Verify the webservice returns error about invalid ApptEndTime. Go back to 'AddAppointment' request for of the Appointment Scheduling web service. Enter desired value in the 'ApptEndTime' field without quotes. Verify the webservice files successfully. Login to myAvatar. Open the 'Scheduling Calendar' form. Verify that the appointment is on the calendar and the appointment details are correct as filed from the web service.	Topics • Client Charge Input • Web Services • Add New Appointment
Update 31 Summary \| Details Console Widget Viewer Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Leaves Scenario 1: 'Console Widget Viewer' - 'Diagnosis' and 'Return From Leaves' forms. Specific Setup: Tester has access to the 'Console Widget Viewer'. The 'Diagnosis' and 'Return From Leaves' forms have been added to the 'Console Widget Viewer'. Client A: Client has a diagnosis record. The client was placed on ‘Leave’ and has a 'Return From Leaves' record. Steps Access the 'Console Widget Viewer' for the client. Verify that the 'Diagnosis' record displays correctly. Verify that the 'Return From Leaves' record displays correctly. Return to homeview.	Topics • Console Widget • NX
Update 32 Summary \| Details Service Fee/Cross Reference Maintenance - Practitioner Category Scenario 1: 'Service Fee/Cross Reference Maintenance' - Form Validation (Avatar Cal-PM) Specific Setup: Crystal Reports or other SQL reporting tool Dictionary Update - Staff File - Practitioner Category (79): Note a dictionary code that has more than five characters, not how many characters there are. Steps Open Avatar Cal-PM 'Service Fee/Cross Reference Maintenance' form. Select 'Enter New' or 'Edit Existing' in the 'Enter New Or Edit Existing Fee/Cross Reference' field. Enter/select values for 'Service Code' and 'From Date' fields (and select Service Fee/Cross Reference entry for edit if applicable). Enter/select values for 'Practitioner Category', 'Location', 'Practitioner' and/or 'Program' Service Fee/Cross Reference entry criteria if desired. Ensure that 'Fixed Fee Unit' and 'User Defined Fee Unit' fields are present in form. In case where selected Service Code is defined as 'User Defined' (via Avatar Cal-PM 'Service Codes' form 'Type Of Fee' field) - ensure that the 'Fixed Fee Unit' field is disabled (as field only applies to Fixed Fee Service Codes). In case where selected Service Code is defined as 'Fixed Fee' (via Avatar Cal-PM 'Service Codes' form 'Type Of Fee' field) - ensure that the 'User Defined Fee Unit' field is disabled (as field only applies to User Defined Fee Service Codes). Ensure user help message is present in form for 'User Defined Fee Unit' field (lightbulb icon), containing the following information: "A value entered in this field will make the 'Duration Range' field required. The Unit Quantity amount and gross charge amount generated for the service will be based on the integer entered in this field." Ensure that if value is entered for 'User Defined Fee Unit' field, the 'Duration Range' fee criteria field is required. Enter/select values for 'Duration Range', 'Fee', 'Fixed Fee Unit' and/or 'User Defined Fee Unit' fields (and any other Service Fee/Cross Reference definition fields as desired/required). Click 'Submit' button to file 'Service Fee/Cross Reference Maintenance' form/entry; ensure user is presented with filing confirmation dialog noting 'Service Fee/Cross Reference Maintenance has completed. Do you wish to return to form?'; Click 'Yes' button to return to form. Select 'Edit Existing' in the 'Enter New Or Edit Existing Fee/Cross Reference' field. Enter/select values for 'Service Code' and 'From Date' fields, using same code/date as previously filed Service Fee/Cross Reference entry, and select previously entered/filed Service Fee/Cross Reference entry for view/edit. Ensure previously entered/filed values are present in all form fields for selected Service Fee/Cross Reference entry (including values for 'Fixed Fee Unit' and 'User Defined Fee Unit' fields where applicable). Click 'Service Fee/Cross Reference Definition Report' button to launch report displaying all defined Service Fee/Cross Reference entries. In Service Fee/Cross Reference Definition Report, ensure that existing Service Fee/Cross Reference entries are present, including values for 'Units' field where value defined. Note, 'Units' field in Service Fee/Cross Reference Definition Report will display value of 'Fixed Fee Unit' if present for Fixed Fee Service Codes, and will display value of 'User Defined Fee Unit' if present for User Defined Fee Service Codes Open Crystal Reports or other SQL reporting tool. In Avatar Cal-PM SQL table 'SYSTEM.billing_tx_master_fee_table' (and 'SYSTEM.billing_tx_master_fee_audit' for deleted entries), ensure that data rows are present for all Service Fee/Cross Reference entries filed/updated in system, including values for 'fixed_fee_units' and 'user_defined_fee_units' fields. Click the 'Guarantor Definitions' section. Select 'Enter New' or 'Edit Existing' in the 'Enter New Or Edit Existing Fee/Cross Reference' field. Enter/select values for 'Service Code' and 'From Date' fields (and select Service Fee/Cross Reference entry for edit if applicable). Select values for 'Location', 'Practitioner' and/or 'Program' Service Fee/Cross Reference entry criteria if desired. Select the dictionary code that has more than five characters, and one more category in 'Practitioner Category'. Fill out other fields as desired. Click [Submit]. Return to the form and edit the Guarantor Definition that was submitted. Validate that all fields contain the correct data. Close the form. Financial Eligibility - Guarantor Selection Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Guarantors/Payors Financial Eligibility Scenario 1: 'Financial Eligibility' - file financial eligibility for a client Specific Setup: Guarantors/Payors: Two guarantors, A & B, are identified that each have a 'Default Guarantor Plan' and the 'Associated Plans' only has the value of the 'Default Guarantor Plan' selected. Ensure that the guarantors have different values in 'Default Guarantor Plan' and 'Associated Plans' A client must be enrolled in an existing episode (Client A). Steps Select "Client A" and access the 'Financial Eligibility' form. Select the 'Guarantor Selection' section. Click [Add New Item]. Enter guarantor A in 'Guarantor #' field. Validate an "Information" message is displayed stating: Selecting This Guarantor Will Over-Write Any Previous Plan Information. The Master Plan Information Will Default. Click [OK]. Validate that the correct plan displays in ‘Guarantor Plan. Select "Yes" in the 'Eligibility Verified' field. Enter desired date in the 'Coverage Effective Date' field. Select any value in the 'Client's Relationship To Subscriber' field. Enter any value in the format of LASTNAME,FIRSTNAME in the 'Subscriber's Name' field. Enter any value in the 'Subscriber Address - Street Line 1' field. Enter any value in the 'Subscriber's Address - Zip' field. Enter any value in the 'Subscriber's Social Security #' field. Select any value in the 'Subscriber Sex' field. Select any value in the 'Subscriber Release Of Info' field. Select "Yes" in the 'Subscriber Assignment of Benefits' field. Repeat steps 3 – 17 for guarantor B. Click [Edit] in ‘Guarantor Information’ for guarantor A. Validate that the correct information displays for all fields. Click [Edit] in ‘Guarantor Information’ for guarantor B. Validate that the correct information displays for all fields. Select the 'Financial Eligibility' tab. Select guarantor A in the 'Guarantor #1' field. Select guarantor B in the 'Guarantor #2' field. Click [Submit]. Open the 'Financial Eligibility' form for Client A. Select the 'Guarantor Selection' section. Click [Edit Selected Item] for guarantor A. Validate that all data is correct. Click [Edit Selected Item] for guarantor B. Validate that all data is correct. Close the form.	Topics • Service Fee/Cross Reference Maintenance • NX • Financial Eligibility
Update 33 Summary \| Details Inhibit Billing Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Inhibit Billing By Service Inhibit Billing By Reason Financial Eligibility File Import Inhibited Services For Billing Report Guarantors/Payors Practitioner Numbers By Guarantor and Program Scenario 1: 'Inhibit Billing By Service' - Verification of form filing Specific Setup: Client with one or more service(s) eligible for 'Inhibit Billing By Service' filing. Crystal Reports or other SQL reporting tool. Steps Open the Avatar Cal-PM 'Inhibit Billing By Service' form. Enter/select values for 'Rendering Practitioner', 'Client ID'/'Episode Number', 'Program Where Service Was Rendered', 'Search Start Date'/'Search End Date' and/or 'Liable Guarantor' filter fields to populate/limit service(s) for selection. Select one or more service(s) in the 'Select Service(s) To Mark Billing-Inhibited' field (or deselect to remove Inhibit Billing information for service). Click 'Submit' button to file form/Inhibit Billing entries for selected service(s). Ensure that 'Please Review Your Selection' dialog is presented and displays service(s) from 'Inhibit Billing By Service' form; confirm selected/deselected service(s) are correctly noted in 'Inhibit' column. Click 'OK' button in the 'Please Review Your Selection' dialog to accept selections and continue to form/information filing. If any service is deselected to remove Inhibit Billing entry and service also has one or more 'Inhibit Billing By Reason' entries, ensure that user is presented with alert message noting 'At least one selected service is inhibited by one or more reasons. If you continue the services will be uninhibited for all reasons.' Click 'Yes' button in the 'Continue filing?' dialog to file Inhibit Billing information. Re-open/return to 'Inhibit Billing By Service' form. Enter/select values for filter fields to populate/limit service(s) for selection, using same criteria/selections as in Inhibit Billing filing. In the 'Select Service(s) To Mark Billing-Inhibited' field, ensure that services with Inhibit Billing entry previously filed/removed are marked as selected or deselected (respectively). Open Crystal Reports or other SQL reporting tool. In Avatar Cal-PM SQL table 'SYSTEM.inhibit_billing', ensure that data rows are added/deleted from table based on 'Inhibit Billing By Service' form filing and that field values reflect client/service information selected in form. Scenario 2: 'Inhibit Billing By Reason' - Verification of form filing, 'All Open Services' selection Specific Setup: Dictionary codes/values must be defined for Avatar Cal-PM 'Billing' file Data Element 'Reason for Inhibit' (20520). Client with one or more open charge service(s) eligible for 'Inhibit Billing By Reason' filing. Crystal Reports or other SQL reporting tool. Steps Open the Avatar Cal-PM 'Inhibit Billing By Reason' form (under 'Avatar PM / Billing / Bill Production' menu). Select value in 'Reason for Inhibit' field to add/remove Inhibit Billing entries under 'Reason For Inhibit' code. Selection of value in 'Reason for Inhibit' field is required prior to Inhibit Billing By Reason entry/review/removal in form since services may have Inhibit Billing By Reason entries filed under multiple 'Reason for Inhibit' values. Enter/select values for service search/selection criteria in 'Rendering Practitioner', 'Client ID', 'Episode Number', 'Liable Guarantor', 'Program Where Service Was Rendered', 'Search Start Date' and/or 'Search End Date' fields. ('Client ID' must be specified for 'All Open Services For Client' service selection.) Select 'Uninhibited' in the 'Services to Display' selection field. Ensure 'All Open Services For Client' selection is included in 'Services' field. Selecting 'All Open Services For Client' will file an 'Inhibit Billing By Reason' entry under the selected 'Reason for Inhibit' for all existing open charge service(s) for client, and will automatically file an 'Inhibit Billing By Reason' entry under the selected 'Reason for Inhibit' for each new open charge service added for client while the 'All Open Services For Client' selection is in place. Select 'All Open Services For Client' in 'Services' field for Inhibit Billing By Reason entry. Click 'Inhibit' button to file Inhibit Billing By Reason entry under selected Reason for Inhibit for all existing open charge service(s) for selected client. Ensure user is presented with confirmation dialog noting 'Are you sure you want to inhibit billing for all open services for the selected client/reason?', with 'Yes' and 'No' buttons included; click 'Yes' button to continue with Inhibit Billing By Reason filing. Ensure user is presented with filing confirmation dialog noting 'Inhibit Billing By Reason filed successfully.' Ensure that where Inhibit Billing By Reason entry for 'All Open Services For Client' has been filed under selected 'Reason for Inhibit', 'All Open Services For Client' selection is not displayed/included in the 'Services' selection field when 'Uninhibited' is selected in the 'Services to Display' field. Select 'Inhibited' in the 'Services to Display' selection field. Ensure that where Inhibit Billing By Reason entry for 'All Open Services For Client' has been filed under selected 'Reason for Inhibit', 'All Open Services For Client' selection is displayed/included in the 'Services' selection field when 'Inhibited' is selected in the 'Services to Display' field. Ensure that where Inhibit Billing By Reason entry for 'All Open Services For Client' has been filed under selected 'Reason for Inhibit', 'Services' selection field also includes/displays all open charge service(s) for selected search/selection criteria. This allows for selection of individual service(s) for 'Uninhibit'/removal action where 'All Open Services For Client' Inhibit Billing By Reason entry exists for client. Select 'All Open Services For Client' in 'Services' field for Inhibit Billing By Reason 'Uninhibit'/removal action. Click 'Uninhibit' button to remove Inhibit Billing By Reason entry under selected Reason for Inhibit for all open charge services for client. Ensure user is presented with confirmation dialog noting 'Are you sure you want to uninhibit billing all open services for the selected client/reason?', with 'Yes' and 'No' buttons included; click 'Yes' button to continue with removal of Inhibit Billing By Reason entry/'Uninhibit' action. Ensure user is presented with filing confirmation dialog noting 'Inhibit Billing By Reason filed successfully.' Ensure that open charge service(s) where Inhibit Billing By Reason entry has been removed/'Uninhibited' under selected 'Reason for Inhibit' are not displayed/included in the 'Services' selection field when 'Inhibited' is selected in the 'Services to Display' field. Using client where Inhibit Billing By Reason entry for 'All Open Services For Client' has been filed/exists, enter one or more new open charge services. (New open charge services may originate via Avatar Cal-PM and/or Avatar MSO.) On creation of new open charge services for client where Inhibit Billing By Reason entry for 'All Open Services For Client' has been filed/exists, ensure that Inhibit Billing By Reason entry under selected 'Reason for Inhibit' is automatically filed for services. Open Crystal Reports or other SQL reporting tool. In Avatar Cal-PM SQL table 'SYSTEM.inhibit_billing', ensure that one row is included in table for each distinct open charge service with Inhibit Billing By Reason entry using 'All Open Services For Client'; ensure that service row is removed from 'SYSTEM.inhibit_billing' table only if/when all Inhibit Billing By Reason entries for service are Uninhibited (including use of 'All Open Services For Client' selection). In Avatar Cal-PM SQL table 'SYSTEM.inhibit_billing_reason', ensure that one row is included in table for each Inhibit Reason per open charge service with Inhibit Billing By Reason entry using 'All Open Services For Client'; ensure that Inhibit Reason/service combination row is removed from 'SYSTEM.inhibit_billing_reason' table when Inhibit Billing By Reason entries for Inhibit Reason/service combination are Uninhibited (including use of 'All Open Services For Client' selection). In Avatar Cal-PM SQL table 'SYSTEM.inhibit_reason_global', ensure that one row is included in table for each Inhibit Reason per client where Inhibit Billing By Reason entry exists using 'All Open Services For Client'; ensure that Inhibit Reason/client combination row is removed from 'SYSTEM.inhibit_reason_global' table when Inhibit Billing By Reason entry for Inhibit Reason/client combination are Uninhibited using 'All Open Services For Client' selection. Scenario 3: File Import - 'Client Charge Input' file type - Render a service to the client that is marked as a billing non inhibited Specific Setup: Registry Settings: The registry setting 'Import File Delimiter' is set to desired value. Program Maintenance: Identify an existing program code / name. Note the program code. Admission: An existing client is identified. Note the client's id/name, admission date, admission program code/name. A 'Client Charge Input' import file is created to render a service to the client and mark that service billing non inhibited. The predefined client, episode number, practitioner id, service code, admission program and cost of the service are entered in the file. Steps Open the 'File Import' form. Select the 'Client Charge Input' from the 'File Type' field. Upload the file Import file created in the setup section to mark a service as a billing inhibited. Compile the file. Verify that the file compiles successfully. Select the 'Print File' option. Review the information on compile report. Verify that all the information entered through the 'File Import' file displayed correctly in the specific field. Post the compiled file. Verify that the file posted successfully. Open the 'Crystal Report' or any other SQL data viewer. Run the query against SYSTEM.billing_tx_history SQL table. Verify the 'billable_code' code column is blank for the service. Run the query against SYSTEM.inhibit_billing SQL table. Verify the table does not contain the non inhibited service record of the client. Close the Crystal Report or the SQL Data Viewer. Locate to the 'CLIENT INHIBITED SERVICES (SERVICE DATE LESS THAN 1 YEAR OLD)' WIDGET. Verify the 'Client Name' and 'Episode' column does not display the client's name and episode for the client for whom the non inhibited service is rendered through file import. Open the 'Inhibited Services For Billing Report' form. Enter desired date in the 'Start Date' field. Enter desired date in the 'End Date' field. Select desired client in the 'Client' field. Click [Process Report]. Verify the non inhibited service record does not display in the report. Close the report. Scenario 4: Cal-PM - File Import - 'Client Charge Input' file type - Render a service to the client that is marked as a billing inhibited Specific Setup: Registry Settings: The registry setting 'Import File Delimiter' is set to desired value. Program Maintenance: Identify an existing program code / name. Note the program code. Admission: An existing client is identified. Note the client's id/name, admission date, admission program code/name. A 'Client Charge Input' import file is created to render a service to the client and mark that service billing inhibited. The predefined client, episode number, practitioner id, service code, admission program and cost of the service are entered in the file. Note the file location. Steps Open the 'File Import' form. Select the 'Client Charge Input' from the 'File Type' field. Upload the file Import file created in the setup section to mark a service as a billing inhibited. Compile the file. Verify that the file compiles successfully. Select the 'Print File' option. Review the information on compile report. Verify that all the information entered through the 'File Import' file displayed correctly in the specific field. Post the compiled file. Verify that the file posted successfully. Open the 'Crystal Report' or any other SQL data viewer. Run the query against SYSTEM.billing_tx_history table. Verify the 'billable_code' displays 'X'. Close the Crystal Report or the SQL Data Viewer. Open the 'Close Charges' form. Close the charges rendered to the client. Click [Submit]. Verify the form submits successfully. Open the 'Client Ledger' form. Verify the service is not closed and still in 'Open' status as it is marked as billing inhibited.	Topics • Inhibit Billing • File Import
Update 34 Summary \| Details AR Console - Claim Follow-Up Entry Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: NX View Definition AR Console Configuration AR Console User Defaults Setup System Task Scheduler Scenario 1: AR Console - Validating follow-up entry and services tables for the client/claim selected Specific Setup: Note the tester's 'User Definition', 'User Description'. Registry Setting: Set the 'Avatar PM->Billing->Accounts Receivable Management->->->Enable Accounts Receivable Management Functionality' registry setting to "Yes". Accounts Receivable functionality has been defined. Guarantors/Payors: An existing guarantor is identified to be used. Note the guarantor code/name. Service codes: An existing service code is identified to be used. Note the service code/description. Service Fee/ Cross Reference Maintenance: A fee definition is created for the service code identified in the ' Service Codes' form. Admission: An existing client is identified or a new client is admitted. Note client id, admission program, admission date. Financial Eligibility: A guarantor identified in the 'Guarantors/Payors' form is assigned to the client as a primary guarantor. Recurring Client Charge Input: 3-5 services are rendered to the client. Note service date, service code. Client Ledger: The service distributed correctly to the assigned guarantor. Electronic Billing: All the services are claimed. Note the claim numbers. Use ‘AR Console User Defaults’ to give the tester access to the following: First initial of the client's last name. Admission program Guarantor the claim liability distributed to. Use ‘System Task Scheduler’ to process the ‘Auto AR Batch’ after the claims were created. AR Console: A claim follow up note is created for the first service of the client. Note the information of the claim follow-up note. Steps Access the ‘AR Console’. Enter desired client in the ‘Client' search box. Select a client identified in the setup section. Click [Search]. Validate all the claims for the client are displayed in the ‘Claims with Outstanding Receivables’ grid. Select one claim row, noting the claim number. Validate the 'Claim Service Information' table displays all the services of the client / claim selected. Click [Add Claim Follow-Up/Notes]. Validate the user is navigated to the 'Claim Follow-Up Entry' tab. Validate the 'Client' drop down field is populated with the selected client. Validate that ‘Claim Follow-Up’ drop down field contains the selected claim number. Validate the 'Services' table displays all the services attached to the client/claim selected. Validate the 'Follow-Up Notes' table contains any follow-up note created for the client/claim selected. Click [New row]. Add another follow-up note for the client/claim. Click [File Updates]. Go back to 'AR List' tab. Click [Reset Defaults]. Enter desired client in the ‘Client' search box. Select a client identified in the setup section. Click [Search]. Validate all the claims for the client are displayed in the ‘Claims with Outstanding Receivables’ grid. Select one claim row, noting the claim number. Validate the 'Claim Service Information' table displays all the services of the client / claim selected. Click [Add Claim Follow-Up/Notes]. Validate the user is navigated to the 'Claim Follow-Up Entry' tab. Validate the 'Client' drop down field is populated with the selected client. Validate that ‘Claim Follow-Up’ drop down field contains the selected claim number. Validate the 'Services' table displays all the services attached to the client/claim selected. Validate the 'Follow-Up Notes' table contains all the follow-up notes created for the client/claim selected.	Topics • Accounts Receivable Management • NX
Update 35 Summary \| Details File Import - Payment Adjustment Posting Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: File Import Scenario 1: Cal-PM - File Import - Payment Adjustment Posting Specific Setup: Posting/Adjustment Codes Definition has been used to create payment, adjustment, and transfer definitions. Client Ledger is used to identify a client that has services with an outstanding balance. A file is created to import payments, adjustments, and/or transfers. Steps Open ‘File Import’. Select ‘Payment Adjustment Posting’ in ‘File Type’. Upload the file. Compile the file and print the report if no errors. If there are errors, print the error report, correct the file, upload, and compile the corrected file. Post the file. Close the form. Open ‘Client Ledger’. Validate that the payments, adjustments, and/or transfers posted to the service correctly. Close the report. Close the form.	Topics • File Import • NX
Update 36 Summary \| Details 'Electronic Billing' Support for Services Originating in Avatar MSO Scenario 1: 'Electronic Billing' - Verification of 'Support MSO Other Healthcare Coverage' Registry Setting (Services Originating in Avatar MSO) Specific Setup: Avatar Cal-PM Registry Setting 'Support MSO Other Healthcare Coverage' must be enabled Avatar Cal-PM Registry Setting 'Include Service Level Adjudication Info' must be enabled (and 'Include Service Level Adjudication Information (2430)' field set to 'Yes' via 'Guarantor/Program Billing Defaults' form '837 Professional' and/or '837 Institutional' section for applicable Guarantor/Program) Avatar MSO Registry Setting 'Add Support For The Input Of Third Party Payer Amounts' must be enabled One or more service(s) eligible for Avatar Cal-PM 837 Professional/837 Institutional file inclusion (via 'Electronic Billing' form) originating in Avatar MSO and including Third Party Payment/Adjustment 'Other Healthcare Coverage' information Steps Open Avatar Cal-PM 'Electronic Billing' form. Note, acceptance testing may also be confirmed via Avatar Cal-PM 'Quick Billing' form/functionality Select 837 Professional or 837 Institutional in 'Billing Form' field. Enter/select 837 file sorting criteria, using values which will include service(s) originating in Avatar MSO. Click 'Process' button to sort/generate 837 Professional or 837 Institutional file. Select 'Dump File' in the 'Billing Options' field (or select 'Create File On Server' to review output file directly). Select 'Print' in the 'Print Or Delete Report' field. Select 837 Professional/837 Institutional file sorted which includes services originating in Avatar MSO, and click 'Process' button to display 837 outbound file data. In Avatar Cal-PM 837 Professional/837 Institutional format outbound electronic billing file data - for services originating via Avatar MSO and including Service-Level Third Party Payment/Adjustment 'Other Healthcare Coverage' information, ensure that 2430-SVD-03 Service Line Adjudication Product/Service ID in Avatar Cal-PM 837 file contains 2430-SVD-03 Service Code value from original Avatar MSO inbound claim/service Other Healthcare Coverage information. Example: SVD87755XX7.5HC:90806:HA*11~ 'Client Ledger' Support for Services Originating in Avatar MSO Scenario 1: 'Client Ledger' - Verification of 'Support MSO Other Healthcare Coverage' Registry Setting Specific Setup: Avatar Cal-PM Registry Setting 'Support MSO Other Healthcare Coverage' must be enabled Avatar MSO Registry Setting 'Add Support For The Input Of Third Party Payer Amounts' must be enabled Clinical Data Repository (CDL) link must be enabled for Avatar Cal-PM/Avatar MSO namespace connection (via 'Connect/Disconnect Application Namespace' form) One or more service(s) originating in Avatar MSO and including Third Party Payment/Adjustment 'Other Healthcare Coverage' information Steps Open Avatar Cal-PM 'Client Ledger' form. Select 'Client ID' value for client where services originating in Avatar MSO and including Other Healthcare Coverage information exist. Select 'Claim/Episode/All Episodes' value (and enter/edit 'From Date'/'To Date' values if desired). Select 'Ledger Type' value. Click 'Process' button. Where 'Simple' is selected for 'Ledger Type' - In 'Client Ledger' form display data, ensure that services originating in Avatar MSO and including Other Healthcare Coverage information are denoted with an asterisk () character in the 'Charge' column, and that the 'Charge' ('CHG')* value for service(s) reflects the 'Allowed Amount' value from Avatar MSO Other Healthcare Coverage information for service(s). Note - 'Client Ledger' form 'Guarantor Liability' and 'Line Balance' value(s) for service(s) originating in Avatar MSO with Other Healthcare Coverage information will reflect the 'Cost of Service' value for service filed to Avatar Cal-PM Where 'Crystal' is selected for 'Ledger Type' - In Client Ledger Report data, ensure that for services originating in Avatar MSO and including Other Healthcare Coverage information, the 'Full Charge' value for service(s) reflects the 'Allowed Amount' value from Avatar MSO Other Healthcare Coverage information for service(s). Note - Client Ledger Report 'Guarantor Liability' and 'Line Balance' value(s) for service(s) originating in Avatar MSO with Other Healthcare Coverage information will reflect the 'Cost of Service' value for service filed to Avatar Cal-PM	Topics • Electronic Billing • Claims Processing • NX • Client Ledger
