Avatar Cal-PM 2023 Update 5

1. Open 'Registry Settings' form.
2. Enter search value 'Enable Alternative Service Location'.
3. Select 'Yes' for 'Include Hidden Registry Settings' field.
4. Click 'View Registry Settings' button.
5. Ensure Registry Setting 'Enable Alternative Service Location Fields' is returned (under 'Avatar PM -> Billing -> Client Charge Input' path).
6. 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."

1. Open Avatar Cal-PM 'Dictionary Update' form.
2. Navigate to 'Print Dictionary' section of form.
3. Select 'Client' File.
4. Select 'Individual Data Element' and select Data Element/Dictionary '(579) Place Of Service (837 Professional)'.
5. Click 'Print Dictionary' button to display dictionary fields/values for Data Element.
6. Confirm Avatar Cal-PM 'Client' File Data Element/Dictionary 'Place Of Service (837 Professional)' includes Code '10' with Dictionary Value 'Telehealth - Patient in Home'.
7. Navigate to 'Input Dictionary Code(s)' section of form.
8. Select 'Client' file.
9. Select Data Element/Dictionary '(10006) Location'.
10. Enter/select value for Dictionary Code/Value, and select Extended Dictionary Data Element '(579) Place Of Service (837 Professional)'.
11. 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.

• 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)'

1. Open Avatar Cal-PM 'Electronic Billing' form.
2. Note, 'Quick Billing' form/functions may also be used for 837 generation/validation.
3. Select 837 Professional or 837 Institutional in 'Billing Form' field.
4. Select values for 837 bill generation in the 'Type of Bill', 'Individual or All Guarantors' and 'Billing Type' fields.
5. Select 'Sort File' in the 'Billing Options' field.
6. Select/enter values for service inclusion in 'All Clients or Interim Billing Batch' and 'Program(s)' fields.
7. 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.
8. Select/enter values for any other bill sorting criteria fields as required/desired.
9. Click 'Process' button in form to sort bill.
10. Following 837 bill generation, select 'Dump File' in the 'Billing Options' field.
11. Select 837 file generated, and click 'Process' button in form to view 837 file output data.
12. 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.
13. Example:
14. NM1*77*2*PATIENT'S HOME~N3*1234 CLIENTADDRESS STREET~N4*HERMOSA BEACH*CA*902540000~
15. 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.
16. Example:
17. NM1*77*2*PATIENT'S HOME~N3*1234 CLIENTADDRESS STREET~N4*HERMOSA BEACH*CA*902540000~
18. 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.