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Avatar Cal-PM 2023 Update 28

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Product Requirements / Recommendations

Avatar Cal-PM required
RADplus required

Product Update Form Description

Added a new field 'Assign Subscriber Meds ID#' to the form 'Program Maintenance' to control if a specific program should default MEDS ID# into the Financial Eligibility information of their Medi-Cal subscribers when using the 'California MEDS File Load' form.

Included Updates

3, 11, 16, 17, 21, 26

Required Updates

None

Details
NEW1 CHANGED0 FIXED0
New (1)
Program Maintenance - Assignment of Subscriber MEDS ID#
Program Maintenance functionality has been modified to add a new field to form' new field 'Assign Subscriber Meds ID#'.
The new field works in conjunction with the 'Enable 'Subscriber MEDS ID#' Assignment' registry setting.
Value Added: The new field allows definition by individual program.
Topics
• File Import • Financial Eligibility • NX • Program Maintenance • Registry Settings • Web Services
 
Acceptance Tests
AV-80721 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:
  • Program Maintenance Web Service
  • File Import
  • Program Maintenance
  • Registry Settings (PM)
  • Admission (Outpatient)
  • California MEDS File Load (report)
  • Financial Eligibility
Scenario 1: 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
  1. Using the Avatar Cal-PM 'Program Maintenance' web service, add a value of 'Y' or 'N' to '<tem:AssignSubscriberMEDSID></tem:AssignSubscriberMEDSID>.
  2. 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.
  3. Examples:
  4. 'The following fields are invalid: Program Code : Length exceeded 10 characters limit'.
  5. 'The following fields are invalid: Description : Length exceeded 40 characters limit'.
  6. After correcting the field length issues, please resubmit and verify a successful filing.
  7. Open 'Program Maintenance' to review the program that was added or edit to validate that the data filed correctly.
  8. Close the form.
Scenario 2: 'Program Maintenance' - Form Verification (Avatar Cal-PM)
Specific Setup:
  • Crystal Reports or other SQL reporting tool
Steps
  1. Open the Avatar Cal-PM 'Program Maintenance' form.
  2. Select 'Add' in 'Add or Edit Program' field and enter Program Code (or select 'Edit' in 'Add or Edit Program' field and select existing Program).
  3. Ensure that 'EVV Provider Organization ID' field is present in form; enter value for 'EVV Provider Organization ID' if desired.
  4. Ensure that 'Require Source Of Admission' field is present in form (Yes/No radio button selection field); select value for 'Require Source Of Admission' if desired.
  5. If 'Require Source Of Admission' is set to 'Yes', the 'Source Of Admission' field will be required in the Avatar Cal-PM 'Admission', 'Admission (Outpatient)' and 'Back Dated Admission/Discharge' forms (as well as the Avatar Cal-PM Client Admission Web Service) for the selected Program
  6. Ensure that 'Require Attending Practitioner' field is present in form (Yes/No radio button selection field); select value for 'Require Source Of Admission' if desired.
  7. If 'Require Attending Practitioner' is set to 'Yes', the 'Attending Practitioner' field will be required in the Avatar Cal-PM 'Admission', 'Admission (Outpatient)' and 'Back Dated Admission/Discharge' forms (as well as the Avatar Cal-PM Client Admission Web Service) for the selected Program
  8. Enter/select values for all other Program Maintenance fields as required/desired.
  9. Click 'File Program' button to save Program Maintenance information.
  10. Click 'Print All Programs' button to display Program Maintenance information.
  11. In Program Maintenance report, ensure 'Require Source Of Admission' and 'Require Attending Practitioner' fields are present and reflect values filed via 'Program Maintenance' form.
  12. Open Crystal Reports or other SQL reporting tool.
  13. In Avatar Cal-PM SQL table 'SYSTEM.table_program_definition' - ensure all Program Maintenance information filed is present, including values for 'req_src_adm_code'/'req_src_adm_value' and 'req_attn_pract_code'/'req_attn_pract_value'.
Scenario 3: 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
  1. Access the 'File Import' form.
  2. Select "Program Maintenance" in the 'File Type' field.
  3. Select "Upload New File" in the 'Action' field.
  4. Click [Process Action].
  5. Navigate to the location of "File A" and click [Open].
  6. Select "Compile/Validate File" in the 'Action' field.
  7. Select "File A" in the 'File(s)' field.
  8. Click [Process Action].
  9. Validate a message is displayed stating "Compiled" and click [OK].
  10. Select "Print File" in the 'Action' field.
  11. Select "File A" in the 'File(s)' field.
  12. Click [Process Action].
  13. Validate a report is displayed for the program data in "File A".
  14. Close the report.
  15. Select "Post File" in the 'Action' field.
  16. Select "File A" in the 'File(s)' field.
  17. Click [Process Action].
  18. Validate a message is displayed stating "Posted" and click [OK].
  19. Close the form.
  20. Access the 'Program Maintenance' form.
  21. Select "Edit" in the 'Add Or Edit Program' field.
  22. Select the program imported via 'File Import' in the 'Program' field.
  23. Validate all imported data is populated as expected.
  24. Validate the 'Associated Service Programs' field contains the programs imported in the previous steps.
  25. Validate the 'EVV Provider Organization ID' field contains the value imported in the previous steps.
  26. Close the form.
Scenario 4: 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
  1. Open ‘Financial Eligibility’ for the client.
  2. Select the ‘Guarantor’ section.
  3. Select the ‘Guarantor’ from ‘Program Maintenance’.
  4. Validate that there is no value in ‘Subscriber MEDS ID#’.
  5. Close the form.
  6. Open ‘Registry Settings’
  7. Change the values of 'Subscriber Client Index Number' to ‘Y’ and submit the form.
  8. Open ‘California MEDS File Load’.
  9. Load and submit the file.
  10. Close the form.
  11. Open ‘Financial Eligibility’ for the client.
  12. Select the ‘Guarantor’ section.
  13. Select the ‘Guarantor’ from ‘Program Maintenance’.
  14. Validate that the ‘Subscriber MEDS ID#’ contains the correct value.
  15. Close the form.
Topics
• File Import • Financial Eligibility • NX • Program Maintenance • Registry Settings • Web Services
Table Changes
Table Column Change
table_program_definition assign_subscriber_meds_id_code ADD
table_program_definition assign_subscriber_meds_id_value ADD
file_import_prog_maint assign_subscriber_meds_id_code ADD
file_import_prog_maint assign_subscriber_meds_id_value ADD
WEBSVC.ProgramMaintenanceObject AssignSubscriberMEDSID ADD