Update 37 Summary \| Details CPT Code Definition Scenario 1: 'CPT Code Definition' - Verification of American Medical Association-Provided CPT Code Values Steps Open 'CPT Code Definition' form. Select 'Edit' action in 'Add/Edit/Delete CPT Code' field. In 'CPT Service Code' field, enter search term using CPT Code Description (AMA 'Consumer Descriptor' term) or CPT Code. Ensure 'CPT Service Code' field search results include American Medical Association-provided CPT Service Code(s) for search term/code entered. Select CPT Code from 'CPT Service Code' search results. Confirm value in 'CPT Code Description' field for selected CPT Service Code (from AMA 'Consumer Descriptor' term). Note - location of AMA copyright form field/labels may be affected by any Form Designer changes present for form Scenario 2: 'CPT Code Definition' - Verification of American Medical Association Trademark/Copyright Notice Display Steps Open 'CPT Code Definition' form. Verify the 'CPT Service Code' field in form contains the AMA Trademark 'CPT® Codes' label. Verify the following AMA copyright notice is displayed at the bottom of the form: 'CPT copyright 2021 American Medical Association. All rights reserved.' Note - location of AMA copyright form field/labels may be affected by any Form Designer changes present for form	Topics • CPT Codes
Update 38 Summary \| Details Database Management - Tables Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Crystal Reports or other SQL Reporting tool (PM Namespace) Family Registration (CAL) Scenario 1: Family ID - 'SYSTEM.patient_current_demographics' table Specific Setup: Family Registration: Select an active family. Identify an active member. Query the 'SYSTEM.patient_current_demographics' table specific to the client. Note the value of the 'FAMIID' field, which is the current family ID. Steps Open 'Family Registration'. Select the family that was selected in 'Setup'. Select the member that was identified in 'Setup'. Enter a value in 'End Date Of Family Membership' that is prior to the current date. Click [Submit]. Open 'Family Registration'. Select a different family. Add the member that was identified in 'Setup'. Enter a 'Start Date Of Family Membership' that is after the 'End Date Of Family Membership' in the previous family. Click [Submit]. Query the 'SYSTEM.patient_current_demographics' table specific to the client. Note the value of the 'FAMIID' field, which is the new family ID. Database Management - tables Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Crystal Reports or other SQL Reporting tool (PM Namespace) Discharge (Outpatient) Form and Table Documentation (PM) Scenario 1: Avatar Cal-PM 'Admission' - Verification of Demographic Gender Identity/Sexual Orientation Fields Specific Setup: Crystal Reports or other SQL reporting tool Steps Open Avatar Cal-PM 'Admission', 'Admission (Outpatient)' or 'Pre Admit' form. In Client Search form, enter values for client search criteria and click 'Search' button. Click 'New Client' button for Admission form entry/new client creation (or select Client Search result row for existing client Admission entry/update). Enter/select values for 'Client Name', 'Sex', 'Preadmit/Admission Date', 'Preadmit/Admission Time', 'Program', 'Type Of Admission', 'Admitting Practitioner' and any other required/desired fields in main form section. Navigate to 'Demographics' section of form. Ensure that the following fields are present in 'Demographics' section of 'Admission', 'Admission (Outpatient)' or 'Pre Admit' form: 'Gender Identity' 'Gender Identity (Please Describe)' 'Sexual Orientation' 'Sexual Orientation (Please Describe)' Select value in 'Gender Identity' field. Ensure that the 'Gender Identity (Please Describe)' field is enabled and required if value 'Additional gender category or other, please specify' is selected in 'Gender Identity' field; enter value in 'Gender Identity (Please Describe)' field if enabled/required. Ensure that the ‘Sexual Orientation’ field is conditionally required/not required based on selected Program value (according to ‘Require Sexual Orientation Response During Admission?’ field Avatar Cal-PM ‘Program Maintenance’ form). Select value in 'Sexual Orientation' field. Ensure that the 'Sexual Orientation (Please Describe)' field is enabled and required if value 'Something else, please describe' is selected in 'Sexual Orientation' field; enter value in 'Sexual Orientation (Please Describe)' field if enabled/required. 'Ensure that the 'Are you heterosexual, lesbian, gay, bisexual, transgender or do you question your sexual orientation?' field is not present/is removed from 'Demographics' section of 'Admission', 'Admission (Outpatient)' or 'Pre Admit' form. Enter value in 'Preferred Name' field. Ensure that if invalid spacing/characters are included in 'Preferred Name' value, the entry is disallowed and user is presented with an error dialog noting 'Invalid Format: Limited to alphabetic characters with an optional intervening space, hyphen or apostrophe.' Enter/select values for any other fields in form as required/desired. Click 'Submit' button to file 'Admission', 'Admission (Outpatient)' or 'Pre Admit' form. Re-open Avatar Cal-PM 'Admission', 'Admission (Outpatient)' or 'Pre Admit' form for same client/episode as filed above. Navigate to 'Demographics' section of form. Ensure that previously filed values are present in 'Gender Identity', 'Gender Identity (Please Describe)', 'Sexual Orientation', 'Sexual Orientation (Please Describe)' and 'Preferred Name' fields. Note - Client Demographic field values filed in 'Admission', 'Admission (Outpatient)' or 'Pre Admit' forms may also be confirmed via the Avatar Cal-PM 'Update Client Data' form. Open Crystal Reports or other SQL reporting tool. In Avatar Cal-PM SQL tables 'SYSTEM.patient_current_demographics' and 'SYSTEM.patient_demographic_history', ensure that values are present for all information filed via Avatar Cal-PM 'Admission', 'Admission (Outpatient)' or 'Pre Admit' form including the following fields: 'gender_identity_code' / 'gender_identity_value' 'gender_identity_other' 'sexual_orientation_code' / 'sexual_orientation_value' 'sexual_orientation_other' In Avatar Cal-PM SQL tables 'SYSTEM.view_episode_summary_admit' and 'SYSTEM.view_episode_summary_current', ensure that values are present for all information filed via Avatar Cal-PM 'Admission', 'Admission (Outpatient)' or 'Pre Admit' form including the following fields: 'gender_identity_code' / 'gender_identity_value' 'gender_identity_other' 'sexual_orientation_code' / 'sexual_orientation_value' 'sexual_orientation_other' Note - myAvatar/Avatar NX 'Form Designer' changes for the Gender Identify/Sexual Orientation fields noted above are included in Avatar Cal-PM 2022 Update 80; It may be necessary to revert to the 'Netsmart Produced Changes' Form Designer version for the 'Demographics' and/or 'Other Client Data' sections of 'Admission', 'Admission (Outpatient)' or 'Pre Admit' form for field changes above to be reflected if not present/reflected following Avatar Cal-PM 2022 Update 80 installation. Scenario 2: Avatar Cal-PM 'Update Client Data' - Verification of Demographic Gender Identity/Sexual Orientation Fields Specific Setup: Existing Avatar Cal-PM client record(s) for Demographic information view/update Crystal Reports or other SQL reporting tool Steps Open Avatar Cal-PM 'Update Client Data' form. Select existing client for Demographic information update. Ensure that the following fields are present in 'Demographics' section of 'Update Client Data' form (main form section): 'Gender Identity' 'Gender Identity (Please Describe)' 'Sexual Orientation' 'Sexual Orientation (Please Describe)' Ensure that fields noted above are populated with existing Client Demographic values/information in form display. Select value in 'Gender Identity' field. Ensure that the 'Gender Identity (Please Describe)' field is enabled and required if value 'Additional gender category or other, please specify' is selected in 'Gender Identity' field; enter value in 'Gender Identity (Please Describe)' field if enabled/required. Select value in 'Sexual Orientation' field. Ensure that the 'Sexual Orientation (Please Describe)' field is enabled and required if value 'Something else, please describe' is selected in 'Sexual Orientation' field; enter value in 'Sexual Orientation (Please Describe)' field if enabled/required. 'Ensure that the 'Are you heterosexual, lesbian, gay, bisexual, transgender or do you question your sexual orientation?' field is not present/is removed from 'Update Client Data' form. Enter value in 'Preferred Name' field. Ensure that if invalid spacing/characters are included in 'Preferred Name' value, the entry is disallowed and user is presented with an error dialog noting 'Invalid Format: Limited to alphabetic characters with an optional intervening space, hyphen or apostrophe.' Enter/select values for any other fields in form as required/desired. Click 'Submit' button to file 'Update Client Data form. Re-open Avatar Cal-PM 'Update Client Data' form for same client as filed above. Ensure that previously filed values are present in 'Gender Identity', 'Gender Identity (Please Describe)', 'Sexual Orientation', 'Sexual Orientation (Please Describe)' and 'Preferred Name' fields. In Avatar Cal-PM SQL tables 'SYSTEM.patient_current_demographics' and 'SYSTEM.patient_demographic_history', ensure that values are present for all information filed via Avatar Cal-PM 'Update Client Data' form including the following fields: 'gender_identity_code' / 'gender_identity_value' 'gender_identity_other' 'sexual_orientation_code' / 'sexual_orientation_value' 'sexual_orientation_other' In Avatar Cal-PM SQL tables 'SYSTEM.view_episode_summary_admit' and 'SYSTEM.view_episode_summary_current', ensure that values are present for all information filed via Avatar Cal-PM 'Update Client Data' form including the following fields: 'gender_identity_code' / 'gender_identity_value' 'gender_identity_other' 'sexual_orientation_code' / 'sexual_orientation_value' 'sexual_orientation_other' Note - myAvatar/Avatar NX 'Form Designer' changes for the Gender Identity/Sexual Orientation fields noted above are included in Avatar Cal-PM 2022 Update 80; It may be necessary to revert to the 'Netsmart Produced Changes' Form Designer version for the 'Update Client Data' form for field changes above to be reflected if not present/reflected following Avatar Cal-PM 2022 Update 80 installation. Scenario 3: Avatar Cal-PM 'Discharge' - Verification of Demographic Gender Identity/Sexual Orientation Fields Specific Setup: Existing Avatar Cal-PM client/episode record(s) for 'Discharge', 'Discharge (Outpatient)' and/or 'Pre Admit Discharge' entry Crystal Reports or other SQL reporting tool Steps Open Avatar Cal-PM 'Discharge', 'Discharge (Outpatient)' or 'Pre Admit Discharge' form. Select existing client/episode for Discharge entry. Enter/select values for 'Date Of Discharge', 'Discharge Time', 'Type Of Discharge', 'Discharge Practitioner' and any other required/desired fields in main form section. Navigate to 'Demographics' section of form. Ensure that the following fields are present in 'Demographics' section of 'Discharge', 'Discharge (Outpatient)' or 'Pre Admit Discharge' form: 'Gender Identity' 'Gender Identity (Please Describe)' 'Sexual Orientation' 'Sexual Orientation (Please Describe)' Ensure that fields noted above are populated with existing Client Demographic values/information in form display. Select value in 'Gender Identity' field. Ensure that the 'Gender Identity (Please Describe)' field is enabled and required if value 'Additional gender category or other, please specify' is selected in 'Gender Identity' field; enter value in 'Gender Identity (Please Describe)' field if enabled/required. Select value in 'Sexual Orientation' field. Ensure that the 'Sexual Orientation (Please Describe)' field is enabled and required if value 'Something else, please describe' is selected in 'Sexual Orientation' field; enter value in 'Sexual Orientation (Please Describe)' field if enabled/required. 'Ensure that the 'Are you heterosexual, lesbian, gay, bisexual, transgender or do you question your sexual orientation?' field is not present/is removed from 'Demographics' section of 'Discharge', 'Discharge (Outpatient)' or 'Pre Admit Discharge' form. Enter value in 'Preferred Name' field. Ensure that if invalid spacing/characters are included in 'Preferred Name' value, the entry is disallowed and user is presented with an error dialog noting 'Invalid Format: Limited to alphabetic characters with an optional intervening space, hyphen or apostrophe.' Enter/select values for any other fields in form as required/desired. Click 'Submit' button to file 'Discharge', 'Discharge (Outpatient)' or 'Pre Admit Discharge' form. Re-open Avatar Cal-PM 'Discharge', 'Discharge (Outpatient)' or 'Pre Admit Discharge' form for same client/episode as filed above. Navigate to 'Demographics' section of form. Ensure that previously filed values are present in 'Gender Identity', 'Gender Identity (Please Describe)', 'Sexual Orientation', 'Sexual Orientation (Please Describe)' and 'Preferred Name' fields. Note - Client Demographic field values filed in 'Discharge', 'Discharge (Outpatient)' or 'Pre Admit Discharge' forms may also be confirmed via the Avatar Cal-PM 'Update Client Data' form. Open Crystal Reports or other SQL reporting tool. In Avatar Cal-PM SQL tables 'SYSTEM.patient_current_demographics' and 'SYSTEM.patient_demographic_history', ensure that values are present for all information filed via Avatar Cal-PM 'Discharge', 'Discharge (Outpatient)' or 'Pre Admit Discharge' form including the following fields: 'gender_identity_code' / 'gender_identity_value' 'gender_identity_other' 'sexual_orientation_code' / 'sexual_orientation_value' 'sexual_orientation_other' In Avatar Cal-PM SQL tables 'SYSTEM.view_episode_summary_admit', 'SYSTEM.view_episode_summary_current' and 'SYSTEM.view_episode_summary_discharge', ensure that values are present for all information filed via Avatar Cal-PM 'Discharge', 'Discharge (Outpatient)' or 'Pre Admit Discharge' form including the following fields: 'gender_identity_code' / 'gender_identity_value' 'gender_identity_other' 'sexual_orientation_code' / 'sexual_orientation_value' 'sexual_orientation_other' Note - myAvatar/Avatar NX 'Form Designer' changes for the Gender Identify/Sexual Orientation fields noted above are included in Avatar Cal-PM 2022 Update 80; It may be necessary to revert to the 'Netsmart Produced Changes' Form Designer version for the 'Demographics' and/or 'Other Client Data' sections of 'Discharge', 'Discharge (Outpatient)' or 'Pre Admit Discharge' form for field changes above to be reflected if not present/reflected following Avatar Cal-PM 2022 Update 80 installation. Scenario 4: Form and Table Documentation - 'gender_identity_code' and 'gender_identity_value' Steps Open 'Form and Table Documentation. Select 'Table' in 'Type of Documentation'. Select the 'SYSTEM.patient_current_demographics'. Click [Process]. Click 'Search' and enter 'gender'. Click the search icon. Validate the the form contains: gender_identity_code String 20 Patient's Gender Identity code gender_identity_value String 60 Y Patient's Gender Identity value Repeat for the 'SYSTEM.patient_demographic_history'. Validate that the 'gender_identity_value' field contains a value of '60' for the following tables: 'SYSTEM.patient_current_demographics' 'SYSTEM.patient_demographic_history' 'SYSTEM.view_episode_summary_admit' 'SYSTEM.view_episode_summary_current' 'SYSTEM.view_episode_summary_discharge'. Close the form.	Topics • Family Registration • NX • Pre Admit • Admission • Admission (Outpatient) • Client Management • Update Client Data • Discharge • Pre Admit Discharge • Database Management
Update 39 Summary \| Details Avatar Cal-PM 'Enable CalAIM BH Payment Reforms' Registry Setting Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Guarantors/Payors Client Charge Input (Charge Fee Access) Client Charge Input With Diagnosis Entry Recurring Client Charge Input (Charge Fee Access) Recurring Client Charge Input (Diagnosis Entry) Progress Notes (Group and Individual) Verify Staff Member Appointments Post Staff Member Schedule Scenario 1: 'Electronic Billing' - Verification of 'Enable CalAIM BH Payment Reforms' Registry Setting Specific Setup: Avatar Cal-PM Registry Setting 'Enable CalAIM BH Payment Reforms' must be enabled (payment reform effective date set) Avatar Cal-PM Registry Setting 'Enable SD/MC Minute to Unit Override' may optionally be enabled/disabled If Registry Setting 'Enable SD/MC Minute to Unit Override' is enabled, 'If Short-Doyle Medi-Cal, Override The Minute-Based Treatment Units?' field in 'Guarantor/Program Billing Defaults' form must be set to 'Yes' for applicable Program/Guarantor template 'Bill Cal Billing Units' field in 'Guarantors/Payors' form must be set to 'Yes' for applicable Guarantor One or more Service Codes where 'Type Of Service' value is set to 'Group' and 'Is this an ODS Group Service?' value is set to 'Yes' (via Avatar Cal-PM 'Service Codes' form) One or more ODS Group Service(s) eligible for Avatar Cal-PM 837 Professional/837 Institutional file inclusion Steps Open Avatar Cal-PM 'Electronic Billing' form. Note, 'Quick Billing' form/functions may also be used for 837 generation/validation. Select 837 Professional or 837 Institutional in 'Billing Form' field. Select values for 837 bill generation in the 'Type of Bill', 'Individual or All Guarantors' and 'Billing Type' fields. Select 'Sort File' in the 'Billing Options' field. Select/enter values for service inclusion in 'All Clients or Interim Billing Batch' and 'Program(s)' fields. Select/enter values for 'Create Claims' (and 'Date of Claim' if 'Yes'), 'First Date of Service to Include' and 'Last Date of Service to Include' fields. Select/enter values for any other bill sorting criteria fields as required/desired. Click 'Process' button in form to sort bill. Select 'Run Report' in the 'Billing Options' field Select 'Print' in the 'Print Or Delete Report' field. Select 837 Professional/837 Institutional file sorted which includes one or more Cal Billing Unit/ODS Group Services and click 'Process' button to display 837 Electronic Billing Report. In Avatar Cal-PM 837 Professional/837 Institutional format outbound electronic billing file report information including Cal Billing Unit/ODS Group Services - ensure that Service Cost/Liability ('Amount') and Service Units ('Unit') values for services are determined as follows: For service dates prior to date defined for 'Enable CalAIM BH Payment Reforms' Registry Setting, ensure that ODS Group Service total charge/liability and service units are set according to the 'Bill Cal Billing Units' field/setting for applicable Guarantor (and 'If Short-Doyle Medi-Cal, Override The Minute-Based Treatment Units?' field if enabled in 'Guarantor/Program Billing Defaults' form/template). For service dates on or after date defined for 'Enable CalAIM BH Payment Reforms' Registry Setting, ensure that service total charge/liability and service units are set without Cal Billing Units calculations under the 'Bill Cal Billing Units' field/setting for applicable Guarantor (and the 'If Short-Doyle Medi-Cal, Override The Minute-Based Treatment Units?' field is regarded as 'No' if enabled in 'Guarantor/Program Billing Defaults' form/template). Select 'Dump File' in the 'Billing Options' field (or select 'Create File On Server' to review output file directly). Select 'Print' in the 'Print Or Delete Report' field. Select 837 Professional/837 Institutional file sorted which includes one or more Cal Billing Unit/ODS Group Services and click 'Process' button to display 837 outbound file data. In Avatar Cal-PM 837 Professional/837 Institutional format outbound electronic billing file data including Cal Billing Unit/ODS Group Services - ensure that Service Cost/Liability and Service Units (2400-SV1/SV2 Quantity/Monetary Amount) values for services are determined as follows: For service dates prior to date defined for 'Enable CalAIM BH Payment Reforms' Registry Setting, ensure that ODS Group Service total charge/liability and service units are set according to the 'Bill Cal Billing Units' field/setting for applicable Guarantor (and 'If Short-Doyle Medi-Cal, Override The Minute-Based Treatment Units?' field if enabled in 'Guarantor/Program Billing Defaults' form/template). For service dates on or after date defined for 'Enable CalAIM BH Payment Reforms' Registry Setting, ensure that service total charge/liability and service units are set without Cal Billing Units calculations under the 'Bill Cal Billing Units' field/setting for applicable Guarantor (and the 'If Short-Doyle Medi-Cal, Override The Minute-Based Treatment Units?' field is regarded as 'No' if enabled in 'Guarantor/Program Billing Defaults' form/template). Scenario 2: 'Client Charge Input' - Verification of 'Enable CalAIM BH Payment Reforms' Registry Setting Specific Setup: Avatar Cal-PM Registry Setting 'Enable CalAIM BH Payment Reforms' must be enabled (payment reform effective date set) Avatar Cal-PM Registry Setting 'Use The Medi-Cal Fee As The Usual & Customary Fee' may optionally be enabled/disabled If Registry Setting 'Use The Medi-Cal Fee As The Usual & Customary Fee' is disabled, 'Use Medi-Cal Rules For Fee Calculations' field in 'Guarantors/Payors' form must be set to 'Yes' for applicable Guarantor(s) One or more Service Codes where 'Type Of Service' value is set to 'Group' and 'Is this an ODS Group Service?' value is set to 'Yes' (via Avatar Cal-PM 'Service Codes' form) Applicable Group Service Fee/Override value calculation may be determined by 'Apply Multiple Practitioner Calculations To This Service Using' field in 'Service Codes' form is defined/applicable to service Client record eligible for 'Client Charge Input' form service entry where applicable Guarantor(s) is/are assigned via client Financial Eligibility record Steps Open Avatar Cal-PM 'Client Charge Input' form. Note, acceptance testing may also be confirmed via Avatar Cal-PM 'Client Charge Input (Charge Fee Access)', 'Client Charge Input With Diagnosis Entry', 'Client Charge Input (Charge Fee Access And Diagnosis Entry)', 'Recurring Client Charge Input', 'Recurring Client Charge Input (Charge Fee Access)', 'Recurring Client Charge Input With Diagnosis Entry' and/or 'Recurring Client Charge Input (Charge Fee Access And Diagnosis Entry)' forms Enter value for 'Date of Service'. Enter/select values for 'Client ID', 'Episode Number', 'Program', 'Service Code' and 'Practitioner' fields, using Service Code defined as ODS Group Service and entering value for the 'Enter The Number Of Clients In The Group' dialog/prompt. Enter value for 'Co-Practitioner' and 'Co-Practitioner 2' fields for ODS Group Service if desired (as well as detailed Duration fields 'Face-to-Face Time', 'Documentation and Travel Time', etc if present/configured in form). Enter/select values for any other service entry fields as desired/required. Click 'Submit' button to file form/service. Open Avatar Cal-PM 'Client Ledger' form. Select 'Client ID' value for client where ODS Group Service(s) entered. Select 'Claim/Episode/All Episodes' value (and enter/edit 'From Date'/'To Date' values if desired). Select 'Ledger Type' value. Click 'Process' button. In Client Ledger information/report data for ODS Group Services filed in system - ensure that 'Total Charge' and/or 'Guarantor Liability' values for services are determined as follows: For service dates prior to date defined for 'Enable CalAIM BH Payment Reforms' Registry Setting, ensure that ODS Group Service total charge/liability is set according to the 'Use the Medi-Cal Fee as The Usual & Customary Fee' Registry Setting (and 'Use Medi-Cal Rules For Fee Calculations' field if enabled in 'Guarantors/Payors' form) and 'Is this an ODS Group Service' field for selected Service Code. For service dates on or after date defined for 'Enable CalAIM BH Payment Reforms' Registry Setting, ensure that service total charge/liability is set without ODS Group Service calculations under the 'Use the Medi-Cal Fee as The Usual & Customary Fee' Registry Setting (and 'Use Medi-Cal Rules For Fee Calculations' field if enabled in 'Guarantors/Payors' form is regarded as 'No') and the 'Is this an ODS Group Service' field for selected Service Code is regarded as 'No'. Scenario 3: 'Progress Notes (Group and Individual)' - Verification of 'Enable CalAIM BH Payment Reforms' Registry Setting Specific Setup: Avatar CWS Progress Note form(s) configured for Avatar Cal-PM group service entry/creation Avatar Cal-PM Registry Setting 'Enable CalAIM BH Payment Reforms' must be enabled (payment reform effective date set) Avatar Cal-PM Registry Setting 'Use The Medi-Cal Fee As The Usual & Customary Fee' may optionally be enabled/disabled If Registry Setting 'Use The Medi-Cal Fee As The Usual & Customary Fee' is disabled, 'Use Medi-Cal Rules For Fee Calculations' field in 'Guarantors/Payors' form must be set to 'Yes' for applicable Guarantor(s) One or more Service Codes where 'Type Of Service' value is set to 'Group' and 'Is this an ODS Group Service?' value is set to 'Yes' (via Avatar Cal-PM 'Service Codes' form) Applicable Group Service Fee/Override value calculation may be determined by 'Apply Multiple Practitioner Calculations To This Service Using' field in 'Service Codes' form is defined/applicable to service Service Group must be defined for Progress Note/group service entry (via Avatar Cal-PM 'Group Registration' form) Service Group/client records eligible for Progress Note/group service entry where applicable Guarantor(s) is/are assigned via client Financial Eligibility record Steps Open Avatar CWS Progress Note form for group progress note/group service entry. Navigate to 'Group Default Notes' section of form for Group Service entry. Enter/select values for 'Date Of Group', 'Practitioner', 'Progress Note For', 'Note Type', 'Service Program', 'Service Charge Code' and 'Service Duration' fields, using Service Code defined as ODS Group Service. Enter value for 'Co-Practitioner' and 'Co-Practitioner 2' fields for ODS Group Service if desired (as well as detailed Duration fields 'Face-to-Face Time', 'Documentation and Travel Time', etc if present/configured in form). Enter/select values for any other progress note/group service entry fields as desired/required. Click 'Submit' button to file form/group progress note/group service entry. Finalize Progress Note entry for one or more clients included in selected Service Group so that one or more ODS Group Services associated to finalized Progress Note entries are created. Open Avatar Cal-PM 'Client Ledger' form. Select 'Client ID' value for client where Progress Note/ODS Group Service(s) entered. Select 'Claim/Episode/All Episodes' value (and enter/edit 'From Date'/'To Date' values if desired). Select 'Ledger Type' value. Click 'Process' button. In Client Ledger information/report data for ODS Group Services filed in system via Progress Note entry - ensure that 'Total Charge' and/or 'Guarantor Liability' values for services are determined as follows: For service dates prior to date defined for 'Enable CalAIM BH Payment Reforms' Registry Setting, ensure that ODS Group Service total charge/liability is set according to the 'Use the Medi-Cal Fee as The Usual & Customary Fee' Registry Setting (and 'Use Medi-Cal Rules For Fee Calculations' field if enabled in 'Guarantors/Payors' form) and 'Is this an ODS Group Service' field for selected Service Code. For service dates on or after date defined for 'Enable CalAIM BH Payment Reforms' Registry Setting, ensure that service total charge/liability is set without ODS Group Service calculations under the 'Use the Medi-Cal Fee as The Usual & Customary Fee' Registry Setting (and 'Use Medi-Cal Rules For Fee Calculations' field if enabled in 'Guarantors/Payors' form is regarded as 'No') and the 'Is this an ODS Group Service' field for selected Service Code is regarded as 'No'. Scenario 4: 'Scheduling Calendar' - Verification of 'Enable CalAIM BH Payment Reforms' Registry Setting Specific Setup: Avatar Appointment Scheduling must be installed Avatar Cal-PM Registry Setting 'Enable CalAIM BH Payment Reforms' must be enabled (payment reform effective date set) Avatar Cal-PM Registry Setting 'Use The Medi-Cal Fee As The Usual & Customary Fee' may optionally be enabled/disabled If Registry Setting 'Use The Medi-Cal Fee As The Usual & Customary Fee' is disabled, 'Use Medi-Cal Rules For Fee Calculations' field in 'Guarantors/Payors' form must be set to 'Yes' for applicable Guarantor(s) One or more Service Codes where 'Type Of Service' value is set to 'Group' and 'Is this an ODS Group Service?' value is set to 'Yes' (via Avatar Cal-PM 'Service Codes' form) Applicable Group Service Fee/Override value calculation may be determined by 'Apply Multiple Practitioner Calculations To This Service Using' field in 'Service Codes' form is defined/applicable to service Service Group must be defined for Appointment/group service entry (via Avatar Cal-PM 'Group Registration' form) Service Group/client records eligible for Scheduling Calendar/Appointment Scheduling group service entry where applicable Guarantor(s) is/are assigned via client Financial Eligibility record Steps Open Avatar Cal-PM 'Scheduling Calendar' form. Select date and Practitioner for Appointment Scheduling entry; right click and select 'Add Appointment' action. Enter/select values for 'Appointment Site', 'Appointment Date', 'Appointment Start Time', 'Duration', 'Appointment End Time', 'Appointment Status', 'Recurrence Schedule', 'Service Code', 'Program', 'Location', 'Group' and 'Practitioner' fields, using Service Code defined as ODS Group Service. Enter value for 'Co-Practitioner' and 'Co-Practitioner 2' fields for ODS Group Service if desired (as well as detailed Duration fields 'Face-to-Face Time', 'Documentation and Travel Time', etc if present/configured in form). Enter/select values for any other Scheduling Calendar entry fields as desired/required. Click 'Submit' button to file form/appointments/group service entries. Verify Appointment for one or more staff members where Appointment/group service entered (via Avatar Cal-PM 'Verify Staff Member Appointments' form). Post Appointment for one or more staff members where Appointment/group service entered (via Avatar Cal-PM 'Post Staff Member Schedule' form) so that one or more ODS Group Services associated to Appointment Scheduling entries are created for clients included in selected Service Group. Open Avatar Cal-PM 'Client Ledger' form. Select 'Client ID' value for client where ODS Group Service(s) entered. Select 'Claim/Episode/All Episodes' value (and enter/edit 'From Date'/'To Date' values if desired). Select 'Ledger Type' value. Click 'Process' button. In Client Ledger information/report data for ODS Group Services filed in system via Appointment Scheduling/Scheduling Calendar entries - ensure that 'Total Charge' and/or 'Guarantor Liability' values for services are determined as follows: For service dates prior to date defined for 'Enable CalAIM BH Payment Reforms' Registry Setting, ensure that ODS Group Service total charge/liability is set according to the 'Use the Medi-Cal Fee as The Usual & Customary Fee' Registry Setting (and 'Use Medi-Cal Rules For Fee Calculations' field if enabled in 'Guarantors/Payors' form) and 'Is this an ODS Group Service' field for selected Service Code. For service dates on or after date defined for 'Enable CalAIM BH Payment Reforms' Registry Setting, ensure that service total charge/liability is set without ODS Group Service calculations under the 'Use the Medi-Cal Fee as The Usual & Customary Fee' Registry Setting (and 'Use Medi-Cal Rules For Fee Calculations' field if enabled in 'Guarantors/Payors' form is regarded as 'No') and the 'Is this an ODS Group Service' field for selected Service Code is regarded as 'No'. Scenario 5: Avatar Cal-PM Registry Settings - Verification of 'Enable CalAIM BH Payment Reforms' Registry Setting Steps Open 'Registry Settings' form. Enter search value 'Enable CalAIM BH Payment Reforms' and click 'View Registry Settings' button. Ensure Registry Setting 'Enable CalAIM BH Payment Reforms' is returned (under 'Avatar PM -> Billing -> Services' path). Ensure 'Registry Setting Details' field contains the following explanation text: "Setting a date allows for the logic enabled through the 'Use the Medi-Cal Fee as The Usual & Customary Fee' and 'Enable SD/MC Minute to Unit Override' Registry Settings to no longer be evaluated for dates of service on or after the date specified. This will allow the Registry Settings noted above (and related fields) to be enabled for billing/services with dates of service prior to the date specified; Defining of date in this Registry Setting will allow for billing/services with dates of service on or after specified date to be processed as if the Registry Settings noted above are disabled (and as if the 'Use Medi-Cal Rules For Fee Calculations' and 'If Short-Doyle Medi-Cal, Override The Minute-Based Treatment Units?' fields are set to 'No' in the 'Guarantor/Payors' forms). The 'Bill Cal Billing Units' field within the 'Guarantor/Payors' form will behave as defined for billing/services with dates of service prior to the date specified in this Registry Setting but will be regarded as 'No' for dates of service on or after the date specified. The 'Is this an ODS Group Service' field within the 'Service Codes' form will behave as defined for billing/services with dates of service prior to the date specified in this Registry Setting but will be regarded as 'No' for dates of service on or after the date specified."	Topics • Registry Settings • Electronic Billing • NX • CalAIM Billing • Client Charge Input • Progress Notes • Scheduling Calendar
Update 40 Summary \| Details Cal-OMS Discharge Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: ClosedEpisodecheck Scenario 1: Cal-OMS Discharge - file a discharge Specific Setup: The myAvatar Cal-PM system is setup for LASAPCS and enables multiple Cal-OMS admissions. Client A is admitted to a program that supports Cal-OMS. One or more Cal-OMS admissions exist for the client. Note the value of the 'Cal-OMS Type of Service' field. To test that the Cal-OMS Discharge field 'Mental Health Medication In The Last 30 Days' does not allow selection of 'Client unable to answer', please use a value other than "Nonresidential/Outpatient Detoxification" (3), "Residential Detoxification (hospital)" (4), or "Residential Detoxification (non-hospital)" (5), or 'Disability, "Developmentally Disabled". Client B is admitted to a program that supports Cal-OMS. One or more Cal-OMS admissions exist for the client. Note the value of the 'Cal-OMS Type of Service' field. To test that the Cal-OMS Discharge field 'Mental Health Medication In The Last 30 Days' does allow selection of 'Client unable to answer', please use one of the following values: "Nonresidential/Outpatient Detoxification" (3), "Residential Detoxification (hospital)" (4), or "Residential Detoxification (non-hospital)" (5), or 'Disability, "Developmentally Disabled". Steps Open ‘Cal-OMS Discharge’ for Client A. Fill in desired data for the form. Select ‘'Client unable to answer.' in the ‘Mental Health Medication In The Last 30 Days' field. Validate that a message is received stating: Cannot select 'Client unable to answer' unless the Cal-OMS Type of Service is 'Nonresidential / Outpatient Detoxification ' (3), 'Residential Detoxification (hospital)' (4), or 'Residential Detoxification (non-hospital)' (5), or 'Disability' on the corresponding Cal-OMS Admission form is 'Developmentally Disabled'. Click [OK]. Select a different value in the ‘Mental Health Medication In The Last 30 Days' field. Submit the form. Open ‘Cal-OMS Discharge’ for Client B. Fill in desired data for the form. Select ‘'Client unable to answer.' in the ‘Mental Health Medication In The Last 30 Days' field. Validate that no message is received. Submit the form.	Topics • Cal-OMS
Update 41 Summary \| Details Compile/Edit/Post/Unpost Roll-Up Services Worklist Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Guarantors/Payors Practitioner Numbers By Guarantor and Program Roll-Up Services Definition Compile/Edit/Post/Unpost Roll-Up Services Worklist Financial Eligibility Scenario 1: Roll-Up Services Definition - Service Codes are User Defined with Durations Specific Setup: Roll-Up Services Definition: The definition contains services that use a ‘Duration Range’ in the 'Service Fee/Cross Reference Maintenance' definition. Note the service code for the roll-up services, and the codes for the component services. Client A: Has ‘component service codes’ that are within the ‘Duration Range’, and some that are not in the ‘Duration Range’. The services are ready for the ‘Compile/Edit/Post/Unpost Roll-Up Services Worklist’ process. Steps Open ‘Compile/Edit/Post/Unpost Roll-Up Services Worklist’. Enter the desired values to process the compile for the ‘Roll-Up Services Definition’. Review the report to ensure the data is correct. Post the Roll-Up Services Worklist’. Close the form. Open ‘Client Ledger’ and validate that the roll-up process correctly processed the services and fees. Close the form.	Topics • Roll-Up Service Definition • Compile/Edit/Post/Unpost Roll-up Services Worklist • NX
Update 42 Summary \| Details Facility Defaults - CarePathways Configuration Scenario 1: 'Facility Defaults' form - field validations Steps Open the 'Registry Setting' form. Set the 'Enable CarePathways Benchmarking and Analytics' to 'Y'. Submit the form. Open the 'Facility Defaults' form. Verify the 'CarePathways Configuration' section is available on the form. Click on the 'CarePathways Configuration' tab. Verify system navigates user to the 'CarePathways Configuration' section correctly. Populate required fields as needed. Click [Submit]. Open the 'Registry Setting' form. Set the 'Enable CarePathways Benchmarking and Analytics' to 'N'. Submit the form. Open the 'Facility Defaults' form. Verify the 'CarePathways Configuration' section is not available on the form. Populate any desired fields. Validate the 'Provider Country' field is displayed. Select the desired value in the 'Provider Country' field. Note: this field is populated based off the dictionary values under the 'Client' file, '(150) Country Of Origin' data element in 'Dictionary Update'. Click [Submit]. Access Crystal Reports or other SQL Reporting tool. Create a report using the 'SYSTEM.table_facility_defaults' SQL table. Validate a row is displayed for the data on file. Validate the 'provider_country_code' field contains the code associated to the 'Provider Country' selected. Validate the 'provider_country_value' field contains the value associated to the 'Provider Country' selected. Close the report.	Topics • Facility Defaults
Update 43 Summary \| Details Service Codes - Use Site or Service Based Appointment Color Coding Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Service Code Upload Process Service Codes Scenario 1: Registry Settings - Use Site or Service Based Appointment Color Coding Steps Internal testing only Scenario 2: Cal-PM - Service Code Upload Process - workflow and form validation Specific Setup: 'Testing File 1' All columns will contain valid values. Note the values for the following columns for verification purposes: Service Code Service Code Definition Should This Visit Be Included On The CCD Save the file locally with a '.txt' extension. 'Testing File 2' All columns will contain valid values, except column 131, ‘Should This Visit Be Included On The CCD?’. In 'Should This Visit Be Included On The CCD?' put "Y" and in 'Is This Service a Visit' put "N" which disables the 'Should This Visit Be Included On The CCD?' field. Save the file locally with a '.txt' extension. 'Testing File 3' The file contains 1 valid row for the Accepted Report and 2 for the Rejected report. Save the file locally with a '.txt' extension. Steps Open the 'Service Code Upload Process' form. Enter the file path for "Testing File 1" in the 'Filename' field. Select "Compile" in the 'Compile Or Post' field. Select desired value in the 'Override Existing Service Code' field. Click [Submit]. Verify that a "Submitting" message is displayed which states: Compile completed. To review results, review accepted report. Leave the form open. Access the 'Service Code Upload Accepted Codes' form. Select "Testing File 1" in the 'Select Desired Service Code Import File Name' field. Click [Process]. Verify that the 'Service Code Upload Accepted Report' displays. Verify the data matches the data in "Testing File 1" for: 'Service Code', 'Service Code Definition' and 'Should This Visit Be Included On The CCD'. Close the report and the form. Return to the open 'Service Code Upload Process' form. Select 'Post' in the 'Compile Or Post' field. Select desired value in the 'Override Existing Service Code' field. Click [Submit] and close the form. Access the 'Service Codes' form. Select "Edit" in the 'Add New or Edit Existing' field. Enter the service code from "Testing File 1" in the 'Service Code' field. Verify the data matches the data in "Testing File 1" for: 'Service Code Definition' and 'Should This Visit Be Included On The CCD?'. Close the form. Access the 'Service Code Upload Process' form. Enter the file path for "Testing File 2" in the 'Filename' field. Select "Compile" in the 'Compile Or Post' field. Select desired value in the 'Override Existing Service Code' field. Click [Submit]. Verify that a "Submitting" message is displayed which states: Compile completed. To review results review rejected report. Leave the form open. Access the 'Service Code Upload Rejected Codes' form. Select "Testing File 2" in the 'Select Desired Service Code Import File Name' field. Click [Process]. Verify that the 'Service Code Upload Rejected Report' displays. Validate that the 'Should This Visit Be Included On The CCD?' error message states: Due To 'Is This Service A Visit' Invalid Entry: 'Should This Visit Be Included On The CCD?' cannot be set when this field is not set to "Y". Close the report and the form. Access the 'Service Codes' form. Select "Edit" in the 'Add New or Edit Existing' field. Enter the service code from "Testing File 2" in the 'Service Code' field. Verify that the service code does not exist. Close the form. Access the "Service Code Upload Process" form. Enter the file path for "Testing File 3" in the 'Filename' field. Select "Compile" in the "Compile or Post" field. Click [Submit]. Leave this form open. Access the "Service Code Upload Accepted Codes" form. Set the "Select Desired Service Code Import File Name" to Testing File 3. Click [Process]. Validate "Service Code" from the report matches the first column in Testing File 3. Validate "Service Code Description" from the report matches the third column in Testing File 3 Validate "Group Code" from the report matches the 11th column in Testing File 3. Validate "Insurance Charge Category" from the report matches the 12th column in Testing File 3. Validate "Is This Service A Visit" matches the 16th column in Testing File 3. Validate "Is this an ODS Group Service" matches the 132nd column of Testing File 3. Close the report and the form. Access the "Service Code Upload Rejected Code" form. Set the "Select Desired Service Code Import File Name" to Testing File 3. Click [Process]. Validate 2 rows in the same file are listed as rejected. Close the report. Return to the open "Service Code Upload Process" form. Select "Post" in "Compile or Post" field. Click [Submit]. Access the "Service Codes" form. Edit the "Service Code" from the "Service Code" from column 1 in Testing File 3. Validate the "Service Code Definition" matches column 3 in Testing File 3. Validate the "Group Code" matches column 11 in Testing File 3. Validate the "Insurance Coverage Category" matches column 12 in Testing File 3. Validate "Is This Service A Visit" matches column 16 in Testing File 3. Validate "Is This an ODS Group Service" matches column 132 in Testing File 3. Close report. Close all forms.	Topics • Registry Settings • NX • Service Codes
Update 44 Summary \| Details ProviderConnect Enterprise - 'Sexual Orientation' data Scenario 1: ProviderConnect Enterprise- Validate the 'PutProgramAdmission' action Specific Setup: The 'Avatar CareFabric->ProviderConnect Enterprise->Contracting Providers->->->Enable External Connections' must be set to "Y". The 'Managing Organization Definition' form must be configured for a valid managing organization. A client must exist in the configured managing organization's system with the following on file: 'Date of Birth', 'Social Security Number', 'Employment Status', 'Sexual Orientation', and 'Education' (Client A). A practitioner must have a NPI that is mapped to a matching practitioner in the managing organization's system (Practitioner A). Steps Access the 'Admission' form. Verify the 'Select Client' dialog is displayed. Enter the last name of the client that exists in the managing organization's system in the 'Last Name' field. Enter the first name of the client that exists in the managing organization's system in the 'First Name' field. Enter the sex of the client that exists in the managing organization's system in the 'Sex' field. Click [Search]. Validate a "Search Results" message is displayed stating: No matches found. Click [OK] and [New Client]. Validate a "Client" message is displayed stating: Auto Assign Next ID Number? Click [Yes]. Enter the desired date in the 'Preadmit/Admission Date' field. Enter the desired time in the 'Preadmit/Admission Time' field. Select any program that is selected in the 'Associated Admission Programs' field in the 'Managing Organization Definition' form in the 'Program' field. Select the desired value in the 'Type Of Admission' field. Select desired value in the 'Source Of Admission' field. Enter "Practitioner A" in the 'Admitting Practitioner' field. Select the "ProviderConnect Enterprise Identifiers" section. Click [Add New Item]. Select the defined managing organization in the 'External Organization' field. Click [Search]. Select the matching client record in the 'Select Matching Client Record' dialog. Click [OK]. Validate the 'External ID' field contains the client ID for the client in the managing organization's system. Click [Update Demographics]. Validate an "Information" message is displayed stating: Client Demographics Information Updated. Click [OK]. Select the "Demographics" section. Validate demographic fields have been updated to match the managing organizations record. Validate the 'Education' field contains the value on file in the managing organization's system. Validate the 'Employment Status' field contains the value on file in the managing organization's system. Validate the 'Sexual Orientation' field contains the value on file in the managing organization's system. Select the "Admission" section. Validate the 'Date of Birth' field contains the value on file in the managing organization's system. Validate the 'Social Security Number' field contains the value on file in the managing organization's system. Click [Submit]. Access the 'ProviderConnect Enterprise Action Log'. Enter the desired date in the 'From Date' and 'Through Date' fields. Enter the desired time in the 'From Time' and 'Through Time' fields. Select the desired organization in the 'Managing Organization' field. Select "PutProgramAdmission" in the 'Action Name' field. Click [View Action Log]. Verify the 'ProviderConnect Enterprise Action Log' Report is displayed. Validate the 'ProviderConnect Enterprise Action Log' Report contains a row for the 'PutProgramAdmission' action that was triggered from the 'Admission' form with a result of "Success". Close the report and the form.	Topics • Admission
Update 45 Summary \| Details Avatar Cal-PM - Support for Mobile CareGiver+ Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Client Alternate Addresses Scenario 1: Client Alternate Addresses - Form Validations Specific Setup: The 'Enable Client Alternate Addresses' registry setting must be set to "Y". A client is admitted in an existing episode (Client A). Steps Access the 'Client Alternate Addresses' form. Select "Client A" in the 'Client' field. Select "Add" in the 'Add/Edit' field. Enter the desired value in the 'Description' field. Enter the desired date in the 'Address Start Date' field. Enter the desired date in the 'Address End Date' field. Enter the desired value in the 'Address Line 1' field. Enter the desired value in the 'Address Line 2' field. Enter the desired value in the 'Zip' field. Enter the desired value in the 'City' field. Select the desired value in the 'State' field. Enter the desired value in the 'Contact Name field. Enter the desired value in the 'Contact Phone' field. Enter the desired value in the 'Address Notes' field. Select "Yes" in the 'Enabled' field. Click [File]. Validate a message is displayed stating: Saved. Click [OK]. Validate the 'Client' field contains "Client A". Select "Edit" in the 'Add/Edit' field. Validate the 'Select Existing Address' field contains the alternate address filed in the previous steps with the 'Address Start Date', 'Address End Date', and 'Description'. Select the address filed in the previous steps in the 'Select Existing Address' field. Validate all previously filed data is displayed. Close the form. Access Crystal Reports or other SQL Reporting Tool. Select the PM namespace. Create a report using the 'SYSTEM.client_alternate_address' SQL table. Validate there is a row for "Client A" will all previously filed data. Close the report. Scenario 2: Validate the 'Enable Alternate Client Addresses' registry setting Steps Access the 'Registry Settings' form. Enter "Client Alternate Addresses" in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Validate the 'Registry Setting' field contains "Avatar PM->Client Management->Client Information->->->Enable Client Alternate Addresses". Validate the 'Registry Setting Detail' field contains "Selecting 'Y' will add the 'Client Alternate Addresses' form to the menu. Selecting 'N' will remove the form from the menu." Validate the 'Registry Setting Value' field contains "N" by default. Enter "Y" in the 'Registry Setting Value' field. Click [Submit] and close the form. Access the 'User Definition' form. Select the logged in user in the 'Select User' field. Select the "Forms and Tables" section. Click [Select Forms for User Access]. Validate the 'Client Alternate Addresses' form is available for selection under "Avatar PM". Select read/write permissions for the form. Click [OK] and [Submit]. Refresh forms. Access the 'Client Alternate Addresses' form. Validate the form displays as expected. Close the form. Access the 'Registry Settings' form. Enter "Client Alternate Addresses" in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Validate the 'Registry Setting' field contains "Avatar PM->Client Management->Client Information->->->Enable Client Alternate Addresses". Enter "N" in the 'Registry Setting Value' field. Click [Submit] and close the form. Refresh forms. Validate the 'Search Forms' search no longer returns the 'Client Alternate Addresses' form since disabling the registry setting removes the form from the menu. Scenario 3: Dictionary Update - Validate the 'Location' dictionary Steps Access the 'Dictionary Update' form. Select "Client" in the 'File' field. Select "Data Element Number" in the 'Data Element' field. Select "(10006) Location" in the 'Data Element' field. Enter the desired value in the 'Dictionary Code' field. Enter the desired value in the 'Dictionary Value' field. Validate the 'Extended Dictionary Data Element' field contains "(587) Place Of Service (Mobile CareGiver+)". Select "(587) Place Of Service (Mobile CareGiver+)" in the 'Extended Dictionary Data Element' field. Select the desired value in the 'Extended Dictionary Value (Single Dictionary)' field. Click [Apply Changes] & Click [OK]. Select the "Print Dictionary" section. Select "Client" in the 'File' field. Select "Data Element Number" in the 'Data Element' field. Select "(587) Place Of Service (Mobile CareGiver+)" in the 'Data Element' field. Click [Print Dictionary]. Validate the location dictionary is displayed with the place of service filed in the previous steps. Click [Close] and close the form.	Topics • Registry Settings • Client Alternate Addresses • Dictionary
Update 46 Summary \| Details File Import - CPT Code Definition Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: File Import Scenario 1: Cal-PM - File Import - CPT Code Definition - Add / Edit Specific Setup: Registry setting: Set Import File Delimiter = desired vale, noting the value. File Import: A 'CPT Code Description' file type is added to the File Import. Import a file to add new CPT code. Import a file to edit above CPT code. Steps Open the "File Import" form. Select the "CPT Code Description" in the 'File Type' field. Select "Upload New File" in the 'Action' field. Click [Process Action]. Select the "File A". Select "Compile/Validate File" in the 'Action' field. Select the "File A" in the 'Files(s)' field. Click [Process Action]. Validate an Information message is displayed stating: Compiled Click [OK]. Select "Print File" in the 'Action' field. Select the "File A" in the 'Files(s)' field. Click [Process Action]. Validate the Report Viewer displays the contents of the file. Click [Close Report]. Select "Post File" in the 'Action' field. Click [Process Action]. Select the "File A". Validate an Information message is displayed stating: Posted. Click [OK] and close the form. Open the "CPT Code Definition" form. Click [Edit]. Validate the form is filed with the data based on the uploaded file. Close the form. Follow steps 1-24 for Edit CPT Code File Import.	Topics • File Import
Update 47 Summary \| Details Financial Eligibility - Policy Number Override section Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Guarantors/Payors Financial Eligibility Scenario 1: Fast Financial Eligibility - Add/Edit record Specific Setup: Client is admitted and has no 'Fast Financial Eligibility', 'Family Financial Eligibility', 'Financial Eligibility', or 'Cross Episode Financial Eligibility' records. An active 'Guarantors/Payors' exists. Steps Open 'Fast Financial Eligibility'. Add the eligibility record and submit the form. Open 'Fast Financial Eligibility'. Edit the eligibility record and submit the form. Open 'Fast Financial Eligibility'. Verify that the edited information displays correctly. Scenario 2: Cal-PM - Financial Eligibility - Policy Number Override - Subscriber Client Index Number Specific Setup: Registry Setting: Set Add Policy Number Override = Y. Allow Policy Number By Date Sort = Y. Enable MHSA/DIG Data Collection Fields = Y. Guarantor/Program Billing Defaults: Set Override Policy Number With CIN # = Y in 837P and 837I sections. Client A: Financial Eligibility: Enter the 'Subscriber Policy number in the 'Guarantor Selection' section. Note the value. Enter 'Subscriber Client Index Number' in the 'Guarantor Selection' section. Note the value. Enter 'Subscriber Client Index Number' in the 'Policy Number Override' section. Note the value. Enter 'Policy Number' in the 'Policy Number Override' section. Note the value. Has unclaimed services, for different/same service codes, that can be billed on the 837 Professional. Use 'Client Ledger' to note the service codes, dates of service, financial class, and guarantor. Client has an active diagnosis record. Create Interim Batch. Close the charges using 'Close Charges'. Client B: Financial Eligibility: Enter the 'Subscriber Policy number in the 'Guarantor Selection' section. Note the value. Enter 'Subscriber Client Index Number' in the 'Guarantor Selection' section. Note the value. Enter 'Subscriber Client Index Number' in the 'Policy Number Override' section. Note the value. Enter 'Policy Number' in the 'Policy Number Override' section. Note the value. Has unclaimed services, for different/same service codes, that can be billed on the 837 Institutional. Use 'Client Ledger' to note the service codes, dates of service, financial class, and guarantor. Client has an active diagnosis record. Create Interim Batch. Close the charges using 'Close Charges'. Steps Open 'Electronic Billing'. Create an 837 Professional for Client A. Review the dump file to verify. Open dump file and validate the subscriber client index number contains the value in the 'Policy Number 'Override' section. Close the report. Create an 837 Institutional for Client B. Review the dump file to verify. Open dump file and validate the subscriber client index number contains the value in the 'Policy Number 'Override' section. Close the report. Close the form. Guarantor/Program Billing Defaults Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Financial Eligibility File Import File Import - Compile/Post Report Scenario 1: Validate 'Guarantor Program Billing Defaults', 'Sort Claims by Month' = Yes. Specific Setup: Client A: Has unbilled, closed, services for a two-month date range. Tester knows the date range, guarantor, financial class of the guarantor and the program. The 'Guarantor/Program Billing Defaults' template used to bill the services has a value of 'Yes' in 'Sort Claims by Month' in the 837 Professional and/or 837 Institutional sections. Steps Open 'Electronic Billing'. Create a bill for the services entering both months of service in the billing date range. Review the dump file. Validate that the client has two CLM segments. Validate that the service DTP segments after the first CLM segment are for the first month of service. Validate that the service DTP segments after the second CLM segment are for the second month of service. Click [X]. Click [X]. Scenario 2: Validate 'Guarantor Program Billing Defaults', 'Sort Claims by Month' = No. Specific Setup: Client A: Has unbilled, closed, services for a two-month date range. Tester knows the date range, guarantor, financial class of the guarantor and the program. The 'Guarantor/Program Billing Defaults' template used to bill the services has a value of 'Yes' in 'Sort Claims by Month' in the 837 Professional and/or 837 Institutional section. Steps Open 'Electronic Billing'. Create a bill for the services entering both months of service in the billing date range. Review the dump file. Validate that the client has only one CLM segment. Validate that the service DTP segments after the first CLM segment are for both months of service. Click [X]. Click [X]. Scenario 3: 'File Import' - Verification of 'Guarantor/Program Billing Defaults Template' Import (Avatar Cal-PM) Specific Setup: Avatar Cal-PM 'Guarantor/Program Billing Defaults' Import File containing one or more valid import rows for 837 Professional information: 'Rendering Provider Entity Type Qualifier (2310B/2420A-NM1-02)' field/segment 127 'Rendering Provider Last Or Organization Name (2310B/2420A-NM1-03)' field/segment 128 'Rendering Provider First Name (2310B/2420A-NM1-04)' field/segment 129 'Rendering Provider Middle Name (2310B/2420A-NM1-05)' field/segment 130 'Rendering Provider Name Suffix (2310B/2420A-NM1-07)' field/segment 131 'Rendering Provider Identification Code Qualifier (2310B/2420A-NM1-08)' field/segment 132 'Rendering Provider Identification Code (2310B/2420A-NM1-09)' field/segment 133 'Rendering Provider Taxonomy Code (2310B/2420A-PRV-03)' field/segment 134 'Rendering Provider Reference Identification Qualifier (2310B/2420A-REF-01)' field/segment 135 'Rendering Provider Reference Identification (2310B/2420A-REF-01)' field/segment 136 'Rendering Provider Reference Identification Qualifier-2 (2310B/2420A-REF-01)' field/segment 137 'Rendering Provider Identification Code-2 (2310B/2420A-REF-02)' field/segment 138 'Specify How Rendering Provider Information Should Be Populated' field/segment 139 Crystal Reports or other SQL reporting tool Steps Open Avatar Cal-PM 'File Import' form. Select File Type 'Guarantor/Program Billing Defaults'. Select 'Upload New File' in 'Action' field and Click 'Process Action' button. Select Avatar Cal-PM 'Guarantor/Program Billing Defaults' import file including value for one or more of the following 837 Professional fields/segments and click 'Open' button: Select 'Compile/Validate File' in 'Action' field. Select loaded 'Guarantor/Program Billing Defaults' import file and click 'Process Action' button. 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. Click 'OK' button. Select 'Print File' in 'Action' field to view successfully compiled import data; Select compiled import file and click 'Process Action' button. In 'Guarantor/Program Billing Defaults' File Import Report, ensure that all valid import row(s) are included in report with segment/value details. Select 'Post File' in 'Action' field to post successfully compiled import data; Select compiled import file and click 'Process Action' button. 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. Open Avatar Cal-PM 'Guarantor/Program Billing Defaults' form. Select 'Edit Template' in 'Action' field and select imported Guarantor/Program Billing Defaults template for review/edit. Navigate to '837 Professional' section of form. Ensure that imported values for 837 Professional Rendering Provider (2310B/2420A) fields noted above are present for selected template. Open Crystal Reports or other SQL reporting tool. In Avatar Cal-PM SQL table 'SYSTEM.file_import_gpbd_p837', ensure that new row is filed in table for each successfully compiled/posted import row, including values for following fields: 'rendering_entity_code'/'rendering_entity_value' 'rendering_first_name' 'rendering_last_org_name' 'rendering_middle_name' 'rendering_suffix' 'rendering_id_qual_code'/'rendering_id_qual_value' 'rendering_id' 'rendering_taxonomy' 'rendering_ref_qual_code'/'rendering_ref_qual_value' 'rendering_ref_id' 'rendering_ref_qual2_code'/'rendering_ref_qual2_value' 'rendering_ref_id2' 'use_rnd_if_notfound_code'/'use_rnd_if_notfound_value' For Avatar Cal-PM 'Guarantor/Program Billing Defaults - 837 Professional' format/layout, please refer to 'Avatar_Cal-PM_File_Import_Record_Layouts.xls' document included with update.	Topics • Financial Eligibility • NX • 837 Professional • 837 Institutional • Guarantor/Program Billing Defaults • File Import
Update 48 Summary \| Details Cal-OMS Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Cal-OMS Submission Dynamic Form - Cal-OMS File Submission Scenario 1: 'Cal-OMS Admission' - Form Verification Specific Setup: Avatar Cal-PM Registry Setting 'Do Not Allow User To Continue Filing With Errors' may optionally be enabled/disabled Client record eligible for Cal-OMS Admission record entry/edit Steps Open Avatar Cal-PM 'Cal-OMS Admission' form. Select client/episode for Cal-OMS Admission entry (or select existing Cal-OMS Admission record for view/edit). Enter all required and desired data on the form. File the form. Return to the form and choose the admission record to Edit. Validate that all the filed data for the fields exist. Close form. Compile/ Print and Submit(Create File) the admission using the "Cal-OMS Submission" form. Cal-OMS Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Cal-OMS Admission Web Service Scenario 1: Cal-OMS Admission Web Service - Verification of Web Service Filing Specific Setup: Avatar Cal-PM Registry Setting 'Enable LA County Reporting Requirements' must be enabled (set to 'YC'). Avatar Cal-PM Registry Setting 'Enable Non LA County Requirements' must be enabled (set to 'Y'). Application utilizing the Avatar Cal-PM 'Cal-OMS Admission' web service (including Netsmart ProviderConnect). One or more client(s) with episodes eligible for 'Cal-OMS Admission' record filing. Crystal Reports or other SQL reporting tool. Steps Using the 'Cal-OMS Admission' web service (and/or 'Cal-OMS Admission V2' web service), submit request to 'FileCalOMSAdmission' method to create or update Cal-OMS Admission record. Confirm 'Cal-OMS Admission' web service responds with confirmation data/ID on successful filing of 'FileCalOMSAdmission' method. Example:"<Confirmation>ClientID:111\|\|EP:1\|\|UniqueID:OMA.001</Confirmation>" Confirm 'Cal-OMS Admission' web service responds with confirmation message on successful filing of 'FileCalOMSAdmission' method. Example:"<Message>Cal-OMS Admission web service has been filed successfully.</Message>" Confirm 'Cal-OMS Admission' web service responds with successful status value on successful filing of 'FileCalOMSAdmission' method. Example:"<Status>1</Status>" Open Avatar Cal-PM 'Cal-OMS Admission' form and select client/episode/Cal-OMS Admission record filed via web service for view/update. Confirm Cal-OMS Admission record is created/updated in Avatar Cal-PM, with values/data submitted via web service, including the following fields: 'Record To Be Submitted' 'Ethnicity' 'What is your Principal Source of Referral?' 'Primary Drug Route of Administration' 'Secondary Drug Route of Administration' 'Which of the following medication is prescribed as part of treatment?' 'Current Living Arrangements' 'Race 1' 'Race 2' 'Race 3' 'Race 4' 'Race 5' Open Crystal Reports or other SQL reporting tool. In Avatar Cal-PM SQL table 'SYSTEM.cal_oms_admission', ensure data values are filed/present for all fields as filed via web service, including LA-Specific field values noted above.	Topics • Cal-OMS • NX • Web Services
Update 49 Summary \| Details 'External Documents' widget Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: CareConnect HIE Configuration Consent For Access External Documents Form and Table Documentation (PM) Scenario 1: 'External Documents' widget - Validation when 'Carequality' is enabled and 'Consent Model' is "Opt Out" Specific Setup: Carequality is enabled in the 'CareConnect HIE Configuration' form. One or more organizations are defined as favorites in the 'Organization: Exceptions and Favorites' field. "Query" is selected in the 'Consent Model' field in the 'CareConnect HIE Configuration' form. A client is enrolled in an active episode with consent granted to a network and an organization in 'Consent For Access' (Client A). The logged in user must have a view configured with the 'External Documents' widget and the 'Console Widget Viewer'. Steps Select "Client A" and navigate to the 'External Documents' widget. Click [Search]. Validate the 'External Documents' widget contains CCDs from: Any organization(s) defined as "Favorite" in the 'Carequality Configuration' section of the 'CareConnect HIE Configuration' form Any organization with consent granted in 'Consent for Access' All networks in the Network List Click [View] for any CCD. Validate the CCD displays in the 'Console Widget Viewer', Click [Close All]. Scenario 2: 'External Documents' widget - Validation when 'Carequality' is enabled and 'Consent Model' is "Query" Specific Setup: Carequality is enabled in the 'CareConnect HIE Configuration' form. One or more organizations are defined as favorites in the 'Organization: Exceptions and Favorites' field. "Query" is selected in the 'Consent Model' field in the 'CareConnect HIE Configuration' form. A client is enrolled in an active episode with consent granted to a network and an organization in 'Consent For Access' (Client A). The logged in user must have a view configured with the 'External Documents' widget and the 'Console Widget Viewer'. Steps Select "Client A" and navigate to the 'External Documents' widget. Click [Search]. Validate the 'External Documents' widget contains CCDs from: Any organization(s) defined as "Favorite" in the 'Carequality Configuration' section of the 'CareConnect HIE Configuration' form Any organization with consent granted in 'Consent for Access' All networks in the Network List Click [View] for any CCD. Validate the CCD displays in the 'Console Widget Viewer', Click [Close All]. Scenario 3: 'External Documents' widget - Validation when 'Carequality' is disabled and 'Consent Model' is "Opt In" Specific Setup: Carequality is disabled in the 'CareConnect HIE Configuration' form. "Opt In" is selected in the 'Consent Model' field in the 'CareConnect HIE Configuration' form. A client is enrolled in an active episode with consent granted to a network (Network A) in 'Consent For Access' (Client A). The logged in user must have a view configured with the 'External Documents' widget and the 'Console Widget Viewer'. Steps Select "Client A" and navigate to the 'External Documents' widget. Click [Search]. Validate the 'External Documents' widget contains a CCD from "Network A". Click [View]. Validate the CCD displays in the 'Console Widget Viewer', Click [Close All]. Scenario 4: 'External Documents' widget - Validation when 'Carequality' is enabled and 'Consent Model' is "Opt In" Specific Setup: Carequality is enabled in the 'CareConnect HIE Configuration' form. One or more organizations are defined as favorites in the 'Organization: Exceptions and Favorites' field. "Opt In" is selected in the 'Consent Model' field in the 'CareConnect HIE Configuration' form. A client is enrolled in an active episode with consent granted to a network and an organization in 'Consent For Access' (Client A). The logged in user must have a view configured with the 'External Documents' widget and the 'Console Widget Viewer'. Steps Select "Client A" and navigate to the 'External Documents' widget. Click [Search]. Validate the 'External Documents' widget contains CCDs from: Any organization(s) defined as "Favorite" in the 'Carequality Configuration' section of the 'CareConnect HIE Configuration' form Any organization with consent granted in 'Consent for Access' Any network with consent granted in 'Consent for Access' Click [View] for any CCD. Validate the CCD displays in the 'Console Widget Viewer', Click [Close All]. Scenario 5: Form and Table Documentation - Validate the 'SYSTEM.external_documents' table Specific Setup: Crystal Reports or other SQL reporting tool is required. Steps Access the 'Form and Table Documentation' PM form. Select "Table" in the 'Type of Documentation' field. Select "SYSTEM.external_documents" in the 'Table(s) to be Documented' field. Click [Process]. Validate the 'SQL Table Documentation' window is displayed for the 'SYSTEM.external_documents' SQL table. Validate the 'organization' column has a max length of "4096". Click [Dismiss] and close the form. Scenario 6: Dictionary Update - Validate the 'Network' dictionary Specific Setup: The 'CareConnect HIE Configuration' form must be configured to upload CCDs to a Health Information Exchange. Steps Access the 'Dictionary Update' PM form. Select the "Print Dictionary" section. Select "Client" in the 'File' field. Select "Individual Data Element" in the 'Individual or All Data Elements' field. Select "(36020) Network" in the 'Data Element' field. Click [Print Dictionary]. Validate the report displays all configured networks. Close the report and the form. Diagnosis - 'Default 'Add To Problem List' to "Yes" on New Diagnosis' registry setting Scenario 1: Diagnosis - Validate the 'Default 'Add To Problem List' to "Yes" on New Diagnosis' registry setting Specific Setup: The 'Default 'Add To Problem List' to "Yes" on New Diagnosis' registry setting is set to "Y". A client is enrolled in an existing episode (Client A). Steps Select "Client A" and access the 'Diagnosis' form. Select the desired value in the 'Type Of Diagnosis' field. Enter the desired date in the 'Date Of Diagnosis' field. Enter the desired time in the 'Time Of Diagnosis' field. Click [New Row]. Search for and select the desired diagnosis in the 'Diagnosis Search' field. Select "Active" in the 'Status' field. Validate the 'Add To Problem List' field contains "Yes" by default. Select the desired practitioner in the 'Diagnosing Practitioner' field. Click [New Row]. Search for and select the desired new diagnosis in the 'Diagnosis Search' field. Select "Rule-out" in the 'Status' field. Validate the 'Add To Problem List' field is disabled and does not contain a value. Select the desired practitioner in the 'Diagnosing Practitioner' field. Click [Submit]. Select "Client A" and access the 'Problem List' form. Click [View/Enter Problems]. Validate only the active diagnosis filed in the previous steps displays in the 'Problem List'. Close the form. Access Crystal Reports or other SQL Reporting Tool. Create a report using the 'SYSTEM.client_diagnosis_entry' SQL table. Validate two rows are displayed for the diagnosis records added in the previous steps. Validate that the active diagnosis has "Yes" in the 'add_prob_list_value' field. Validate the ruled-out diagnosis has "No Entry" in the 'add_prob_list_value' field. Close the report.	Topics • Carequality • External Document Widget • Query/Reporting • Registry Settings • Diagnosis • Problem List
Update 51 Summary \| Details Avatar Cal-PM 'Cal-OMS Administrative Discharge' Form Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Cal-OMS Administrative Discharge Scenario 1: 'Cal-OMS Administrative Discharge' - Form Verification Specific Setup: Avatar Cal-PM Registry Setting 'Enable LA County Reporting Requirements' may optionally be enabled (value 'Y' or 'YC') or disabled (value 'N') One or more client(s) with episodes eligible for 'Cal-OMS Admission'/Cal-OMS Administrative Discharge' entry One or more client(s) with existing 'Cal-OMS Admission' record eligible for 'Cal-OMS Administrative Discharge' entry Steps Open Avatar Cal-PM 'Cal-OMS Administrative Discharge' form. Select Client ID and Cal-OMS Admission record/episode for Cal-OMS Administrative Discharge record entry/edit. In 'Cal-OMS Administrative Discharge' form, ensure that 'Discharge Process Date' field is present in form where Avatar Cal-PM Registry Setting 'Enable LA County Reporting Requirements' is enabled; ensure that 'Discharge Process Date' field is not present in form where Avatar Cal-PM Registry Setting 'Enable LA County Reporting Requirements' is disabled. Enter/select values for all 'Cal-OMS Administrative Discharge' form fields as required/desired, including value for 'Discharge Process Date' field if enabled/present in form. Click 'Submit' button to file 'Cal-OMS Administrative Discharge' form/record. Re-open 'Cal-OMS Administrative Discharge' form, selecting same Client ID and Cal-OMS Admission/episode where Cal-OMS Discharge record previously filed. Ensure values for all 'Cal-OMS Administrative Discharge' form fields are present where previously entered/filed, including value for 'Discharge Process Date' field if enabled/present in form.	Topics • Registry Settings • Cal-OMS • NX
Update 52 Summary \| Details Service Code Upload Process Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Spreadsheet Remittance Posting Service Code Upload Process Scenario 1: Validate 'Spreadsheet Remittance Posting' submission. Specific Setup: The following registry setting has a value of “Y”: Avatar PM->Billing->Client Charge Input->->->Include Start - End Times. In “Client Lookup/Header Configuration Manager” set the “First Alternate Lookup” to “Subscriber Policy #”. This is in the “Alternate Lookup” section of the form. Have a client with services that are rendered and distributed to a primary guarantor (Guarantor A), that need to be transferred to another guarantor, (Guarantor B). Note the following for the eligibility records: “Coverage Effective Dates”, “Coverage Expiration Dates”, “Coverage Description”, “Level Start Date”, “Level End Date” and "Subscriber Policy Number". This information can be displayed in a popup window with hover functionality. Note the service: “Practitioner/Provider name”, “Duration”, "Start Time", “End Time”, and “Service Code Definition”. This information can be displayed in a popup window with hover functionality. Steps Open "Spreadsheet Remittance Posting". Enter the "Subscriber Policy Number" in "Client". Validate that the correct client is displayed in the results. Enter the "Client ID" in "Client". Validate that the correct client is displayed in the results. Select the client. Select the "Episode" pertaining to the services. Select the "Guarantor A" in "Guarantor To Post For". Click [OK] on the guarantor balance message. Enter a "Posting Date". Enter a "Date of Receipt". Click [Launch Work Screen]. Select a row. Hover over "Service Date". Validate that a popup window displays the following: "Provider", "Duration", "Start Time", "End Time" and "Service Code". Enter desired value in "Payment Amount". Select desired "Payment Code". Enter desired value in "Transfer Amount". Hover over the "Transfer Guar" field. Validate that a popup window displays the following: "Active Guarantor", "Coverage Effective Date", "Coverage Expiration Date", "Level Start Date", and "Level End Date". Select "Guarantor B'' in "Transfer Guar". Validate that the "New Balance" is correct. Repeat payments and/or transfer for additional rows. Click [Accept]. Click [Submit]. Scenario 2: Cal-PM - Service Code Upload Process - workflow and form validation Specific Setup: 'Testing File 1' All columns will contain valid values. Note the values for the following columns for verification purposes: Service Code Service Code Definition Should This Visit Be Included On The CCD Save the file locally with a '.txt' extension. 'Testing File 2' All columns will contain valid values, except column 131, ‘Should This Visit Be Included On The CCD?’. In 'Should This Visit Be Included On The CCD?' put "Y" and in 'Is This Service a Visit' put "N" which disables the 'Should This Visit Be Included On The CCD?' field. Save the file locally with a '.txt' extension. 'Testing File 3' The file contains 1 valid row for the Accepted Report and 2 for the Rejected report. Save the file locally with a '.txt' extension. Steps Open the 'Service Code Upload Process' form. Enter the file path for "Testing File 1" in the 'Filename' field. Select "Compile" in the 'Compile Or Post' field. Select desired value in the 'Override Existing Service Code' field. Click [Submit]. Verify that a "Submitting" message is displayed which states: Compile completed. To review results, review accepted report. Leave the form open. Access the 'Service Code Upload Accepted Codes' form. Select "Testing File 1" in the 'Select Desired Service Code Import File Name' field. Click [Process]. Verify that the 'Service Code Upload Accepted Report' displays. Verify the data matches the data in "Testing File 1" for: 'Service Code', 'Service Code Definition' and 'Should This Visit Be Included On The CCD'. Close the report and the form. Return to the open 'Service Code Upload Process' form. Select 'Post' in the 'Compile Or Post' field. Select desired value in the 'Override Existing Service Code' field. Click [Submit] and close the form. Access the 'Service Codes' form. Select "Edit" in the 'Add New or Edit Existing' field. Enter the service code from "Testing File 1" in the 'Service Code' field. Verify the data matches the data in "Testing File 1" for: 'Service Code Definition' and 'Should This Visit Be Included On The CCD?'. Close the form. Access the 'Service Code Upload Process' form. Enter the file path for "Testing File 2" in the 'Filename' field. Select "Compile" in the 'Compile Or Post' field. Select desired value in the 'Override Existing Service Code' field. Click [Submit]. Verify that a "Submitting" message is displayed which states: Compile completed. To review results review rejected report. Leave the form open. Access the 'Service Code Upload Rejected Codes' form. Select "Testing File 2" in the 'Select Desired Service Code Import File Name' field. Click [Process]. Verify that the 'Service Code Upload Rejected Report' displays. Validate that the 'Should This Visit Be Included On The CCD?' error message states: Due To 'Is This Service A Visit' Invalid Entry: 'Should This Visit Be Included On The CCD?' cannot be set when this field is not set to "Y". Close the report and the form. Access the 'Service Codes' form. Select "Edit" in the 'Add New or Edit Existing' field. Enter the service code from "Testing File 2" in the 'Service Code' field. Verify that the service code does not exist. Close the form. Access the "Service Code Upload Process" form. Enter the file path for "Testing File 3" in the 'Filename' field. Select "Compile" in the "Compile or Post" field. Click [Submit]. Leave this form open. Access the "Service Code Upload Accepted Codes" form. Set the "Select Desired Service Code Import File Name" to Testing File 3. Click [Process]. Validate "Service Code" from the report matches the first column in Testing File 3. Validate "Service Code Description" from the report matches the third column in Testing File 3 Validate "Group Code" from the report matches the 11th column in Testing File 3. Validate "Insurance Charge Category" from the report matches the 12th column in Testing File 3. Validate "Is This Service A Visit" matches the 16th column in Testing File 3. Validate "Is this an ODS Group Service" matches the 132nd column of Testing File 3. Close the report and the form. Access the "Service Code Upload Rejected Code" form. Set the "Select Desired Service Code Import File Name" to Testing File 3. Click [Process]. Validate 2 rows in the same file are listed as rejected. Close the report. Return to the open "Service Code Upload Process" form. Select "Post" in "Compile or Post" field. Click [Submit]. Access the "Service Codes" form. Edit the "Service Code" from the "Service Code" from column 1 in Testing File 3. Validate the "Service Code Definition" matches column 3 in Testing File 3. Validate the "Group Code" matches column 11 in Testing File 3. Validate the "Insurance Coverage Category" matches column 12 in Testing File 3. Validate "Is This Service A Visit" matches column 16 in Testing File 3. Validate "Is This an ODS Group Service" matches column 132 in Testing File 3. Close report. Close all forms.	Topics • Spreadsheet Remittance Posting • Service Codes
Update 53 Summary \| Details 'CareConnect Inbox' - Referrals Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Ambulatory Progress Notes Treatment Plan Patient Health Questionnaire-9 CareConnect Inbox Progress Notes (Group and Individual) Care Connect Inbox CareFabric Monitor Scenario 1: 'CareConnect Inbox' POV - Send a referral with client attachments Specific Setup: A client is enrolled in an existing episode (Client A). "Client A" has the records on file for the following: 'Ambulatory Progress Notes', 'Progress Notes (Group and Individual)', 'Treatment Plan', and 'Patient Health Questionnaire-9'. Must have access to the 'CareConnect Inbox' widget. Steps Access the 'CareConnect Inbox' widget. Start a new referral. Select the desired contact in the 'Add Contact' field. Enter the desired value in the 'Subject' field. Search for and select the desired provider in the 'Provider Search' field. Search for and select "Client A" in the 'Client Search' field. Click [Attach CCD]. Validate the generated CCD is displayed and click [Attach CCD]. Click [Client Attachments]. Select "Client A's" existing episode in the 'Episode' field. Select "Admission", "Ambulatory Progress Notes", "Progress Notes (Group and Individual)", "Treatment Plan", "Patient Health Questionnaire-9", and "Update Client Data" in the 'Forms to Attach' field. Click [Generate PDF]. Validate all of the client attachment PDF's are displayed. Select the 'Admission' PDF. Validate the admission data is displayed. Select the 'Ambulatory Progress Notes' PDF. Validate the progress note data is displayed. Select the 'Progress Notes (Group and Individual)' PDF. Validate the progress note data is displayed. Select the 'Patient Health Questionnaire-9' PDF. Validate the assessment data is displayed. Select the 'Treatment Plan' PDF. Validate the treatment plan data is displayed. Select the 'Update Client Data' PDF. Validate the client data is displayed. Send the referral.	Topics • CareConnect Inbox
Update 54 Summary \| Details Avatar Cal-PM - support for Integrated eSignature functionality Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Pre Admit Discharge Scenario 1: 'Admission' form - Field Validation Specific Setup: A client is enrolled in an existing episode (Client A). Steps Select "Client A" and access the 'Admission' form. Select an existing episode and click [Edit]. Select the "Demographics" section. Validate the 'Consent On File For Use of Integrated eSignature' field is present with values of "Yes" and "No". Select "No" in the 'Consent On File For Use of Integrated eSignature' field. Click [Submit]. Select "Client A" and access the 'Admission' form. Select an existing episode and click [Edit]. Select the "Demographics" section. Validate "No" is selected in the 'Consent On File For Use of Integrated eSignature' field. Close the form. Access Crystal Reports or other SQL reporting tool. Create a report using the 'SYSTEM.patient_current_demographics' SQL table. Navigate to the row for "Client A". Validate the 'esig_consent_on_file_code' field is present and contains "N". Validate the 'esig_consent_on_file_value' field is present and contains "No". Close the report. Create a report using the 'SYSTEM.patient_demographic_history' SQL table. Navigate to the row for "Client A". Validate the 'esig_consent_on_file_code' field is present and contains "N". Validate the 'esig_consent_on_file_value' field is present and contains "No". Close the report. Scenario 2: 'Update Client Data' form - Verification of 'Client Demographics' form fields Specific Setup: A client is enrolled in an existing episode (Client A). Steps Select "Client A" and access the 'Update Client Data' form. Validate the 'Consent On File For Use of Integrated eSignature' field is present with values of "Yes" and "No". Select "Yes" in the 'Consent On File For Use of Integrated eSignature' field. Click [Submit]. Select "Client A" and access the 'Update Client Data' form. Validate "Yes" is selected in the 'Consent On File For Use of Integrated eSignature' field. Close the form. Access Crystal Reports or other SQL reporting tool. Create a report using the 'SYSTEM.patient_current_demographics' SQL table. Navigate to the row for "Client A". Validate the 'esig_consent_on_file_code' field is present and contains "Y". Validate the 'esig_consent_on_file_value' field is present and contains "Yes". Close the report. Create a report using the 'SYSTEM.patient_demographic_history' SQL table. Navigate to the row for "Client A". Validate the 'esig_consent_on_file_code' field is present and contains "Y". Validate the 'esig_consent_on_file_value' field is present and contains "Yes". Close the report. Scenario 3: 'Admission (Outpatient)' form - Field Validation Specific Setup: A client is enrolled in an existing outpatient episode (Client A). Steps Select "Client A" and access the 'Admission (Outpatient)' form. Select an existing episode and click [Edit]. Select the "Demographics" section. Validate the 'Consent On File For Use of Integrated eSignature' field is present with values of "Yes" and "No". Select "Yes" in the 'Consent On File For Use of Integrated eSignature' field. Click [Submit]. Select "Client A" and access the 'Admission (Outpatient)' form. Select an existing episode and click [Edit]. Select the "Demographics" section. Validate "Yes" is selected in the 'Consent On File For Use of Integrated eSignature' field. Close the form. Access Crystal Reports or other SQL reporting tool. Create a report using the 'SYSTEM.patient_current_demographics' SQL table. Navigate to the row for "Client A". Validate the 'esig_consent_on_file_code' field is present and contains "Y". Validate the 'esig_consent_on_file_value' field is present and contains "Yes". Close the report. Create a report using the 'SYSTEM.patient_demographic_history' SQL table. Navigate to the row for "Client A". Validate the 'esig_consent_on_file_code' field is present and contains "Y". Validate the 'esig_consent_on_file_value' field is present and contains "Yes". Close the report. Scenario 4: 'Discharge' form - Field Validation Specific Setup: A client is enrolled in an existing episode (Client A). Steps Select "Client A" and access the 'Discharge' form. Select an existing episode and click [Edit]. Enter the desired date in the 'Date Of Discharge' field. Enter the desired time in the 'Discharge Time' field. Select the desired value in the 'Type Of Discharge' field. Select the desired practitioner in the 'Discharge Practitioner' field. Select the "Demographics" section. Validate the 'Consent On File For Use of Integrated eSignature' field is present with values of "Yes" and "No". Select "Yes" in the 'Consent On File For Use of Integrated eSignature' field. Click [Submit]. Select "Client A" and access the 'Discharge' form. Select the discharged episode and click [Edit]. Select the "Demographics" section. Validate the 'Consent On File For Use of Integrated eSignature' field contains "Yes". Close the form. Access Crystal Reports or other SQL reporting tool. Create a report using the 'SYSTEM.patient_current_demographics' SQL table. Navigate to the row for "Client A". Validate the 'esig_consent_on_file_code' field is present and contains "Y". Validate the 'esig_consent_on_file_value' field is present and contains "Yes". Close the report. Create a report using the 'SYSTEM.patient_demographic_history' SQL table. Navigate to the row for "Client A". Validate the 'esig_consent_on_file_code' field is present and contains "Y". Validate the 'esig_consent_on_file_value' field is present and contains "Yes". Close the report. Scenario 5: 'Pre Admit' form - Field Validation Specific Setup: A client is enrolled in an existing Pre Admit episode (Client A). Steps Select "Client A" and access the 'Pre Admit' form. Select an existing episode and click [Edit]. Select the "Demographics" section. Validate the 'Consent On File For Use of Integrated eSignature' field is present with values of "Yes" and "No". Select "Yes" in the 'Consent On File For Use of Integrated eSignature' field. Click [Submit]. Select "Client A" and access the 'Pre Admit' form. Select an existing episode and click [Edit]. Select the "Demographics" section. Validate "Yes" is selected in the 'Consent On File For Use of Integrated eSignature' field. Close the form. Access Crystal Reports or other SQL reporting tool. Create a report using the 'SYSTEM.patient_current_demographics' SQL table. Navigate to the row for "Client A". Validate the 'esig_consent_on_file_code' field is present and contains "Y". Validate the 'esig_consent_on_file_value' field is present and contains "Yes". Close the report. Create a report using the 'SYSTEM.patient_demographic_history' SQL table. Navigate to the row for "Client A". Validate the 'esig_consent_on_file_code' field is present and contains "Y". Validate the 'esig_consent_on_file_value' field is present and contains "Yes". Close the report. Scenario 6: 'Pre Admit Discharge' form - Field Validation Specific Setup: A client is enrolled in an existing Pre Admit episode (Client A). Steps Select "Client A" and access the 'Pre Admit Discharge' form. Select an existing episode and click [Edit]. Enter the desired date in the 'Date Of Discharge' field. Enter the desired time in the 'Discharge Time' field. Select the desired value in the 'Type Of Discharge' field. Select the desired practitioner in the 'Discharge Practitioner' field. Populate any other desired fields. Select the "Demographics" section. Validate the 'Consent On File For Use of Integrated eSignature' field is present with values of "Yes" and "No". Select "No" in the 'Consent On File For Use of Integrated eSignature' field. Click [Submit]. Select "Client A" and access the 'Pre Admit Discharge' form. Select the previously discharged Pre Admit episode and click [Edit]. Select the "Demographics" section. Validate "No" is selected in the 'Consent On File For Use of Integrated eSignature' field. Close the form. Access Crystal Reports or other SQL reporting tool. Create a report using the 'SYSTEM.patient_current_demographics' SQL table. Navigate to the row for "Client A". Validate the 'esig_consent_on_file_code' field is present and contains "N". Validate the 'esig_consent_on_file_value' field is present and contains "No". Close the report. Create a report using the 'SYSTEM.patient_demographic_history' SQL table. Navigate to the row for "Client A". Validate the 'esig_consent_on_file_code' field is present and contains "N". Validate the 'esig_consent_on_file_value' field is present and contains "No". Close the report. Scenario 7: 'Call Intake' form - Field Validation Specific Setup: A client is enrolled in an existing Call Intake program (Client A). Steps Select "Client A" and access the 'Call Intake' form. Select the existing call intake record and click [Edit]. Select the "Demographics" section. Validate the 'Consent On File For Use of Integrated eSignature' field is present with values of "Yes" and "No". Select "No" in the 'Consent On File For Use of Integrated eSignature' field. Click [Submit]. Select "Client A" and access the 'Call Intake' form. Select the existing call intake record and click [Edit]. Select the "Demographics" section. Validate "No" is selected in the 'Consent On File For Use of Integrated eSignature' field. Close the form. Access Crystal Reports or other SQL reporting tool. Create a report using the 'SYSTEM.patient_current_demographics' SQL table. Navigate to the row for "Client A". Validate the 'esig_consent_on_file_code' field is present and contains "N". Validate the 'esig_consent_on_file_value' field is present and contains "No". Close the report. Create a report using the 'SYSTEM.patient_demographic_history' SQL table. Navigate to the row for "Client A". Validate the 'esig_consent_on_file_code' field is present and contains "N". Validate the 'esig_consent_on_file_value' field is present and contains "No". Close the report. Scenario 8: The 'ClientAdmission' - 'AddAdmission' web service: Admission of a new client Steps Access SoapUI for the 'ClientAdmission' - 'AddAdmission' web service. Enter the system code that will be used to log into Avatar in the 'SystemCode' field. Enter the user name that will be used to log into Avatar in the 'UserName' field. Enter the password that will be used to log into Avatar in the 'Password' field. Enter the desired date in the 'AdmissionDate' field. Enter the desired time in the 'AdmissionTime' field. Enter the desired practitioner in the 'AdmittingPractitioner' field. Enter the desired value in the 'ClientFirstName' field. Enter the desired value in the 'ClientLastName' field. Enter the desired value in the 'ClientMiddleName' field. Enter the corresponding name in the 'ClientName' field. Enter the desired value in the 'ESignatureConsentOnFile' field. Note: "Y" and "N" are accepted values. Enter the desired value in the 'Program' field. Enter the desired value in the 'Sex' field. Populate any other required and desired fields. Click [Run]. Validate the 'Confirmation' field contains a value such as: "Client Unique ID: # Unique ID: #". Validate the 'Message' field contains: "Client Admission web service has been filed successfully". Select the client filed in the previous steps and access the 'Admission' form. Select the record filed in the previous steps and click [Edit]. Validate all populated fields are displayed. Select the "Demographics" section. Validate the 'Client Last Name' field contains the value filed in the previous steps. Validate the 'Client First Name' field contains the value filed in the previous steps. Validate the 'Client Middle Name' field contains the value filed in the previous steps. Validate the 'Consent On File For Use of Integrated eSignature' field contains the value filed in the previous steps. Close the form. Scenario 9: Validate the 'ClientDemographics' - 'UpdateClientDemographics' web service Specific Setup: A client is enrolled in an existing episode (Client A). Steps Access SoapUI for the 'ClientDemographics' - 'UpdateClientDemographics' web service. Enter the system code that will be used to log into Avatar in the 'SystemCode' field. Enter the user name that will be used to log into Avatar in the 'UserName' field. Enter the password that will be used to log into Avatar in the 'Password' field. Enter the desired value in the 'ESignatureConsentOnFile' field. Note: "Y" and "N" are accepted values. Populate any other desired fields. Enter "Client A" in the 'ClientID' field. Click [Run]. Validate the 'Message' field contains: Client Demographics web service has been filed successfully. Select "Client A" and access the 'Update Client Data' form. Validate the 'Consent On File For Use of Integrated eSignature' field contains the value filed in the previous steps. Validate all populated fields are displayed. Close the form. 'Outbound Referral History' form Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Outbound Referral History Scenario 1: Outbound Referral History - Form Validations Specific Setup: Must be configured for CareConnect. A client is enrolled in an existing episode (Client A). Steps Access the 'Outbound Referral History' form. Select "Client A" in the 'Client Search' field. Click [New Row] in the 'Referrals' grid. Enter the desired value in the 'Receiving Organization' field. Select the desired provider in the 'Receiving Provider' field. Select the desired provider in the 'Referring Provider' field. Enter the desired value in the 'Reason For Referral' field. Enter the desired value in the 'Notes Field' field. Select the desired value in the 'Status' field. Click [Submit]. Access the 'Outbound Referral History' form. Select "Client A" in the 'Client Search' field. Validate the 'Referrals' grid contains the record filed in the previous steps. Close the form.	Topics • Admission • Update Client Data • Admission (Outpatient) • Discharge • Pre Admit • Pre Admit Discharge • Call Intake • Web Services • Outbound Referral History
Update 55 Summary \| Details Cal-PM CarePOV system - Selecting client Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Product Updates (PM) Internal Test Only	Topics • Client Search
Update 56 Summary \| Details File Import - Service Guarantor Definition Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Guarantors/Payors Service Fee/Cross Reference and Guarantor Definition Export File Import Scenario 1: File Import - Service Guarantor Definitions Specific Setup: Note: This functionality is for any service code type, including CCBHC service codes. Please contact your Netsmart representative to enable CCBHC Billing functionality, if desired. CCBHC setup has been completed. The 'Avatar_PM_File_Import_Record_Layouts' spreadsheet is included in the update zip file to assist in creating the 'Service Guarantor Definitions' file to import. Identify an existing service code. Create a 'File Import' for the 'Service Guarantor Definition' file type that contains the service code. Note the value of each field included in the file. Steps Open 'File Import'. Select Service Guarantor Definitions’ in 'File Type'. Load, compile and post the file. Open 'Service Fee/Cross Reference Maintenance', 'Guarantor Definitions', and review the imported record in edit mode. Validate that all values equal the values in the imported file. Click [Guarantor Definitions Report]. Validate that guarantor information is correct for the service code. Close the report. Close the form.	Topics • File Import
Update 58 Summary \| Details 'Task Scheduler Status' widget Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: System Task Scheduler Task Scheduler Status Scenario 1: Validate the 'Task Scheduler Status' widget Specific Setup: In the 'System Task Scheduler', a minimum of two active tasks and one inactive task should be filed. 'View Definition' form has been used to add the ‘Task Scheduler Status’ widget to HomeView for the logged in user. Steps Access the ‘Task Scheduler Status’ widget on the Home View. Validate that the widget can be undocked, refreshed, and either minimized (Non NX View) or removed (NX View). Validate that the widget contains the following columns: ‘Application’, ‘Task’. ‘Inactive’, ‘Recur’, ‘Start Date’, ‘End Date’, ‘Last Run Start Date’, ‘Last Run Start Time’, ‘Last Run End Date’, ‘Last Run End Time’, and ‘Last Run Status’. Validate the data in each column is accurate. Note that for any task which errors, the error will display in the 'Last Run Status' column.	Topics • Widgets • System Task Scheduler
Update 59 Summary \| Details Electronic Billing - Error Report Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Financial Eligibility Scenario 1: 'Electronic Billing' report - validate data in error report. Specific Setup: Client A: Note the client’s program. Has closed, unclaimed services that can be billed on the 837 Institutional. Note the guarantor the liability distribute to. The client does not have an active diagnosis record. This will cause an error report to generate in electronic billing. If desired, create an interim billing batch to use in electronic billing. Client B: Note the client’s program. Has closed, unbilled services that can be billed on the 837 Professional. Note the guarantor the liability distribute to. The client does not have an active diagnosis record. This will cause an error report to generate in electronic billing. If desired, create an interim billing batch to use in electronic billing. Steps Open 'Electronic Billing' form. Compile an unclaimed bill for Client A. Validate that a message is received stating: No Valid Information Found. Please Check The Error Report. Click [OK]. Select 'Run Report' in 'Billing Options'. Select 'Print' in 'Print Or Delete Report'. Select the 'File'. Click [Print 837 Report]. Validate that the report launches and contains a link to 'Required Data Missing: Patient Claim Data'. Click the link. Verify that the error is that the diagnosis is missing and that the listing does not contain a program that the client is not enrolled in. Repeat steps above for Client B.	Topics • Electronic Billing • NX
Update 60 Summary \| Details 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
Update 61 Summary \| Details Avatar Cal-PM Sub-System Code Program Restrictions Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: System Code Definition Scenario 1: 'Admission' - Verification of Form Pre-Display Program Restrictions for Sub-System Code Specific Setup: One or more sub-system codes must be enabled/defined in Avatar Cal-PM, with no 'Associated Programs' assigned (via 'System Code Definition' form) One or more client record(s) with Admission/Episode record(s) existing in system Steps Login to Avatar Cal-PM sub-system code with no Associated Program(s) defined/associated. Open 'Admission' form, selecting client where one or more Admission/Episode record(s) exist in system. Note - Acceptance testing may also be confirmed via Avatar Cal-PM 'Admission (Outpatient)' and/or 'Pre Admit' forms In 'Admission' form pre-display - ensure that pre-display includes no Admission/Episode records for client where no Associated Program(s) are defined/associated to current sub-system code (as only Admission/Episode records under Programs applicable to/allowed for current sub-system code are available, as defined in 'System Code Definition' form 'Associated Programs' field). Click 'Cancel' button to close 'Admission' form/pre-display. Login to Avatar Cal-PM sub-system code with one or more Associated Program(s) defined/associated. Open 'Admission' form, selecting client where one or more Admission/Episode record(s) exist in system. In 'Admission' form pre-display - ensure that pre-display includes only Admission/Episode records under Programs applicable to/allowed for current sub-system code (as defined in 'System Code Definition' form 'Associated Programs' field). Select existing record for view/update and click 'Edit' button to open Admission form/record (or click 'Add' or 'Cancel' buttons to add Admission record or close form/pre-display, respectively).	Topics • Admission • Sub-System Code • NX
Update 62 Summary \| Details The 'ClientPreAdmitDischarge' web service Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Pre Admit Discharge Scenario 1: Discharge a client via the 'ClientPreAdmitDischarge' web service Specific Setup: A client is enrolled in an existing Pre Admit episode (Client A). Must have access to SoapUI or other web service tool. Steps Access SoapUI for the 'ClientPreAdmitDischarge' - 'PreAdmitDischargeClient' web service. Enter the system code that will be used to log into Avatar in the 'SystemCode' field. Enter the user name that will be used to log into Avatar in the 'UserName' field. Enter the password that will be used to log into Avatar in the 'Password' field. Enter the desired date in the 'DateOfDischarge' field. Enter the desired practitioner in the 'DischargePractitioner' field. Enter the desired time in the 'DischargeTime' field. Enter the desired value in the 'TypeOfDischarge' field. Enter "Client A" in the 'ClientID' field. Enter the Pre Admit episode number to be discharged in the 'EpisodeNumber' field. Click [Run]. Validate the 'Message' field contains: Client Discharge web service has been filed successfully. Select "Client A" and access the 'Pre Admit Discharge' form. Validate all populated fields are displayed as entered in the web service. Close the form.	Topics • Pre Admit Discharge • Web Services • Discharge
Update 63 Summary \| Details Avatar PM 'Cal-PM Admission' form Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: 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
Update 64 Summary \| Details 'Electronic Billing' Support for Services Originating in Avatar MSO Scenario 1: 'Electronic Billing' - Verification of 'Support MSO Other Healthcare Coverage' Registry Setting (Services Originating in Avatar MSO) Specific Setup: Avatar Cal-PM Registry Setting 'Support MSO Other Healthcare Coverage' must be enabled Avatar Cal-PM Registry Setting 'Include Service Level Adjudication Info' must be enabled (and 'Include Service Level Adjudication Information (2430)' field set to 'Yes' via 'Guarantor/Program Billing Defaults' form '837 Professional' and/or '837 Institutional' section for applicable Guarantor/Program) Avatar MSO Registry Setting 'Add Support For The Input Of Third Party Payer Amounts' must be enabled One or more service(s) eligible for Avatar Cal-PM 837 Professional/837 Institutional file inclusion (via 'Electronic Billing' form) originating in Avatar MSO and including Third Party Payment/Adjustment 'Other Healthcare Coverage' information Steps Open Avatar Cal-PM 'Electronic Billing' form. Note, acceptance testing may also be confirmed via Avatar Cal-PM 'Quick Billing' form/functionality Select 837 Professional or 837 Institutional in 'Billing Form' field. Enter/select 837 file sorting criteria, using values which will include service(s) originating in Avatar MSO. Click 'Process' button to sort/generate 837 Professional or 837 Institutional file. Select 'Dump File' in the 'Billing Options' field (or select 'Create File On Server' to review output file directly). Select 'Print' in the 'Print Or Delete Report' field. Select 837 Professional/837 Institutional file sorted which includes services originating in Avatar MSO, and click 'Process' button to display 837 outbound file data. In Avatar Cal-PM 837 Professional/837 Institutional format outbound electronic billing file data - for services originating via Avatar MSO and including Service-Level Third Party Payment/Adjustment 'Other Healthcare Coverage' information, ensure that 2430-SVD-03 Service Line Adjudication Product/Service ID in Avatar Cal-PM 837 file contains 2430-SVD-03 Service Code value from original Avatar MSO inbound claim/service Other Healthcare Coverage information with any modifiers if/where present. Examples: SVD87755XX7.5HC:90806*11~ SVD87755XX7.5HC:90806:HA*11~ SVD87755XX7.5HC:90806:HA:HE*11~ SVD87755XX7.5HC:90806:HA:HE:HF*11~ SVD87755XX7.5HC:90806:HA:HE:HF:ZZ*11~	Topics • Electronic Billing • Claims Processing • NX
Update 65 Summary \| Details File Import - Client Charge Input Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: File Import Scenario 1: File Import - Render service to the client using multiple add-on codes Specific Setup: The following registry setting has a value of 'Y': Avatar PM->System Maintenance->Service Code Maintenance->->->Enable Multiple Add-On Code Per Primary Code Functionality. Dictionary Update has been used to update 'Other Tabled File, 291, Service Code Type' to have a value of 'Yes' in the extended dictionary 'Allow Multiple Add-On Code Definition' for all dictionary codes. A 'Service Code' identified with a 'Service Code Category' of 'Primary Code' has at least two values selected in 'Select Multiple Add-On Code'. An outpatient client is identified. Note the program. The client has an active diagnosis record, and an active financial eligibility record, noting the financial class. A 'Client Charge Input', 'File Import' file has been created import the primary service and add-on services. Steps Open the 'File Import' form. Select the 'Client Charge Input' from the 'File Type' field. Upload the 'Multiple Add-Ons' file created in the setup section. Compile the file. Verify the information message : 'Compiled'. Click [OK]. Post the file. Verify the file posted successfully. Close the form. Open the Client Ledger. Validate the Primary service code display with Multiple Add-on codes. Scenario 2: 837 Professional billilng when 'Enable Multiple Add-On Code Per Primary Code Functionality' = Y. Specific Setup: The following registry setting has a value of 'Y': Avatar PM->System Maintenance->Service Code Maintenance->->->Enable Multiple Add-On Code Per Primary Code Functionality. Dictionary Update has been used to update 'Other Tabled File, 291, Service Code Type' to have a value of 'Yes' in the extended dictionary 'Allow Multiple Add-On Code Definition' for all dictionary codes. A 'Service Code' identified with a 'Service Code Category' of 'Primary Code' has at least two values selected in 'Select Multiple Add-On Code'. An outpatient client is identified. Note the program. The client has an active diagnosis record, and an active financial eligibility record, noting the financial class. A service has been created for the above 'Service Code'. Note the date of service. The service has been closed. Use 'Client Ledger' to note the fee for the 'Service Code' and for each 'Add-On Code'. Note the total fee. Steps Open 'Electronic Billing'. Create an '837 Professional' bill for the service. Review the dump file to validate that the amount in the 'CLM' is equal to the total fee and that the amounts in the 'SV1' segments is equal to the total fee. Close the dump file. Close the form. Query the SYSTEM.billing_tx_master table. Locate the 'Service Code' selected in Setup. Validate that the 'multi_addon_svc_code' displays all add-on service code numbers selected in the primary service code. Validate that the 'multi_addon_svc_value' displays all add-on service code descriptions selected in the primary service code.	Topics • Client Charge Input • File Import • NX • 837 Professional
Update 66 Summary \| Details File Import Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: File Import Service Codes Product Updates (PM) Scenario 1: File Import - 'Service Fee/Cross Reference' file type Specific Setup: The registry setting 'Import File Delimiter' is enabled with desired value. An existing service code is identified. Note the service code. File Import: File 1: A 'Service Fee/Cross Reference Maintenance' import file is created for the service code and contains a leading $ sign in the 'Fee' field. Note the value of each field included in the file. Note the file name. File 2: A 'Service Fee/Cross Reference Maintenance' import file is created for the service code and contains only the amount in the 'Fee' field. Note the value of each field included in the file. Note the file name. Steps Open the 'File Import' form. Select the 'Service Fee/Cross Reference Maintenance' from the 'File Type' field. Upload File 1. Compile the file. Verify the information message: "File [File Name] contains one or more errors. These errors can be reviewed using 'Print Errors' action". Click [OK] button. Select the 'Print Errors' option. Review the error report. Verify the report displays the error: 'Invalid numeric format'. Click [X]. Upload File 2. Compile the file. Verify the information message: 'Compiled'. Click [OK]. Post File 2. Verify the file posted successfully. Open the 'Service Fee/Cross Reference Maintenance' form. Edit the service code mentioned in the file import file. Enter the 'From Date' same as the date entered in the file import file. Verify the fee of the service displays correctly as entered in File 2. Click [Close Form].	Topics • Service Fee/Cross Reference Maintenance • File Import
Update 67 Summary \| Details SQL Table Validation - SYSTEM.view_episode_summary_admit table Scenario 1: SQL table validation - SYSTEM.view_episode_summary_admit - Outpatient Client Admission on the cache system Specific Setup: Admission: Create a new client and do not enter date of birth of the client. Note the client id. Steps Open the 'Crystal report' or any other SQL data viewer. Query the 'Select * from SYSTEM.view_episode_summary_admit' table. Verify the client without a date of birth have a blank value in the 'c_date_of_birth' field. Open the 'Admission (Outpatient)' form for the client. Edit an existing admission record. Enter desired date of birth. Open the 'Crystal report' or any other SQL data viewer. Query the 'Select * from SYSTEM.view_episode_summary_admit' table for the client. Verify the client updated with a date of birth have correct date in the 'c_date_of_birth' field.	Topics • Admission • Admission (Outpatient) • Database Tables • NX
Update 69 Summary \| Details 274 Provider Directory - SQL Tables Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: 274 - Provider Directory Definition Scenario 1: 274 - Provider Directory Definition - Site Definition Specific Setup: Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’. Steps Open ‘274 - Provider Directory Definition’. Select the 'Site Definition’ section. Validate that ‘Add or Edit Site’ is the only required field on the form. Select ‘Add’ in ‘Add or Edit Site’. Validate that ‘Site or Location of Service Name (2100A-NM1-03)', ‘Provider Group’ and ‘Active’ are now required fields. Click [X]. Open 'Site Specific Section Modeling' for Avatar PM. Select 'TABLE27400 (274 - Provider Directory Definition) Site Definition’ in 'Site Specific Selection'. Click [OK]. Select the ‘Site Specific Section’ option. Click on row ‘60’ in ‘Prompt Order’. Click [Edit Selected Item]. Validate that ‘Label’ is disabled and contains ‘Facility ID (2140DA-REF-02)’. Validate that ‘Initially Enabled’ = ‘Yes’. Validate that ‘Initially Required’ = 'No'. Select ‘Yes’ in ‘Initially Required’. As desired, set other ‘Prompt Order’ rows to a value of ‘Yes’ in ‘Initially Required’. Note the values of the other fields, specifically the ‘Label’. Click [Submit]. Click ‘Refresh Forms’ icon. Open ‘274 - Provider Directory Definition’. Select the ‘Site Definition’ section. Validate that ‘Facility ID (2140DA-REF-02)’ is required. Validate that all other rows that were updated to be required display as required. The 'Label' that was noted is the field name. Add desired data to the form. Click [File Site Details]. Select the filed Site and validate that the data displays correctly. If desired, create additional desired ‘Site Definitions’ and file them. Click [X]. Open ‘274 - Provider Directory Definition’. Select the 'Site Definition’ section. Select any site and validate that the filed data displays correctly. Click [X]. Scenario 2: 274 - Provider Directory Definition - Provider Definition Specific Setup: Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’. 274 Provider Directory Definition: A minimum of one 'Group Definition' exists. A minimum of one 'Site Definition' exists. Steps Open ‘274 - Provider Directory Definition’. Validate that the form opened to the ‘Group Definition’ section. Select the ‘Provider Definition’ section. Validate that ‘Provider’ is the only required field on the form. Select a ‘Provider’. Validate that ‘Associated Site’ and ‘Active’ are now required fields. Click [X]. Open 'Site Specific Section Modeling' for Avatar PM. Select 'TABLE27400 (274 = Provider Directory Definition) Provider Definition’ in 'Site Specific Selection'. Click [OK]. Select ‘Site Specific Section’ option. Click on row ‘84’ in ‘Prompt Order’. Click [Edit Selected Item]. Validate that ‘Label’ is disabled and contains ‘Provider Identifier - Secondary (2140EA-REF-02)’. Validate that ‘Initially Enabled’ = ‘Yes’. Validate that ‘Initially Required’ = 'No'. Select ‘Yes’ in ‘Initially Required’. As desired, set other ‘Prompt Order’ rows to a value of ‘Yes’ in ‘Initially Required’. Note the values of the other fields, specifically the ‘Label’. Click [Submit]. Click ‘Refresh Forms’ icon. Open ‘274 - Provider Directory Definition’. Select the ‘Provider Definition’ section. Validate that ‘Provider Identifier - Secondary (2140EA-REF-02)’ is now required. Validate that all other rows that were updated to be required display as required. The 'Label' that was noted is the field name. Add desired data to the form. Click [File Provider Details]. Select the same provider and site. Validate that the submitted date displays correctly. Select the ‘Provider’ that was submitted in ‘Provider’. Select a new value in ‘Associated Site’. Validate that a ‘Provider-Site Records On File’ item displays the message ‘Record to default Information From’ and contains a drop down list of ‘Sites’. Select a site and click [OK]. Validate that the data defaulted into the fields. Click [File Provider Details]. Create additional desired ‘Provider Definitions’ for the same provider for another site and then inactivate the provider in one of the three sites. The provider will not display in the submission for the inactive site. Create additional desired ‘Provider Definitions’. Click [X]. Open ‘274 - Provider Directory Definition’. Select the ‘Provider Definition’ section. Select the desired provider and site. Validate that the submitted date displays correctly. Click [X]. 274 Provider Directory - Update Class Mapping/Submission File Logic/File Import Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: 274 - Provider Directory Submission 274 - Provider Directory Definition Scenario 1: 274 - Provider Directory Submission - form validation Specific Setup: An output directory has been defined in ‘Facility Defaults’ field ‘Output Path On Server For State Reporting Files’. Steps Open ‘274 - Provider Directory Submission’. Validate that the ‘Options’, ‘Reporting Period (MM/YY)’, and ‘File Description’ fields are required. Select ‘Compile File’ in ‘Options’. Enter the desired value in ‘Reporting Period (MM/YY)’. Enter the desired value in ‘File Description’. Click [Process File]. The ‘Health Care Provider Directory’ report will open. The report can contain the following links: ‘274 Submission’, ‘Required Data Missing/Invalid - Directory Defaults’, ‘Required Data Missing/Invalid - Group’, ‘Required Data Missing/Invalid – Site’, ‘‘Required Data Missing/Invalid – Provider’, and ‘‘Required Data Missing/Invalid – Other’. Click on the link for any ‘Required Data Missing/Invalid’ links and review the data in the sub report. Correct the data as desired. Click on the link for ‘274 Submission’ and review the data in the report. Providers will not display for the sites in which they are inactive. Close the report. Select ‘Dump File’ in ‘Options’. Validate that ‘Select File’ in now required. Select the file compiled above in ‘Select File’. Click [Process File]. The ‘Health Care Provider Directory’ report will open and display the data that will be included in the dump file. Close the report. Select ‘Create File On Server For Submission’ in ‘Options’. Select the file compiled above in ‘Select File’. Click [Process File]. The ‘Create File’ item is received with the message ‘Process Completed’. Click [OK]. Select ‘Run Report’ Select ‘Create File On Server For Submission’ in ‘Options’. Select the file compiled above in ‘Select File’. Click [Process File]. The ‘Health Care Provider Directory’ report will open and contain the same links the previously opened. Close the report. ‘Options’ contains ‘Delete File’. If deleting a file is desired, select ‘Delete File’. Select the file compiled above in ‘Select File’. Click [Process File]. Close the form. Scenario 2: 274 - Provider Directory Definition - Site Definition Specific Setup: Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’. Steps Open ‘274 - Provider Directory Definition’. Select the 'Site Definition’ section. Validate that ‘Add or Edit Site’ is the only required field on the form. Select ‘Add’ in ‘Add or Edit Site’. Validate that ‘Site or Location of Service Name (2100A-NM1-03)', ‘Provider Group’ and ‘Active’ are now required fields. Click [X]. Open 'Site Specific Section Modeling' for Avatar PM. Select 'TABLE27400 (274 - Provider Directory Definition) Site Definition’ in 'Site Specific Selection'. Click [OK]. Select the ‘Site Specific Section’ option. Click on row ‘60’ in ‘Prompt Order’. Click [Edit Selected Item]. Validate that ‘Label’ is disabled and contains ‘Facility ID (2140DA-REF-02)’. Validate that ‘Initially Enabled’ = ‘Yes’. Validate that ‘Initially Required’ = 'No'. Select ‘Yes’ in ‘Initially Required’. As desired, set other ‘Prompt Order’ rows to a value of ‘Yes’ in ‘Initially Required’. Note the values of the other fields, specifically the ‘Label’. Click [Submit]. Click ‘Refresh Forms’ icon. Open ‘274 - Provider Directory Definition’. Select the ‘Site Definition’ section. Validate that ‘Facility ID (2140DA-REF-02)’ is required. Validate that all other rows that were updated to be required display as required. The 'Label' that was noted is the field name. Add desired data to the form. Click [File Site Details]. Select the filed Site and validate that the data displays correctly. If desired, create additional desired ‘Site Definitions’ and file them. Click [X]. Open ‘274 - Provider Directory Definition’. Select the 'Site Definition’ section. Select any site and validate that the filed data displays correctly. Click [X].	Topics • 274 - Provider Directory
Update 71 Summary \| Details Client Demographic forms - 'Preferred Appointment Site' field Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Pre Admit Discharge Assign MR# SoapUI - UpdateAdmission Scenario 1: Validate the 'Admission' form for a new client Specific Setup: Sites are defined with hours in the 'Site Registration' form. Steps Access the 'Admission' form. Admit a new client into any episode. Populate all required and desired fields. Select the "Demographics" section. Select the desired site in the 'Preferred Appointment Site' field. Please note: this field is present in Avatar NX only. Click [Submit]. Access the 'Admission' form for the client admitted in the previous steps. Click [Edit] for the episode added in the previous steps. Validate the previously filed data is displayed. Select the "Demographics" section. Validate the 'Preferred Appointment Site' field contains the value filed in the previous steps. Close the form. Scenario 2: 'Update Client Data' - Verification of form filing Specific Setup: Sites are defined with hours in the 'Site Registration' form. A client is enrolled in an existing episode (Client A). Steps Select "Client A" and access the 'Update Client Data' form. Select the desired value in the 'Preferred Appointment Site' field. Please note: this field is present in Avatar NX only. Populate any other desired fields. Click [Submit]. Select "Client A" and access the 'Update Client Data' form. Validate the previously filed data is displayed. Validate the 'Preferred Appointment Site' field contains the value selected in the previous steps. Close the form. Scenario 3: 'Discharge' form - Field Validation Specific Setup: Sites are defined with hours in the 'Site Registration' form. A client is enrolled in an existing episode (Client A). Steps Select "Client A" and access the 'Discharge' form. Select an existing episode and click [Edit]. Enter the desired date in the 'Date Of Discharge' field. Enter the desired time in the 'Discharge Time' field. Select the desired value in the 'Type Of Discharge' field. Select the desired practitioner in the 'Discharge Practitioner' field. Select the "Demographics" section. Select the desired value in the 'Preferred Appointment Site' field. Please note: this field is present in Avatar NX only. Click [Submit]. Select "Client A" and access the 'Discharge' form. Select the discharged episode and click [Edit]. Validate all previously filed data is displayed. Select the "Demographics" section. Validate the 'Preferred Appointment Site' field contains the value filed in the previous steps. Close the form. Scenario 4: 'Pre Admit' form - Field Validation Specific Setup: Sites are defined with hours in the 'Site Registration' form. A client is enrolled in an existing Pre Admit episode (Client A). Steps Select "Client A" and access the 'Pre Admit' form. Select an existing episode and click [Edit]. Select the "Demographics" section. Select the desired value in the 'Preferred Appointment Site' field. Please note: this field is present in Avatar NX only. Click [Submit]. Select "Client A" and access the 'Pre Admit' form. Select an existing episode and click [Edit]. Select the "Demographics" section. Validate the 'Preferred Appointment Site' field contains the value filed in the previous steps. Close the form. Scenario 5: 'Call Intake' form - Field Validation Specific Setup: Sites are defined with hours in the 'Site Registration' form. A client is enrolled in an existing Call Intake program (Client A). Steps Select "Client A" and access the 'Call Intake' form. Select the existing call intake record and click [Edit]. Select the "Demographics" section. Select the desired value in the 'Preferred Appointment Site' field. Please note: this field is present in Avatar NX only. Click [Submit]. Select "Client A" and access the 'Call Intake' form. Select the existing call intake record and click [Edit]. Select the "Demographics" section. Validate the 'Preferred Appointment Site' field contains the value filed in the previous steps. Close the form. Scenario 6: Pre Admit Discharge web service validation Specific Setup: Sites are defined with hours in the 'Site Registration' form. A client is enrolled in an existing Pre Admit episode (Client A). Steps Access SoapUI for the 'ClientPreAdmitDischarge' - 'PreAdmitDischargeClient' web service. Enter the system code that will be used to log into Avatar in the 'SystemCode' field. Enter the user name that will be used to log into Avatar in the 'UserName' field. Enter the password that will be used to log into Avatar in the 'Password' field. Enter the desired date in the 'DateOfDischarge' field. Enter the desired practitioner in the 'DischargePractitioner' field. Enter the desired time in the 'DischargeTime' field. Enter the desired value in the 'PreferredAppointmentSite' field. Enter the desired value in the 'TypeOfDischarge' field. Enter "Client A" in the 'ClientID' field. Enter the episode number to be discharged in the 'EpisodeNumber' field. Click [Run]. Validate the 'Message' field contains: Client Pre-Admit Discharge web service has been filed successfully. Select "Client A" and access the 'Pre Admit Discharge' form. Validate all populated fields are displayed as entered in the web service. Select the "Demographics" section. Validate the 'Preferred Appointment Site' field contains the value entered via web service. Close the form. Scenario 7: Discharge a client via the 'ClientDischarge' web service Specific Setup: Sites are defined with hours in the 'Site Registration' form. A client is enrolled in an existing episode (Client A). Steps Access SoapUI for the 'ClientDischarge' - 'DischargeClient' web service. Enter the system code that will be used to log into Avatar in the 'SystemCode' field. Enter the user name that will be used to log into Avatar in the 'UserName' field. Enter the password that will be used to log into Avatar in the 'Password' field. Enter the desired date in the 'DateOfDischarge' field. Enter the desired practitioner in the 'DischargePractitioner' field. Enter the desired time in the 'DischargeTime' field. Enter the desired value in the 'PreferredAppointmentSite' field. Enter the desired value in the 'TypeOfDischarge' field. Enter "Client A" in the 'ClientID' field. Enter the episode number to be discharged in the 'EpisodeNumber' field. Click [Run]. Validate the 'Message' field contains: Client Discharge web service has been filed successfully. Select "Client A" and access the 'Discharge' form. Validate all populated fields are displayed as entered in the web service. Select the "Demographics" section. Validate the 'Preferred Appointment Site' field contains the value entered via web service. Close the form. Scenario 8: The 'ClientAdmission' - 'UpdateAdmission' web service: Update Admission for an existing client Specific Setup: Sites are defined with hours in the 'Site Registration' form. A client must be enrolled in an existing episode (Client A). Steps Access SoapUI for the 'ClientAdmission' - 'UpdateAdmission' web service. Enter the system code that will be used to log into Avatar in the 'SystemCode' field. Enter the user name that will be used to log into Avatar in the 'UserName' field. Enter the password that will be used to log into Avatar in the 'Password' field. Populate all required and desired fields. Enter the desired value in the 'PreferredAppointmentSite' field. Enter "Client A" in the 'ClientID' field. Enter "Client A's" episode in the 'Episode' field. Click [Run]. Validate the 'Confirmation' field contains a value such as: "Client Unique ID: # Unique ID: #". Validate the 'Message' field contains: "Client Admission web service has been filed successfully". Select "Client A" and access the 'Admission' form. Select the admission updated in the previous steps and click [Edit]. Validate all populated fields are displayed. Validate the 'Preferred Appointment Site' field contains the value entered via web service. Close the form. Scenario 9: Validate the 'ClientDemographics' - 'UpdateClientDemographics' web service Specific Setup: Sites are defined with hours in the 'Site Registration' form. A client must be enrolled in an existing episode (Client A). Steps Access SoapUI for the 'ClientDemographics' - 'UpdateClientDemographics' web service. Enter the system code that will be used to log into Avatar in the 'SystemCode' field. Enter the user name that will be used to log into Avatar in the 'UserName' field. Enter the password that will be used to log into Avatar in the 'Password' field. Enter the desired value in the 'PreferredAppointmentSite' field Populate any other desired fields. Enter "Client A" in the 'ClientID' field. Click [Run]. Validate the 'Message' field contains: Client Demographics web service has been filed successfully. Select "Client A" and access the 'Update Client Data' form. Validate all populated fields are displayed. Validate the 'Preferred Appointment Site' field contains the value entered via web service. Close the form. Scenario 10: 'Admission (Outpatient)' - Verification of form filing Specific Setup: Sites are defined with hours in the 'Site Registration' form. Steps Access the 'Admission (Outpatient)' form. Admit a new client into any episode. Populate all required and desired fields. Select the "Demographics" section. Select the desired site in the 'Preferred Appointment Site' field. Please note: this field is present in Avatar NX only. Click [Submit]. Access the 'Admission (Outpatient)' form for the client admitted in the previous steps. Click [Edit] for the episode added in the previous steps. Validate the previously filed data is displayed. Select the "Demographics" section. Validate the 'Preferred Appointment Site' field contains the value filed in the previous steps. Close the form. Scenario 11: 'Pre Admit Discharge' - Verification of form filing Specific Setup: Sites are defined with hours in the 'Site Registration' form. A client is enrolled in an existing Pre Admit episode(Client A). Steps Select "Client A" and access the 'Pre Admit Discharge' form. Select an existing episode and click [OK]. Enter the desired date in the 'Date Of Discharge' field. Enter the desired time in the 'Time Of Discharge' field. Select the desired value in the 'Type Of Discharge' field. Select the desired practitioner in the 'Discharge Practitioner' field. Select the "Demographics" section. Select the desired value in the 'Preferred Appointment Site' field. Please note: this field is present in Avatar NX only. Click [Submit]. Select "Client A" and access the 'Pre Admit Discharge' form. Select the discharged episode and click [OK]. Validate the previously filed data is displayed. Select the "Demographics" section. Validate the 'Preferred Appointment Site' field contains the value filed in the previous steps. Close the form.	Topics • Admission • Update Client Data • Pre Admit • Call Intake • Pre Admit Discharge • Web Services • Discharge • Admission (Outpatient)
Update 73 Summary \| Details Envelope import Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Envelope Export (PM) Form Designer (PM) Scenario 1: Envelope Export/Import - 'Include Form Design Changes' in the file set to "Y" Specific Setup: Have a modeled form [FormA], contained in [EnvelopeA], that will be used to make form designer changes Steps Open the 'Form Designer' form. Select [FormA] from the 'Forms' field. Make any type of form designer change in the section [FDchange1]. For example, a field is moved to different location. Save the changes and exit the form. Navigate to form "Envelope Export". Select [EnvelopeA]. In the "Include Form Design Changes? field, select "Yes". Click [Begin Export]. Validate export is completed successfully. [ExportA]. Open the 'Form Designer' form. Select [FormA] from the 'Forms' field. Make another form designer change in the section [FDchange2]. Save the changes and exit the form. Open [FormA]. Validate [FDchange1] and [FDchange2] are both present in the form. Open form "Envelope Import". Click [Select Envelope For Import]. Navigate the location of [ExportA]. Select the file. Select radio button "Overwrite Existing". In the "Include Form Design Changes? field, select "Yes". [Note: "Yes" implies that any form designer changes contained in the import file, 'will' be imported and/or overwrite any existing changes already made on the form]. Click [Begin Import Scan]. Validate there are no errors/warnings found within the import file scan results. Click [Begin Import]. Validate import is completed successfully. Open [FormA]. Select [SectionA]. Validate [FDchange1] is present on the form. Validate [FDchange2] is not present on the form. Quick billing Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Quick Billing Guarantors/Payors Financial Eligibility Quick Billing Rule Definition Scenario 1: Quick Billing - Validating work screen and 837 report through 'Edit Existing' quick billing batch Specific Setup: Registry Setting: The 'Enable New Quick Billing Format' registry setting is enabled. Please note: This is a one-time, system-wide registry setting and the associated functionality cannot be disabled once the registry setting is enabled. Once this setting has been enabled, it will no longer be able to be viewed in the 'Registry Settings' form. Admission: Two outpatient clients are identified. Please note the admission program of the clients. Guarantors/Payor: An existing guarantor is identified. Financial Eligibility: Guarantor identified above is assigned to the clients. Client Charge Input: 1-2 days of professional charges are rendered to the clients. Please note the service codes used during rendering services. Client Ledger: The charges are distributed to the guarantors assigned to the clients. Quick Billing Rule Definition: A new quick billing rule is created as follows: The admission programs are selected in the 'Program' field. An '837 Professional' is selected in the 'Billing Form' field. The guarantors assigned to the clients in their financial eligibility are selected in the 'Guarantors' field. All required fields are populated. The 'Create Interim Billing Batch' field is set to 'Yes'. Steps Open the 'Quick Billing' form. Run a new quick billing batch using the rule created in the setup section. Use a date range spanning services entered. Select 'Create Batch', 'Close Charges', and 'Generate Bills' in the 'Quick Billing Tasks To Execute' field. Submit the form. Verify that compile completes and the prompt states 'Compile Complete'. A Quick Billing Batch and an Interim Billing Batch will be created. Select the 'Edit Existing' option. Select the quick bill that was created in previous step. Submit the form again. Click [OK]. Select the 'Edit Existing' option. Select the quick bill that was created in previous step. Click [Print 837 Report]. Verify the report launched successfully. Close the report. Click [Launch Workscreen]. Verify the work screen contains all the clients included in the batch. Deselect one client from the 'Client' filter at the top of the work screen. Verify the grid does not display the services of that client. Select the same client again from the 'Client' filter at the top of the work screen. Verify the grid displays the services of that client. Save the grid. Verify the grid saves successfully. Close the form.	Topics • Envelope Import • Quick Billing • Quick Billing Rule Definition
Update 78 Summary \| Details 837 Billing Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Guarantors/Payors Financial Eligibility Product Updates (PM) Internal Test Only	Topics • 837 Professional • NX • State Forms
Update 79 Summary \| Details File Import - Client charge input Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: File Import Financial Eligibility Scenario 1: File Import - Render service to the client using multiple add-on codes Specific Setup: The following registry setting has a value of 'Y': Avatar PM->System Maintenance->Service Code Maintenance->->->Enable Multiple Add-On Code Per Primary Code Functionality. Dictionary Update has been used to update 'Other Tabled File, 291, Service Code Type' to have a value of 'Yes' in the extended dictionary 'Allow Multiple Add-On Code Definition' for all dictionary codes. A 'Service Code' identified with a 'Service Code Category' of 'Primary Code' has at least two values selected in 'Select Multiple Add-On Code'. An outpatient client is identified. Note the program. The client has an active diagnosis record, and an active financial eligibility record, noting the financial class. A 'Client Charge Input', 'File Import' file has been created import the primary service and add-on services. Steps Open the 'File Import' form. Select the 'Client Charge Input' from the 'File Type' field. Upload the 'Multiple Add-Ons' file created in the setup section. Compile the file. Verify the information message : 'Compiled'. Click [OK]. Post the file. Verify the file posted successfully. Close the form. Open the Client Ledger. Validate the Primary service code display with Multiple Add-on codes. Scenario 2: 837 Professional billilng when 'Enable Multiple Add-On Code Per Primary Code Functionality' = Y. Specific Setup: The following registry setting has a value of 'Y': Avatar PM->System Maintenance->Service Code Maintenance->->->Enable Multiple Add-On Code Per Primary Code Functionality. Dictionary Update has been used to update 'Other Tabled File, 291, Service Code Type' to have a value of 'Yes' in the extended dictionary 'Allow Multiple Add-On Code Definition' for all dictionary codes. A 'Service Code' identified with a 'Service Code Category' of 'Primary Code' has at least two values selected in 'Select Multiple Add-On Code'. An outpatient client is identified. Note the program. The client has an active diagnosis record, and an active financial eligibility record, noting the financial class. A service has been created for the above 'Service Code'. Note the date of service. The service has been closed. Use 'Client Ledger' to note the fee for the 'Service Code' and for each 'Add-On Code'. Note the total fee. Steps Open 'Electronic Billing'. Create an '837 Professional' bill for the service. Review the dump file to validate that the amount in the 'CLM' is equal to the total fee and that the amounts in the 'SV1' segments is equal to the total fee. Close the dump file. Close the form. Query the SYSTEM.billing_tx_master table. Locate the 'Service Code' selected in Setup. Validate that the 'multi_addon_svc_code' displays all add-on service code numbers selected in the primary service code. Validate that the 'multi_addon_svc_value' displays all add-on service code descriptions selected in the primary service code.	Topics • Client Charge Input • File Import • 837 Professional
Update 80 Summary \| Details 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
Update 82 Summary \| Details Registry Setting - Use Site or Service Based Appointment Color Coding Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Service Codes Scenario 1: Registry Settings - Use Site or Service Based Appointment Color Coding Specific Setup: Using the "Dictionary Update" form from the PM menu: Navigate to the "Print Dictionary" section: Select the "Other Tabled Files" from the "File" dropdown. Print the dictionary for the data element number "60050". Validate there are background colors already defined. Add custom colors if desired by defining the color's hexadecimal code. Print the dictionary for the data element number "60051". Validate there are background colors already defined. Add custom colors if desired by defining the color's hexadecimal code. Print the dictionary for the data element number "60052". Validate there are background colors already defined. Add custom colors if desired by defining the color's hexadecimal code. Steps Open the "Registry Settings" form. Search for the registry setting "Use Site or Service Based Appointment Coding". Validate it is initially set to "0". Attempt to set the registry setting to "3". Validate it informs that "0,1,2" are the only valid options. Set the registry setting to "0". Submit the form to file. Close the form. Note that in myAvatar systems, this functionality isn't available, and the registry setting can't be set. Open the "Site Registration" form. Note that there are no color coding related fields. Close the form. Open the "Service Codes" form. Note that there are no color coding related fields. Close the form. Open the "Registry Settings" form. Search for the registry setting "Use Site or Service Based Appointment Coding". Set the registry setting to "1". Submit the form to file. Close the form. Open the "Site Registration" form. Set unique values into the 3 new color coding fields so you can distinguish one appointment type from another. Submit the form to file. Open the "Site Registration" form. Validate the values of the 3 new color coding fields match what was recorded in previous step. Open the "Service Codes" form. Validate there are no color coding related fields. Close the form. Open the "Registry Settings" form. Search for the registry setting "Use Site or Service Based Appointment Coding". Set the registry setting to "2". Submit the form to file. Close the form. Open the "Site Registration" form. Validate there are no color coding related fields. Close the form. Open the "Service Codes" form. Set unique values into the 3 new color coding fields so you can distinguish one appointment type from another. Submit the form to file. Scenario 2: Service Codes - Color Coding Specific Setup: Using the "Dictionary Update" form from the PM menu: Navigate to the "Print Dictionary" section: Select the "Other Tabled Files" from the "File" dropdown. Print the dictionary for the data element number "60050". Validate there are background colors already defined. Add custom colors if desired by defining the color's hexadecimal code. Print the dictionary for the data element number "60051". Validate there are background colors already defined. Add custom colors if desired by defining the color's hexadecimal code. Print the dictionary for the data element number "60052". Validate there are background colors already defined. Add custom colors if desired by defining the color's hexadecimal code. Steps Open the "Registry Settings" form. Search for the registry setting "Use Site or Service Based Appointment Color Coding". Set the registry setting value to "2". Submit the form. Open the "Service Codes" form. Add a new service code for the "Client/Staff Appointment Color". Fill out all required fields. Set the "Client/Staff Appointment Color" to the desired background/text color combination. Click "File Service Code". Add a new service code for the "Staff-Only Appointment Color". Fill out all required fields. Set the "Staff-Only Appointment Color" to the desired background/text color combination. Click "File Service Code". Add a new service code for the "Group Appointment Color". Fill out all required fields. Set the "Group Appointment Color" to the desired background/text color combination. Click "File Service Code". Open the "Service Codes" form. Validate all 3 new service codes just entered display as previously stored. Open the "Scheduling Calendar". Create a staff/client appointment using the service code added for Client/Staff Appointment. Validate the colors of the appointment's background and text match what was selected for this appointment type. Validate the appointment type edge indicator is appropriate for this type of appointment. Create a staff only appointment using the service code added for Staff Only Appointment. Validate the colors of the appointment's background and text match what was selected for this appointment type. Validate the appointment type edge indicator is appropriate for this type of appointment. Create a group appointment using the service code added for group appointment. Validate the colors of the appointment's background and text match what was selected for this appointment type. Validate the appointment type edge indicator is appropriate for this type of appointment. Scenario 3: Site Registration - Color Coding Specific Setup: Using the "Dictionary Update" form from the PM menu: Navigate to the "Print Dictionary" section: Select the "Other Tabled Files" from the "File" dropdown. Print the dictionary for the data element number "60050". Validate there are background colors already defined. Add custom colors if desired by defining the color's hexadecimal code. Print the dictionary for the data element number "60051". Validate there are background colors already defined. Add custom colors if desired by defining the color's hexadecimal code. Print the dictionary for the data element number "60052". Validate there are background colors already defined. Add custom colors if desired by defining the color's hexadecimal code. Steps Open the "Site Registration" form: Add a new site. Populate all required fields. Click "Add Site Hours of Operation". Enter hours of operation for each day. Click "Site Holidays". Enter days the site isn't open for appointments. Validate the "Client/Staff Appointment Color" dropdown exists on the form. Validate the "Staff-Only Appointment Color" dropdown exists on the form. Validate the "Group Appointment Color" dropdown exists on the form. Select a background/text color combination in the "Client/Staff Appointment Color" dropdown. Select a background/text color combination in the "Staff-Only Appointment Color" dropdown. Select a background/text color combination in the "Group Appointment Color" dropdown. Submit the form. Open the "Site Registration" form: Edit the site that was just added. Validate the background/text color combination in the "Client/Staff Appointment Color" dropdown reflects what was entered. Validate background/text color combination in the "Staff-Only Appointment Color" dropdown reflects what was entered. Open the "Scheduling Calendar". Schedule a client/staff appointment. Validate the background/text color coding matches what was established in the "Site Registration" form for the site. Validate the appointment type edge indicator is appropriate for this type of appointment. Schedule a staff only appointment. Validate the background/text color coding matches what was established in the "Site Registration" form for the site. Validate the appointment type edge indicator is appropriate for this type of appointment. Schedule a group appointment. Validate the background/text color coding matches what was established in the "Site Registration" form for the site. Validate the appointment type edge indicator is appropriate for this type of appointment.	Topics • Registry Settings • Service Codes • Site Registration • NX
Update 84 Summary \| Details Avatar Cal-PM '274 - Provider Directory Definition' Fhir Support Scenario 1: Avatar Cal-PM 'Dictionary Update' - Verification of '274 - Provider Directory Definition' Extended Dictionary Elements Steps Open Avatar Cal-PM 'Dictionary Update' form. Navigate to 'Input Dictionary Code(s)' section of form. Select 'Client' file/indirect. Select Data Element/Dictionary '(10029) Language Code (ISO 639-3)'. Enter/select existing value for Dictionary Code/Value; ensure Extended Dictionary Data Element '(274195) Fhir Language Code' is available for assignment/selection. Note - Default 'Fhir Language Code' Extended Dictionary values will be assigned to existing 'Language Code (ISO 639-3)' Dictionary Codes/Values where applicable to Fhir Provider Directory API support in conjunction with Avatar CareFabric. Select 'Other Tables Files' file/indirect. Select Data Element/Dictionary '(274113) Facility Type (2100DA-N2-01)'. Enter/select value for Dictionary Code/Value; ensure Extended Dictionary Data Element '(274193) Fhir Location Role Type' is available for assignment/selection. Note - Default 'Fhir Location Role Type' Extended Dictionary values will be assigned to existing 'Facility Type (2100DA-N2-01)' Dictionary Codes/Values where applicable to Fhir Provider Directory API support in conjunction with Avatar CareFabric. Select Data Element/Dictionary '(274190) Office Hours Code'. Enter/select value for Dictionary Code/Value; ensure Extended Dictionary Data Element '(274194) Fhir Office Hours Code' is available for assignment/selection. Note - Default 'Fhir Office Hours Code' Extended Dictionary values will be assigned to existing 'Office Hours Code' Dictionary Codes/Values where applicable to Fhir Provider Directory API support in conjunction with Avatar CareFabric. Select Data Element/Dictionary '(274248) Language Proficiency Indicator - 1 (2100EA-LUI-05)'. Enter/select value for Dictionary Code/Value; ensure Extended Dictionary Data Element '(274196) Fhir Language Proficiency Code' is available for assignment/selection. Note - Default 'Fhir Language Proficiency Code' Extended Dictionary values will be assigned to existing 'Language Proficiency Indicator - 1 (2100EA-LUI-05)' Dictionary Codes/Values where applicable to Fhir Provider Directory API support in conjunction with Avatar CareFabric. Select Data Element/Dictionary '(274246) English Proficiency Indicator (2100EA-LUI-05)'. Enter/select value for Dictionary Code/Value; ensure Extended Dictionary Data Element '(274196) Fhir Language Proficiency Code' is available for assignment/selection. Note - Default 'Fhir Language Proficiency Code' Extended Dictionary values will be assigned to existing 'English Proficiency Indicator (2100EA-LUI-05)' Dictionary Codes/Values where applicable to Fhir Provider Directory API support in conjunction with Avatar CareFabric. Select Data Element/Dictionary '(274224) Service Type (2100EA-N2-02)'. Enter/select value for Dictionary Code/Value; ensure the following Extended Dictionary Data Elements are available for assignment/selection: '(274290) Fhir Healthcare Service Category' '(274291) Fhir Healthcare Service Type' '(274292) Fhir Appointment Required' '(274293) Fhir Delivery Methods and Modalities' Note - Default values will not be defined for these Extended Dictionary Data Elements for existing 'Service Type' Dictionary Codes/Values. 274 Provider Functionality Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: File Import 274 - Provider Directory Definition 274 - Provider Directory Defaults 274 - Provider Directory Submission Scenario 1: File Import – 274 Provider Definition Specific Setup: Note the value of the following registry setting for use in creating the file import item: Avatar PM->System Maintenance->File Import->->->Import File Delimiter. The ‘File Import’ spreadsheet has been included in the update zip file. Note: In addition to fields that are required in the spreadsheet, individual agencies may require fields through 'TABLE27400 (274 = Provider Directory Definition) Provider Definition’ in 'Site Specific Section Modeling’. Verify if the agency is requiring additional fields. A ‘274 Provider Definition’ file has been created, with the correct delimiter, according to the ‘File Import’ spreadsheet guidelines, and agency required fields. Note the location of the file. Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’. Steps Open ‘File Import’. Select ‘274 Provider Definition’ in ‘File Type’. The ‘Action’ field is required and defaults to ‘Upload New File’. Click [Process Action]. Navigate to the location of the file in the file explorer and select the file. Click [Open]. Select ‘Compile/Validate File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A message will be received stating that the file compiled or that there were errors. Click [OK]. If there are errors, select ‘Print Errors’ in action. Select the file in ‘Files’. Click [Process Action]. Review the error report and update the file to correct the error. Select ‘Delete File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A ‘Delete File’ message is received stating: Are you sure? Click [Yes]. An ‘Information’ message is received stating: Deleted. Click [OK]. Select ‘Upload New File’ in ‘Action’. Click [Process Action]. Navigate to the location of the file in the file explorer and select the file. Click [Open]. Select ‘Compile/Validate File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A message will be received stating that the file compiled or that there were errors. Click [OK]. If the file compiled, select ‘Print File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. Validate the data in the report. Close the report. Select ‘Post File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. The ‘Information’ message will contain: Posted. Click [OK]. Open ‘274 – Provider Directory Definition’. Select the 'Provider Definition’. Select the ‘Provider’ that was imported. Note the value in the parenthesis. This is the ‘Practitioner/Provider ID'. Validate the data. Close the form. If desired, edit the ‘274 Provider Definition’ file, giving it a new name. At a minimum add the 'Provider Group ID’ to position two and edit one item. Select ‘Upload New File’ in ‘Action’. Click [Process Action]. Navigate to the location of the edited file in the file explorer and select the file. Click [Open]. Select ‘Compile/Validate File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. Click [OK] on the ‘Compiled’ message. Select ‘Print File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. Validate the data in the report. Close the report. Select ‘Post File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. An ‘Information’ message is received stating: Posted. Click [OK]. If desired, select ‘Delete File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A ‘Delete File’ message is received stating: Are you sure? Click [No]. Validate that the message closed. Click [Process Action]. A ‘Delete File’ message is received stating: Are you sure? Click [Yes]. An ‘Information’ message is received stating: Deleted. Click [OK]. Open ‘274 – Provider Directory Definition’. Select the 'Provider Definition’. Select the ‘Provider’ that was edited. Validate the edited data. Close the form. Scenario 2: File Import – 274 Site Definition Specific Setup: Note the value of the following registry setting for use in creating the file import item: Avatar PM->System Maintenance->File Import->->->Import File Delimiter. The ‘File Import’ spreadsheet has been included in the update zip file. Note: In addition to fields that are required in the spreadsheet, individual agencies may require fields through 'TABLE27400 (274 = Provider Directory Definition) Site Definition’ in 'Site Specific Section Modeling’. Verify if the agency is requiring additional fields. A ‘274 Site Definition’ file has been created, with the correct delimiter, according to the ‘File Import’ spreadsheet guidelines, and agency required fields. Note the location of the file. Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’. Steps Open ‘File Import’. Select ‘274 Site Definition’ in ‘File Type’. The ‘Action’ field is required and defaults to ‘Upload New File’. Click [Process Action]. Navigate to the location of the file in the file explorer and select the file. Click [Open]. Select ‘Compile/Validate File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A message will be received stating that the file compiled or that there were errors. Click [OK]. If there are errors, select ‘Print Errors’ in action. Select the file in ‘Files’. Click [Process Action]. Review the error report and update the file to correct the error. Select ‘Delete File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A ‘Delete File’ message is received stating: Are you sure? Click [Yes]. An ‘Information’ message is received stating: Deleted. Click [OK]. Select ‘Upload New File’ in ‘Action’. Click [Process Action]. Navigate to the location of the file in the file explorer and select the file. Click [Open]. Select ‘Compile/Validate File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A message will be received stating that the file compiled or that there were errors. Click [OK]. If the file compiled, select ‘Print File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. Validate the data in the report. Close the report. Select ‘Post File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. The ‘Information’ message will contain: Posted. Click [OK]. Click [X]. Open ‘274 – Provider Directory Definition’. Select the 'Site Definition' section. Select ‘Edit’ in ‘Add or Edit Site’. Select the ‘Site Definition’ that was imported. Note the ‘Site Definition’ value in the parenthesis. This is the ‘Site ID’. Validate the data. Close the form. If desired, edit the ‘274 Site Definition’ file, giving it a new name. At a minimum add the 'Site ID’ to position two and edit one item. Select ‘Upload New File’ in ‘Action’. Click [Process Action]. Navigate to the location of the edited file in the file explorer and select the file. Click [Open]. Select ‘Compile/Validate File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. Click [OK] on the ‘Compiled’ message. Select ‘Print File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. Validate the data in the report. Close the report. Select ‘Post File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. An ‘Information’ message is received stating: Posted. Click [OK]. If desired, select ‘Delete File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A ‘Delete File’ message is received stating: Are you sure? Click [No]. Validate that the message closed. Click [Process Action]. A ‘Delete File’ message is received stating: Are you sure? Click [Yes]. An ‘Information’ message is received stating: Deleted. Click [OK]. Click [X]. Open ‘274 – Provider Directory Definition’. Select the 'Site Definition' section. Select ‘Edit’ in ‘Add or Edit Site’. Select the ‘Site Definition’ that was edited. Validate the edited data. Close the form. Scenario 3: 274 - Provider Directory Defaults Specific Setup: Tester has been given access to the ‘274 - Provider Directory Defaults’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’. Steps Open '274 - Provider Directory Defaults'. Validate that 'Plan Type' is the only required field. Select 'Mental Health Plan' in 'Plan Type'. Validate that 'Healthcare Plan Code' is now required. Add data to the form. Click [Submit]. Open '274 - Provider Directory Defaults'. Validate that 'Plan Type' is the only required field. Select 'Mental Health Plan' in 'Plan Type'. Validate that the submitted data displays correctly. Edit at least on field, noting the edited value. Click [Submit]. Open '274 - Provider Directory Defaults'. Validate that 'Plan Type' is the only required field. Select 'Mental Health Plan' in 'Plan Type'. Validate that the edited data displays correctly. Close the form. Repeat steps 1 - 17 for the 'Plan Type' of 'Drug Medi-Cal Organized Delivery System. Scenario 4: 274 - Provider Directory Submission - form validation Specific Setup: An output directory has been defined in ‘Facility Defaults’ field ‘Output Path On Server For State Reporting Files’. The '274 Provider Directory Definition form has been used to create groups, sites, and providers for Plan Types of 'Mental Health Plan' and 'Drug Med-Cal Organized Delivery System'. Steps Open ‘274 - Provider Directory Submission’. Validate that the ‘Plan Type' field is required. Select 'Mental Health Plan' in 'Plan Type'. Select ‘Compile File’ in ‘Options’. Enter the desired value in ‘Reporting Period (MM/YY)’. Enter the desired value in ‘File Description’. Click [Process File]. The ‘Health Care Provider Directory’ report will open. The report can contain the following links: ‘274 Submission’, ‘Required Data Missing/Invalid - Directory Defaults’, ‘Required Data Missing/Invalid - Group’, ‘Required Data Missing/Invalid – Site’, ‘‘Required Data Missing/Invalid – Provider’, and ‘‘Required Data Missing/Invalid – Other’. Click on the link for any ‘Required Data Missing/Invalid’ links and review the data in the sub report. Correct the data as desired. Click on the link for ‘274 Submission’ and review the data in the report. Providers will not display for the sites in which they are inactive. Close the report. Select ‘Dump File’ in ‘Options’. Validate that ‘Select File’ in now required. Select the file compiled above in ‘Select File’. Click [Process File]. The ‘Health Care Provider Directory’ report will open and display the data that will be included in the dump file. Close the report. Select ‘Create File On Server For Submission’ in ‘Options’. Select the file compiled above in ‘Select File’. Click [Process File]. The ‘Create File’ item is received with the message ‘Process Completed’. Click [OK]. Select ‘Run Report’ Select ‘Create File On Server For Submission’ in ‘Options’. Select the file compiled above in ‘Select File’. Click [Process File]. The ‘Health Care Provider Directory’ report will open and contain the same links the previously opened. Close the report. ‘Options’ contains ‘Delete File’. If deleting a file is desired, select ‘Delete File’. Select the file compiled above in ‘Select File’. Click [Process File]. Close the form. Repeat steps 1 - 31 for the 'Plan Type' of 'Drug Med-Cal Organized Delivery System'. Scenario 5: 274 - Provider Directory Definition - Site Definition Specific Setup: Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’. A 'Group Definition' exists in the '274 - Provider Directory Definition’ form. Steps Open ‘274 - Provider Directory Definition’. Select the 'Site Definition’ section. Validate that ‘Plan Type’ is the only required field on the form. Select 'Mental Health Plan' in ' ‘Plan Type’. Validate that ‘Add or Edit Site’ is now required. Select ‘Add’ in ‘Add or Edit Site’. Validate that ‘Site or Location of Service Name (2100A-NM1-03)', ‘Provider Group’ and ‘Active’ are now required fields. Add desired data to the form. Click [File Site Details]. Click [OK]. Select 'Mental Health Plan' in ' ‘Plan Type’. Select ‘Edit’ in ‘Add or Edit Site’. Select the filed Site and validate that the data displays correctly. Edit at least one field, noting the edited value. Click [File Site Details]. Click [OK]. Select 'Mental Health Plan' in ' ‘Plan Type’. Select ‘Edit’ in ‘Add or Edit Site’. Select the filed Site and validate that the edited data displays correctly. Repeat steps 1 - 19 for Plan Type' of 'Drug Medi-Cal Organized Delivery System'. Close the form. Scenario 6: 274 - Provider Directory Definition - Provider Definition Specific Setup: Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’. 274 Provider Directory Definition: A minimum of one 'Group Definition' exists. A minimum of one 'Site Definition' exists. Steps Open ‘274 - Provider Directory Definition’. Validate that the form opened to the ‘Group Definition’ section. Select the ‘Provider Definition’ section. Validate that ‘Plan Type’ is the only required field on the form. Select 'Mental Health Plan' in 'Plan Type'. Validate that 'Provider' is now required. Select a ‘Provider’. Validate that ‘Associated Site’ and ‘Active’ are now required fields. Select the ‘Associated Site’. Select a value in ‘Active’. Add desired data to the form. Click [File Provider Details]. Click [OK]. Select 'Mental Health Plan' in 'Plan Type'. Select the same provider and site. Validate that the submitted date displays correctly. Edit at least one field, noting the value. Click [File Provider Details]. Click [OK]. Select 'Mental Health Plan' in 'Plan Type'. Select the same provider and site. Validate that the edited data displays. Select a new value in ‘Associated Site’. Validate that a ‘Provider-Site Records On File’ item displays the message ‘Record to default Information From’ and contains a drop down list of ‘Sites’. Select a site and click [OK]. Validate that the data defaulted into the fields. Click [File Provider Details]. Click [OK]. Select 'Drug Medi-Cal Organized Delivery System' in 'Plan Type'. Select the same provider and validate that the 'Currently Associated Sites' field is blank. Repeat steps 9 - 22 for the 'Plan Type' of 'Drug Medi-Cal Organized Delivery System'. Close the form. Scenario 7: File Import – 274 Group Definition Specific Setup: Note the value of the following registry setting for use in creating the file import item: Avatar PM->System Maintenance->File Import->->->Import File Delimiter. The ‘File Import’ spreadsheet has been included in the update zip file. Note: In addition to fields that are required in the spreadsheet, individual agencies may require fields through 'TABLE27400 (274 = Provider Directory Definition) Group Definition’ in 'Site Specific Section Modeling’. Verify if the agency is requiring additional fields. A ‘274 Group Definition’ file has been created, with the correct delimiter, according to the ‘File Import’ spreadsheet guidelines, and agency required fields. Note the location of the file. Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’. Steps Open ‘File Import’. Select ‘274 Group Definition’ in ‘File Type’. The ‘Action’ field is required and defaults to ‘Upload New File’. Click [Process Action]. Navigate to the location of the file in the file explorer and select the file. Click [Open]. Select ‘Compile/Validate File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A message will be received stating that the file compiled or that there were errors. Click [OK]. If there are errors, select ‘Print Errors’ in action. Select the file in ‘Files’. Click [Process Action]. Review the error report and update the file to correct the error. Select ‘Delete File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A ‘Delete File’ message is received stating: Are you sure? Click [Yes]. An ‘Information’ message is received stating: Deleted. Click [OK]. Select ‘Upload New File’ in ‘Action’. Click [Process Action]. Navigate to the location of the file in the file explorer and select the file. Click [Open]. Select ‘Compile/Validate File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A message will be received stating that the file compiled or that there were errors. Click [OK]. If the file compiled, select ‘Print File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. Validate the data in the report. Close the report. Select ‘Post File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. The ‘Information’ message will contain: Posted. Click [OK]. Open ‘274 – Provider Directory Definition’. Select ‘Edit’ in ‘Add or Edit Group’. Select the ‘Provider Group’ that was imported. Note the ‘Provider Group’ value in the parenthesis. This is the ‘Provider Group ID’. Validate the data. Close the form. If desired, edit the ‘274 Group Definition’ file, giving it a new name. At a minimum add the 'Provider Group ID’ to position two and edit one item. Select ‘Upload New File’ in ‘Action’. Click [Process Action]. Navigate to the location of the edited file in the file explorer and select the file. Click [Open]. Select ‘Compile/Validate File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. Click [OK] on the ‘Compiled’ message. Select ‘Print File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. Validate the data in the report. Close the report. Select ‘Post File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. An ‘Information’ message is received stating: Posted. Click [OK]. If desired, select ‘Delete File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A ‘Delete File’ message is received stating: Are you sure? Click [No]. Validate that the message closed. Click [Process Action]. A ‘Delete File’ message is received stating: Are you sure? Click [Yes]. An ‘Information’ message is received stating: Deleted. Click [OK]. Open ‘274 – Provider Directory Definition’. Select ‘Edit’ in ‘Add or Edit Group’. Select the ‘Provider Group’ that was edited. Validate the edited data. Close the form. Scenario 8: 274 - Provider Directory Definition - Group Definition Specific Setup: Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’. Steps Open ‘274 - Provider Directory Definition’. Validate that the form opened to the ‘Group Definition’ section. Validate that ‘Plan Type' is the only required field on the form. Select 'Mental Health Plan' in 'Plan Type'. Validate that ‘Add or Edit Group’ is now required. Select ‘Add’ in ‘Add or Edit Group’. Validate that ‘Active’ and ‘Provider Group Name (2100CA-NM1-03)’ are now required fields. Add desired data to the form, noting the value in 'Provider Group'. Click [File Group Details]. Click [OK]. Select 'Drug Medi-Cal Organized Delivery System' in 'Plan Type'. Select ‘Edit’ in ‘Add or Edit Group’. Set 'Provider Group' to the value noted above. Verify that no search results are returned. Select 'Mental Health Plan' in 'Plan Type'. Select ‘Edit’ in ‘Add or Edit Group’. Set 'Provider Group' to the value noted above. Select the search result for the 'Provider Group' added above. Review the data and edit at least one field, noting the edited value(s). Click [File Group Details]. Click [OK]. Select 'Mental Health Plan' in 'Plan Type'. Select ‘Edit’ in ‘Add or Edit Group’. Set 'Provider Group' to the value noted above. Select the search result for the 'Provider Group' added above. Review the edited field(s) and validate that the edited data was retained. Repeat steps 1 - 26 for 'Plan Type' of 'Drug Medi-Cal Organized Delivery System'. Close the form. 274 - Provider Directory Submission Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: File Import 274 - Provider Directory Definition 274 - Provider Directory Defaults 274 - Provider Directory Submission Scenario 1: File Import – 274 Provider Definition Specific Setup: Note the value of the following registry setting for use in creating the file import item: Avatar PM->System Maintenance->File Import->->->Import File Delimiter. The ‘File Import’ spreadsheet has been included in the update zip file. Note: In addition to fields that are required in the spreadsheet, individual agencies may require fields through 'TABLE27400 (274 = Provider Directory Definition) Provider Definition’ in 'Site Specific Section Modeling’. Verify if the agency is requiring additional fields. A ‘274 Provider Definition’ file has been created, with the correct delimiter, according to the ‘File Import’ spreadsheet guidelines, and agency required fields. Note the location of the file. Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’. Steps Open ‘File Import’. Select ‘274 Provider Definition’ in ‘File Type’. The ‘Action’ field is required and defaults to ‘Upload New File’. Click [Process Action]. Navigate to the location of the file in the file explorer and select the file. Click [Open]. Select ‘Compile/Validate File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A message will be received stating that the file compiled or that there were errors. Click [OK]. If there are errors, select ‘Print Errors’ in action. Select the file in ‘Files’. Click [Process Action]. Review the error report and update the file to correct the error. Select ‘Delete File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A ‘Delete File’ message is received stating: Are you sure? Click [Yes]. An ‘Information’ message is received stating: Deleted. Click [OK]. Select ‘Upload New File’ in ‘Action’. Click [Process Action]. Navigate to the location of the file in the file explorer and select the file. Click [Open]. Select ‘Compile/Validate File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A message will be received stating that the file compiled or that there were errors. Click [OK]. If the file compiled, select ‘Print File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. Validate the data in the report. Close the report. Select ‘Post File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. The ‘Information’ message will contain: Posted. Click [OK]. Open ‘274 – Provider Directory Definition’. Select the 'Provider Definition’. Select the ‘Provider’ that was imported. Note the value in the parenthesis. This is the ‘Practitioner/Provider ID'. Validate the data. Close the form. If desired, edit the ‘274 Provider Definition’ file, giving it a new name. At a minimum add the 'Provider Group ID’ to position two and edit one item. Select ‘Upload New File’ in ‘Action’. Click [Process Action]. Navigate to the location of the edited file in the file explorer and select the file. Click [Open]. Select ‘Compile/Validate File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. Click [OK] on the ‘Compiled’ message. Select ‘Print File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. Validate the data in the report. Close the report. Select ‘Post File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. An ‘Information’ message is received stating: Posted. Click [OK]. If desired, select ‘Delete File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A ‘Delete File’ message is received stating: Are you sure? Click [No]. Validate that the message closed. Click [Process Action]. A ‘Delete File’ message is received stating: Are you sure? Click [Yes]. An ‘Information’ message is received stating: Deleted. Click [OK]. Open ‘274 – Provider Directory Definition’. Select the 'Provider Definition’. Select the ‘Provider’ that was edited. Validate the edited data. Close the form. Scenario 2: File Import – 274 Site Definition Specific Setup: Note the value of the following registry setting for use in creating the file import item: Avatar PM->System Maintenance->File Import->->->Import File Delimiter. The ‘File Import’ spreadsheet has been included in the update zip file. Note: In addition to fields that are required in the spreadsheet, individual agencies may require fields through 'TABLE27400 (274 = Provider Directory Definition) Site Definition’ in 'Site Specific Section Modeling’. Verify if the agency is requiring additional fields. A ‘274 Site Definition’ file has been created, with the correct delimiter, according to the ‘File Import’ spreadsheet guidelines, and agency required fields. Note the location of the file. Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’. Steps Open ‘File Import’. Select ‘274 Site Definition’ in ‘File Type’. The ‘Action’ field is required and defaults to ‘Upload New File’. Click [Process Action]. Navigate to the location of the file in the file explorer and select the file. Click [Open]. Select ‘Compile/Validate File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A message will be received stating that the file compiled or that there were errors. Click [OK]. If there are errors, select ‘Print Errors’ in action. Select the file in ‘Files’. Click [Process Action]. Review the error report and update the file to correct the error. Select ‘Delete File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A ‘Delete File’ message is received stating: Are you sure? Click [Yes]. An ‘Information’ message is received stating: Deleted. Click [OK]. Select ‘Upload New File’ in ‘Action’. Click [Process Action]. Navigate to the location of the file in the file explorer and select the file. Click [Open]. Select ‘Compile/Validate File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A message will be received stating that the file compiled or that there were errors. Click [OK]. If the file compiled, select ‘Print File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. Validate the data in the report. Close the report. Select ‘Post File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. The ‘Information’ message will contain: Posted. Click [OK]. Click [X]. Open ‘274 – Provider Directory Definition’. Select the 'Site Definition' section. Select ‘Edit’ in ‘Add or Edit Site’. Select the ‘Site Definition’ that was imported. Note the ‘Site Definition’ value in the parenthesis. This is the ‘Site ID’. Validate the data. Close the form. If desired, edit the ‘274 Site Definition’ file, giving it a new name. At a minimum add the 'Site ID’ to position two and edit one item. Select ‘Upload New File’ in ‘Action’. Click [Process Action]. Navigate to the location of the edited file in the file explorer and select the file. Click [Open]. Select ‘Compile/Validate File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. Click [OK] on the ‘Compiled’ message. Select ‘Print File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. Validate the data in the report. Close the report. Select ‘Post File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. An ‘Information’ message is received stating: Posted. Click [OK]. If desired, select ‘Delete File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A ‘Delete File’ message is received stating: Are you sure? Click [No]. Validate that the message closed. Click [Process Action]. A ‘Delete File’ message is received stating: Are you sure? Click [Yes]. An ‘Information’ message is received stating: Deleted. Click [OK]. Click [X]. Open ‘274 – Provider Directory Definition’. Select the 'Site Definition' section. Select ‘Edit’ in ‘Add or Edit Site’. Select the ‘Site Definition’ that was edited. Validate the edited data. Close the form. Scenario 3: 274 - Provider Directory Defaults Specific Setup: Tester has been given access to the ‘274 - Provider Directory Defaults’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’. Steps Open '274 - Provider Directory Defaults'. Validate that 'Plan Type' is the only required field. Select 'Mental Health Plan' in 'Plan Type'. Validate that 'Healthcare Plan Code' is now required. Add data to the form. Click [Submit]. Open '274 - Provider Directory Defaults'. Validate that 'Plan Type' is the only required field. Select 'Mental Health Plan' in 'Plan Type'. Validate that the submitted data displays correctly. Edit at least on field, noting the edited value. Click [Submit]. Open '274 - Provider Directory Defaults'. Validate that 'Plan Type' is the only required field. Select 'Mental Health Plan' in 'Plan Type'. Validate that the edited data displays correctly. Close the form. Repeat steps 1 - 17 for the 'Plan Type' of 'Drug Medi-Cal Organized Delivery System. Scenario 4: 274 - Provider Directory Submission - form validation Specific Setup: An output directory has been defined in ‘Facility Defaults’ field ‘Output Path On Server For State Reporting Files’. The '274 Provider Directory Definition form has been used to create groups, sites, and providers for Plan Types of 'Mental Health Plan' and 'Drug Med-Cal Organized Delivery System'. Steps Open ‘274 - Provider Directory Submission’. Validate that the ‘Plan Type' field is required. Select 'Mental Health Plan' in 'Plan Type'. Select ‘Compile File’ in ‘Options’. Enter the desired value in ‘Reporting Period (MM/YY)’. Enter the desired value in ‘File Description’. Click [Process File]. The ‘Health Care Provider Directory’ report will open. The report can contain the following links: ‘274 Submission’, ‘Required Data Missing/Invalid - Directory Defaults’, ‘Required Data Missing/Invalid - Group’, ‘Required Data Missing/Invalid – Site’, ‘‘Required Data Missing/Invalid – Provider’, and ‘‘Required Data Missing/Invalid – Other’. Click on the link for any ‘Required Data Missing/Invalid’ links and review the data in the sub report. Correct the data as desired. Click on the link for ‘274 Submission’ and review the data in the report. Providers will not display for the sites in which they are inactive. Close the report. Select ‘Dump File’ in ‘Options’. Validate that ‘Select File’ in now required. Select the file compiled above in ‘Select File’. Click [Process File]. The ‘Health Care Provider Directory’ report will open and display the data that will be included in the dump file. Close the report. Select ‘Create File On Server For Submission’ in ‘Options’. Select the file compiled above in ‘Select File’. Click [Process File]. The ‘Create File’ item is received with the message ‘Process Completed’. Click [OK]. Select ‘Run Report’ Select ‘Create File On Server For Submission’ in ‘Options’. Select the file compiled above in ‘Select File’. Click [Process File]. The ‘Health Care Provider Directory’ report will open and contain the same links the previously opened. Close the report. ‘Options’ contains ‘Delete File’. If deleting a file is desired, select ‘Delete File’. Select the file compiled above in ‘Select File’. Click [Process File]. Close the form. Repeat steps 1 - 31 for the 'Plan Type' of 'Drug Med-Cal Organized Delivery System'. Scenario 5: 274 - Provider Directory Definition - Site Definition Specific Setup: Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’. A 'Group Definition' exists in the '274 - Provider Directory Definition’ form. Steps Open ‘274 - Provider Directory Definition’. Select the 'Site Definition’ section. Validate that ‘Plan Type’ is the only required field on the form. Select 'Mental Health Plan' in ' ‘Plan Type’. Validate that ‘Add or Edit Site’ is now required. Select ‘Add’ in ‘Add or Edit Site’. Validate that ‘Site or Location of Service Name (2100A-NM1-03)', ‘Provider Group’ and ‘Active’ are now required fields. Add desired data to the form. Click [File Site Details]. Click [OK]. Select 'Mental Health Plan' in ' ‘Plan Type’. Select ‘Edit’ in ‘Add or Edit Site’. Select the filed Site and validate that the data displays correctly. Edit at least one field, noting the edited value. Click [File Site Details]. Click [OK]. Select 'Mental Health Plan' in ' ‘Plan Type’. Select ‘Edit’ in ‘Add or Edit Site’. Select the filed Site and validate that the edited data displays correctly. Repeat steps 1 - 19 for Plan Type' of 'Drug Medi-Cal Organized Delivery System'. Close the form. Scenario 6: 274 - Provider Directory Definition - Provider Definition Specific Setup: Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’. 274 Provider Directory Definition: A minimum of one 'Group Definition' exists. A minimum of one 'Site Definition' exists. Steps Open ‘274 - Provider Directory Definition’. Validate that the form opened to the ‘Group Definition’ section. Select the ‘Provider Definition’ section. Validate that ‘Plan Type’ is the only required field on the form. Select 'Mental Health Plan' in 'Plan Type'. Validate that 'Provider' is now required. Select a ‘Provider’. Validate that ‘Associated Site’ and ‘Active’ are now required fields. Select the ‘Associated Site’. Select a value in ‘Active’. Add desired data to the form. Click [File Provider Details]. Click [OK]. Select 'Mental Health Plan' in 'Plan Type'. Select the same provider and site. Validate that the submitted date displays correctly. Edit at least one field, noting the value. Click [File Provider Details]. Click [OK]. Select 'Mental Health Plan' in 'Plan Type'. Select the same provider and site. Validate that the edited data displays. Select a new value in ‘Associated Site’. Validate that a ‘Provider-Site Records On File’ item displays the message ‘Record to default Information From’ and contains a drop down list of ‘Sites’. Select a site and click [OK]. Validate that the data defaulted into the fields. Click [File Provider Details]. Click [OK]. Select 'Drug Medi-Cal Organized Delivery System' in 'Plan Type'. Select the same provider and validate that the 'Currently Associated Sites' field is blank. Repeat steps 9 - 22 for the 'Plan Type' of 'Drug Medi-Cal Organized Delivery System'. Close the form. Scenario 7: File Import – 274 Group Definition Specific Setup: Note the value of the following registry setting for use in creating the file import item: Avatar PM->System Maintenance->File Import->->->Import File Delimiter. The ‘File Import’ spreadsheet has been included in the update zip file. Note: In addition to fields that are required in the spreadsheet, individual agencies may require fields through 'TABLE27400 (274 = Provider Directory Definition) Group Definition’ in 'Site Specific Section Modeling’. Verify if the agency is requiring additional fields. A ‘274 Group Definition’ file has been created, with the correct delimiter, according to the ‘File Import’ spreadsheet guidelines, and agency required fields. Note the location of the file. Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’. Steps Open ‘File Import’. Select ‘274 Group Definition’ in ‘File Type’. The ‘Action’ field is required and defaults to ‘Upload New File’. Click [Process Action]. Navigate to the location of the file in the file explorer and select the file. Click [Open]. Select ‘Compile/Validate File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A message will be received stating that the file compiled or that there were errors. Click [OK]. If there are errors, select ‘Print Errors’ in action. Select the file in ‘Files’. Click [Process Action]. Review the error report and update the file to correct the error. Select ‘Delete File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A ‘Delete File’ message is received stating: Are you sure? Click [Yes]. An ‘Information’ message is received stating: Deleted. Click [OK]. Select ‘Upload New File’ in ‘Action’. Click [Process Action]. Navigate to the location of the file in the file explorer and select the file. Click [Open]. Select ‘Compile/Validate File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A message will be received stating that the file compiled or that there were errors. Click [OK]. If the file compiled, select ‘Print File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. Validate the data in the report. Close the report. Select ‘Post File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. The ‘Information’ message will contain: Posted. Click [OK]. Open ‘274 – Provider Directory Definition’. Select ‘Edit’ in ‘Add or Edit Group’. Select the ‘Provider Group’ that was imported. Note the ‘Provider Group’ value in the parenthesis. This is the ‘Provider Group ID’. Validate the data. Close the form. If desired, edit the ‘274 Group Definition’ file, giving it a new name. At a minimum add the 'Provider Group ID’ to position two and edit one item. Select ‘Upload New File’ in ‘Action’. Click [Process Action]. Navigate to the location of the edited file in the file explorer and select the file. Click [Open]. Select ‘Compile/Validate File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. Click [OK] on the ‘Compiled’ message. Select ‘Print File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. Validate the data in the report. Close the report. Select ‘Post File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. An ‘Information’ message is received stating: Posted. Click [OK]. If desired, select ‘Delete File’ in ‘Action’. Select the file in ‘Files’. Click [Process Action]. A ‘Delete File’ message is received stating: Are you sure? Click [No]. Validate that the message closed. Click [Process Action]. A ‘Delete File’ message is received stating: Are you sure? Click [Yes]. An ‘Information’ message is received stating: Deleted. Click [OK]. Open ‘274 – Provider Directory Definition’. Select ‘Edit’ in ‘Add or Edit Group’. Select the ‘Provider Group’ that was edited. Validate the edited data. Close the form. Scenario 8: 274 - Provider Directory Definition - Group Definition Specific Setup: Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’. Steps Open ‘274 - Provider Directory Definition’. Validate that the form opened to the ‘Group Definition’ section. Validate that ‘Plan Type' is the only required field on the form. Select 'Mental Health Plan' in 'Plan Type'. Validate that ‘Add or Edit Group’ is now required. Select ‘Add’ in ‘Add or Edit Group’. Validate that ‘Active’ and ‘Provider Group Name (2100CA-NM1-03)’ are now required fields. Add desired data to the form, noting the value in 'Provider Group'. Click [File Group Details]. Click [OK]. Select 'Drug Medi-Cal Organized Delivery System' in 'Plan Type'. Select ‘Edit’ in ‘Add or Edit Group’. Set 'Provider Group' to the value noted above. Verify that no search results are returned. Select 'Mental Health Plan' in 'Plan Type'. Select ‘Edit’ in ‘Add or Edit Group’. Set 'Provider Group' to the value noted above. Select the search result for the 'Provider Group' added above. Review the data and edit at least one field, noting the edited value(s). Click [File Group Details]. Click [OK]. Select 'Mental Health Plan' in 'Plan Type'. Select ‘Edit’ in ‘Add or Edit Group’. Set 'Provider Group' to the value noted above. Select the search result for the 'Provider Group' added above. Review the edited field(s) and validate that the edited data was retained. Repeat steps 1 - 26 for 'Plan Type' of 'Drug Medi-Cal Organized Delivery System'. Close the form.	Topics • Dictionary • 274 - Provider Directory • File Import
Update 86 Summary \| Details Compile/Edit/Post/Unpost Roll-Up Services Worklist Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Compile/Edit/Post/Unpost Roll-Up Services Worklist Scenario 1: The Compile process in the “Compile/Edit/Post/Unpost Roll up Services Worklist” completes successfully. Specific Setup: Service Codes: Identify an existing service code or add a new service code that will be used as the roll-up service. Identify two existing service codes or add two service codes that will be used as the component services. Roll-Up Service Definition: Specify the roll-up service code and the component service code(s) you added/edited in the previous step. Select 'All Services Not Yet Rolled Up' for the 'Component Services Date Rules' field. Identify an existing client or admit a new client in an outpatient episode. A guarantor is assigned to the client. Client Charge Input: At least 2 component services are rendered to a client. Be sure the component service dates span at least two or three months. Make sure the two-component services are with different locations. Client Ledger: The component services are distributed correctly to the client. Steps Open the 'Compile/Edit/Post/Unpost Roll-Up Services Worklist' form. Select the through date which includes the service date. Select the [Compile Worklist] button. Verify that the work list compiles without any error. Verify that we get a success message saying, 'Compile Compile'. Select [Ok]. Click the [Run Report]. Verify the Roll-Up Services Worklist includes the correct services rendered within the chosen 'Through Date'. Verify that the report has details of both the RollUp service and the Component service(s) along with other related service data. Open the SQL Querying tool and validate that the "SYSTEM.rollup_services_worklist" data table can be accessed without any error(s). Validate that the rollup entries are stored and shown in the table. Observe that the entries are with that 'rollup_location_code' column value as blank. Close the SQL window. Scenario 2: Compile/Edit/Post/Unpost Roll-Up Services Worklist - Submitting without 'From Date' Specific Setup: Service Codes: Identify an existing service definition or add a new service definition that will be used as the roll-up service. Identify an existing service definition or add a new service definition that will be used as the component services. Roll-Up Service Definition: Specify the roll-up service code and the component service code(s) you added/edited in the previous step. Select 'All Services Not Yet Rolled Up' for the 'Component Services Date Rules' field. Identify an existing client or admit a new client in outpatient episode. A guarantor is assigned to the client. Client Charge Input: At least 2 component services are rendered to a client. Be sure the component service dates span at least two or three months. Client Ledger: The component services are distributed correctly to the client. Steps Access the 'Compile/Edit/Post/Unpost Roll-Up Services Worklist' form. Enter the current date in the 'Through Date' field. Click [Compile Worklist]. Validate that an 'Information' message is displayed that states: "Compile complete." Click [OK]. Click [Run Report]. Validate the 'Roll-Up Services Worklist' report is displayed. Validate that the correct client's name is displayed. Validate the contents of the Roll-Up are displayed. Close the report. Select "Post Roll-Up Services Worklist" Select the desired date 'Through Date' field. Select a desired value in the 'Write Off Posting Code' field. Click [Post Worklist]. Validate that a Post complete message is displayed. Click [OK] and close the form. Access the 'Client Ledger' form. Select "Client A" in the 'Client ID' field. Select "Episode" in the 'Claim/Episode/All Episodes' field. Select "Episode 1" in the 'Episode Number' field. Validate the 'From Date' field contains the admission date of the episode. Validate the 'To Date' field contains the last date of service that is included in the Client ledger. Select "Simple" in the 'Ledger Type' field. Click [Process]. Validate that the 'Client Ledger Report' is displayed. Validate that the 'Client Ledger Report' contains the desired client. Validate that the 'Client Ledger Report' contains the correct Roll-Up services. Validate that a 'Processing Report has Completed. Do You wish to Return to form?' message is displayed. Click [No].	Topics • Compile/Edit/Post/Unpost Roll-up Services Worklist
Update 87 Summary \| Details Alternative Service Location - Edit Service Information forms Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Edit Service Information (Charge Fee Access) Scenario 1: Edit Service Information Specific Setup: Registry Settings: Set the "Enable Alternative Service Location Fields" Registry setting to "Y". Client Data: An existing client is identified and guarantors are assigned to the client in the Financial Eligibility. Service: Services 1, 2, and 3 should be picked from existing or newly created and the Fee definitions should be defined for the service(s). Charges should be created for the Client with Services. Steps Open the 'Edit Service Information' form. Select the Client. Select the 'Service Start Date' and 'Service End Date'. Click the [Select Service(s) To Edit] button. Check the service-1 to edit. Click the [OK] button. Verify that the facility location fields are not required when none of them are valued. Verify that the field ‘Facility Location Code Identifier’ is a text field. Enter a value in any one of the 'Facility Location' Fields. Verify that the facility location fields on the 'Edit Service Information' form are set as required whenever any one of the fields is valued. Fill in all the Facility Location field values. Select [Submit]. Select [No] in the form return. Open the SQL Querying tool and validate that the filed Facility Location values for the service is stored with a unique 'JOIN_TO_TX_HISTORY' ID value in the below tables: "SYSTEM".billing_tx_address "SYSTEM".billing_claim_address "SYSTEM".billing_tx_history Close the SQL query window. Access the 'Edit Service Information' form. Select the Client. Select the 'Service Start Date' and 'Service End Date'. Click the [Select Service(s) To Edit] button. Check the service-2 to edit. Click the [OK] button. Fill in the Facility Location values exactly similar to the Service-1. Fill in all other required fields. Select [Submit]. Select [Yes]. Click the [Select Service(s) To Edit] button. Check the service-3 to edit. Click the [OK] button. Fill in the Facility Location values completely different from the Service-2. Fill in all other required fields. Select [Submit]. Select [Yes]. Click the [Select Service(s) To Edit] button. Check the service-1 and service-2 to edit. Click the [OK] button. Verify that the facility location information field values are populated and displayed in the form when the services selected for edit have the facility location information matching. Make any updates in the Facility location field(s). Select [Submit]. Select [Yes]. Click the [Select Service(s) To Edit] button. Check the service-1 to edit. Click the [OK] button. Verify that the newly updated location value is being shown. Open the SQL Querying tool and validate that the filed Facility Location values for the service are added with the new value(s) with a unique 'JOIN_TO_TX_HISTORY' ID values in the below tables: "SYSTEM".billing_tx_address "SYSTEM".billing_claim_address "SYSTEM".billing_tx_history Close the SQL query window. Return to the form. Select the [Select Service(s) To Edit] button. Select [Yes]. Check the service-2 and service-3 to edit. Click the [OK] button. Verify that the facility location information field values are not pulled in and displayed in the form when the services selected for edit have the facility location information not matching each other. Fill in the Facility location field(s). Select [Submit]. Select [Yes]. Check the service-2 and service-3 to edit. Click the [OK] button. Verify that the facility location information field values are populated and displayed in the form when the services selected for edit have the facility location information matching. Select [Discard]. Select [Yes]. Scenario 2: The 837 professional bill compiles successfully. Specific Setup: _{Client Data:} _{An existing outpatient client is identified and guarantors are assigned to the client in the Financial Eligibility.} _{Registry Settings:} _{Set the "Enable Alternative Service Location Fields" Registry setting to "Y".} _Service: _{Service should be picked from existing or newly created and the Fee definitions should be defined for the service(s).} _{Services are charged and the liability is distributed to the primary guarantor of the client.} _{Charges are Closed.} _{Charges should be created for the Client with Service.} _{The Facility Location field values are filed for the services using the 'Edit Service Information' for}m. Steps Open the 'Electronic Billing' form. Compile the 837 professional bill for the guarantor. Verify that the 837 professional bill will be compiled successfully. Verify that when billing services out via 837, the appropriate facility location information(s) are included in the 837 file. Scenario 3: Edit Service Information (Charge Fee Access) - Validation Specific Setup: Registry Settings: Set the "Enable Alternative Service Location Fields" Registry setting to "Y". Client Data: An existing client is identified, and guarantors are assigned to the client in the Financial Eligibility. Service: Services 1, 2, and 3 should be picked from existing or newly created and the Fee definitions should be defined for the service(s). Charges should be created for the Client with Services. Steps Open the 'Edit Service Information (Charge Fee Access)' form. Select the Client. Select the 'Service Start Date' and 'Service End Date'. Click the [Select Service(s) To Edit] button. Check the service-1 to edit. Click the [OK] button. Verify that the facility location fields are not required when none of them are valued. Verify that the field ‘Facility Location Code Identifier’ is a text field. Enter a value in any one of the 'Facility Location' Fields. Verify that the facility location fields on the 'Edit Service Information (Charge Fee Access)' form are set as required whenever any one of the fields is valued. Fill in all the Facility Location field values. Select [Submit]. Select [No] in the form return. Open the SQL Querying tool and validate that the filed Facility Location values for the service are stored with a unique 'JOIN_TO_TX_HISTORY' ID value in the below tables, "SYSTEM".billing_tx_address "SYSTEM".billing_claim_address "SYSTEM".billing_tx_history Close the SQL query window. Access the 'Edit Service Information' form. Select the Client. Select the 'Service Start Date' and 'Service End Date'. Click the [Select Service(s) To Edit] button. Check the service-2 to edit. Click the [OK] button. Fill in the Facility Location values exactly similar to the Service-1. Fill in all other required fields. Select [Submit]. Select [Yes]. Click the [Select Service(s) To Edit] button. Check the service-3 to edit. Click the [OK] button. Fill in the Facility Location values completely different from the Service-2. Fill in all other required fields. Select [Submit]. Select [Yes]. Click the [Select Service(s) To Edit] button. Check the service-1 and service-2 to edit. Click the [OK] button. Verify that the facility location information field values are populated and displayed in the form when the services selected for edit have the facility location information matching. Make any updates in the Facility location field(s). Select [Submit]. Select [Yes]. Click the [Select Service(s) To Edit] button. Check the service-1 to edit. Click the [OK] button. Verify that the newly updated location value is being shown. Open the SQL Querying tool and validate that the filed Facility Location values for the service are added with the new value(s) with unique 'JOIN_TO_TX_HISTORY' ID values in the below tables, "SYSTEM".billing_tx_address "SYSTEM".billing_claim_address "SYSTEM".billing_tx_history Close the SQL query window. Return to the form. Select the [Select Service(s) To Edit] button. Select [Yes]. Check the service-2 and service-3 to edit. Click the [OK] button. Verify that the facility location information field values are not pulled in and displayed in the form when the services selected for edit have the facility location information not matching each other. Fill in the Facility location field(s). Select [Submit]. Select [Yes]. Check the service-2 and service-3 to edit. Click the [OK] button. Verify that the facility location information field values are populated and displayed in the form when the services selected for edit have the facility location information matching. Select [Discard]. Select [Yes].	Topics • Edit Service Information • 837 Professional
Update 92 Summary \| Details Avatar MSO to Parent System Service Filing, Void/Replacement Claims Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Delete Service Scenario 1: 'Delete Service' - Verification of Charge Reversal Posting for Replacement/Void Claims Including Add-On Services Specific Setup: Avatar PM/Cal-PM Registry Setting 'Enable Multiple Add-On Code Per Primary Code Functionality' may optionally be enabled/disabled. 'File Services On Closing Of Batch Or Creation of EOB?' must be set to 'Yes' (via Avatar MSO 'MSO to Parent System Integration Mapping' form 'Service Filing' section) One or more 'Approved' status 'Void' and/or 'Replacement' claims for Avatar PM/Cal-PM services (with closed charges) originating in Avatar MSO where Primary and Add-On Service are present in original claim. Steps Open Avatar MSO 'Close Batch' form. Select Avatar MSO Claims Processing batch containing one or more 'Approved' status 'Replacement' claim for Primary and Add-On services eligible for filing to parent Avatar PM/Cal-PM system (where original service charges are closed in Avatar PM/Cal-PM): Note - Retro Claim Adjudication entries from Avatar MSO 'Void' 837 Professional/837 Institutional claims are pushed/filed to Avatar PM/Cal-PM parent system on posting in MSO, as no Avatar MSO Claims Processing Batch is created; Retro Claim Adjudication entries from Avatar MSO 'Replacement' 837 Professional/837 Institutional claims are pushed/filed to Avatar PM/Cal-PM parent system on closing of Claims Processing Batch for Replacement Claims/Services in MSO Note - Acceptance Testing may also be confirmed via Avatar PM/Cal-PM 'Delete Service' form for Primary services with one or more associated Add-On services associated Set 'Close Batch' field to 'Yes' (and click 'OK' button to close warning message dialog). Click 'Submit' button to close batch/file services to parent Avatar PM/Cal-PM system. Open 'Client Ledger' form in parent Avatar PM/Cal-PM system. Select 'Client ID' value for client where services are present in Avatar MSO closed status Claims Processing batch. Select 'Claim/Episode/All Episodes' value. Select 'Ledger Type' value. In Client Ledger data - ensure that 'Approved' status original claim services originating in Avatar MSO are present in Avatar PM/Cal-PM system following 'Close Batch' filing (where services are valid for filing to parent system). In Client Ledger data - ensure that services originating in Avatar MSO where 'Replacement' or 'Void' claim has subsequently been processed in Avatar MSO (resulting in Retro Claim Adjudication service takeback entries) are updated in Avatar PM/Cal-PM parent system as follows: Original Primary and Add-On services in 'Open' charge status will be deleted in Avatar PM/Cal-PM parent system, and new/replacement services will be filed/present in Avatar PM/Cal-PM system following 'Close Batch' filing (if 'Approved' status and where replacement services are valid for filing to parent system) Original Primary and Add-On services in 'Closed' and 'Unbilled' charge status (not claimed) will have service deletion reversal code ('DELETE') filed in Avatar PM/Cal-PM parent system, and new/replacement services will be filed/present in Avatar PM/Cal-PM system following 'Close Batch' filing (if 'Approved' status and where replacement services are valid for filing to parent system) Original Primary and associated Add-On services in 'Closed' and 'Unbilled' charge status (not claimed) will have Charge Payment/Reversal adjustment filed in Avatar PM/Cal-PM parent system for the amount of the original service: Posting/Adjustment Code as defined via Avatar MSO 'Set System Defaults' form for MSO-originating services; Posting/Adjustment Code as selected if using Avatar PM/Cal-PM 'Delete Service' form	Topics • Delete Service • 837 Professional
Update 15 Summary \| Details Delete MHSA XML Submitted File(s) Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Practitioner Enrollment MHSA XML Submission Delete MHSA XML Submitted File(s) Scenario 1: MHSA XML Submission / Deletion Specific Setup: System is defined to support ‘MHSA XML Submission’. Facility Defaults: Output Path On Server for State Reporting Files field contains the directory where files will be placed on creation. Client is identified that will be output to the ‘MHSA XML Submission’. Note the admission date. Steps Open ‘MHSA XML Submission’. Select ‘Compile’ in ‘Options’. Enter desired value in ‘Through Date’. Click [Submit]. Click [Yes]. Select ‘Print’ in ‘Options’. Select the compiled file in ‘Select File To Print/Submit’. Click [Print Selected File Information]. Validate the report data. Close the report. Select ‘Submit (Create File)’ in ‘Options’. Select the compiled file in ‘Select File To Print/Submit’. Select ‘Review’ in ‘Create File’. Click [OK]. Click [Yes]. Review the directory to validate that the ‘Review’ file was created. Validate the data. Select ‘Final’ in ‘Create File’. Click [OK]. Click [Yes]. Review the directory to validate that the ‘Final’ file was created. Validate the data. Close the form. Open ‘Delete MHSA XML Submitted File(s)’. Validate that the ‘Last Submitted File; field contains the file that was submitted. Click [Submit]. Click [OK]. Close the form. Open ‘Delete MHSA XML Submitted File(s)’. Validate that the deleted file does not exist. Close the form.	Topics • NX • MHSA Assessment

Avatar_Cal-PM_2023_Quarterly_Release_2023.04_Details.csv