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Avatar Cal-PM 2023 Update 75

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Product Requirements and Recommendations

Avatar Cal-PM required
RADplus required

Recommended Update Level

Avatar Cal-PM 2023 Monthly Release 2023.04.00
RADplus 2023 Monthly Release 2023.04.00

Product Update Description

The following modifications have been made: 1) The registry setting '837I-Dates To Populate 2300 DTP' is added. This setting allows users to override the Statement From and To Date (2300-DTP-03) in the 837 Institutional file with the first and last date of service on the bill or with the 'Coverage Effective Date' and 'Coverage End Date' fields on the 'Financial Eligibility' form. 2) The registry setting 'Restrict Coverage Effective Date Edits Too Prior Dates Only' is added. This setting allows users to prevent a date from being entered in the 'Coverage Effective Date' field that is later than the date currently on file.

Required Updates

None

Included Updates

3, 5, 7, 8, 11, 13, 16, 17, 21, 24, 26, 28, 32, 38, 39, 43, 45, 46, 47, 48, 51, 52, 54, 56, 61, 63, 65, 66, 67, 69, 70, 71

Details
NEW4 CHANGED0 FIXED0
New (4)
Registry Setting
The registry setting 'Restrict Coverage Effective Date Edits Too Prior Dates Only' is added. This setting allows users to prevent a date from being entered in the 'Coverage Effective Date' field that is later than the date currently on file.
Value Added: Agencies can restrict 'Coverage Effective Date' as desired.
Topics
• Electronic Billing • File Import • Financial Eligibility • Guarantor/Program Billing Defaults • Registry Settings • Web Services
 
Registry Setting
The registry setting '837I-Dates To Populate 2300 DTP' is added. This setting allows users to override the Statement From and To Date (2300-DTP-03) in the 837 Institutional file with the first and last date of service on the bill or with the 'Coverage Effective Date' and 'Coverage End Date' fields on the 'Financial Eligibility' form.
Value Added: Allows users to override the Statement From and To Date (2300-DTP-03) in the 837 Institutional.
Topics
• Electronic Billing • File Import • Financial Eligibility • Guarantor/Program Billing Defaults • Registry Settings
 
Registry Setting
The crystal report and the file import for the 837 Institutional are updated to show the new field value 'Include Discharge Date In Statement To Date (2300-DTP)' added by the new registry setting '837I-Dates To Populate 2300 DTP' valued as '1'.
Value Added: New field is added into the GPBD File import and crystal report.
Topics
• Electronic Billing • File Import • Financial Eligibility • Guarantor/Program Billing Defaults • Registry Settings
 
Registry Setting
The registry setting '837I-Dates To Populate 2300 DTP' is added. This setting allows users to override the Statement From and To Date (2300-DTP-03) in the 837 Institutional file with the first and last date of service on the bill or with the 'Coverage Effective Date' and 'Coverage End Date' fields on the 'Financial Eligibility' form.
Value Added: Allows users to override the Statement From and To Date (2300-DTP-03) in the 837 Institutional.
Topics
• Electronic Billing • File Import • Financial Eligibility • Guarantor/Program Billing Defaults • Registry Settings
 
Acceptance Tests
AV-83267 Summary | Details
Registry Setting
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Admission
  • Client Charge Input
  • Client Ledger
  • Create Interim Billing Batch File
  • Diagnosis
  • Discharge
  • Electronic Billing
  • Financial Eligibility
  • Registry Settings (PM)
  • File Import
Scenario 1: 837I Compile - With '837I-Dates To Populate 2300 DTP' RS 1
Specific Setup:
  • Guarantor:
  • An active guarantor is identified or created - "Guarantor 1".
  • Guarantor/Program Billing Defaults Template:
  • An active 'Guarantor/Program Billing Defaults' template is identified or created that includes "Guarantor 1" - "Template 1".
Steps
  1. Open the 'Registry Settings' form.
  2. Set the 'Limit Registry Settings to the Following Search Criteria' text input box to "837I-Dates To Populate 2300 DTP".
  3. Select 'Yes' in 'Include Hidden Registry Settings'.
  4. Click [View Registry Settings].
  5. Validate that the registry setting exists and show the respective values.
  6. Set the 'Registry Setting Value' field to '1'.
  7. Click [Submit].
  8. Click [OK].
  9. Click [No].
  10. Open the 'Guarantor/Program Billing Defaults' form.
  11. Select 'Edit Template'.
  12. Select "Template 1" from the 'Select Template' dropdown.
  13. Select '837 Institutional'.
  14. Validate that the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' is shown with the following options, (none selected by default):
  15. Yes (Inpatient/Outpatient)
  16. Yes (Outpatient Only)
  17. Yes (Inpatient Only)
  18. No (Inpatient/Outpatient)
  19. Click [Submit].
  20. Click [No].
  21. Open the 'Admission' form.
  22. Admit an Inpatient client - "Client 1".
  23. Using the 'Diagnosis' form, File an active diagnosis record for "Client 1".
  24. File the 'Financial Eligibility' form for "Client 1", with "Guarantor 1".
  25. Specify the 'Coverage Effective Date' and 'Coverage Expiration Date' in the financial eligibility.
  26. Create charges for "Client 1" for more than one date, with the dates between the dates saved in step 21.
  27. Create a new Interim Billing Batch File, "Batch 1", which covers the services created for "Client 1" in step 22.
  28. Close the charges using the Interim Billing Batch File, "Batch 1".
  29. Open 'Client Ledger'.
  30. Select "Client 1" and the respective Episode.
  31. Validate that all the services are closed.
  32. Open 'Electronic Billing'.
  33. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  34. Set 'First Date Of Service To Include' with a date before the 'Coverage Effective Date' filed in step 21.
  35. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  36. Click [Process].
  37. Validate that the compile completes successfully.
  38. Click [OK].
  39. Select 'Dump File' from 'Billing Options'.
  40. Select 'Print' from 'Print Or Delete Report'.
  41. Select the file compiled in step 31.
  42. Click [Process].
  43. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first and last dates of the services being billed.
  44. Close the report.
  45. Click [No].
  46. Open 'Discharge' form.
  47. Set the 'Date Of Discharge' field to a date that is the day after the last day of service.
  48. Fill in all the required fields and select [Submit].
  49. Open 'Electronic Billing'.
  50. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  51. Set 'First Date Of Service To Include' with the date before the 'Coverage Effective Date' filed in step 21.
  52. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  53. Click [Process].
  54. Validate that the compile completes successfully.
  55. Click [OK].
  56. Select 'Dump File' from 'Billing Options'.
  57. Select 'Print' from 'Print Or Delete Report'.
  58. Select the file compiled in step 46.
  59. Click [Process].
  60. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first date of the service being billed and the discharge date file in step 41.
  61. Close the report.
  62. Click [No].
  63. Open the 'Guarantor/Program Billing Defaults' form.
  64. Select 'Edit Template'.
  65. Select "Template 1" from the 'Select Template' dropdown.
  66. Select '837 Institutional'.
  67. Set the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' to 'Yes (Inpatient/Outpatient)'.
  68. Click [Submit].
  69. Click [No].
  70. Open 'Electronic Billing'.
  71. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  72. Set 'First Date Of Service To Include' a date before the 'Coverage Effective Date' filed in step 21.
  73. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  74. Click [Process].
  75. Validate that the compile completes successfully.
  76. Click [OK].
  77. Select 'Dump File' from 'Billing Options'.
  78. Select 'Print' from 'Print Or Delete Report'.
  79. Select the file compiled in step 65.
  80. Click [Process].
  81. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first date of the service being billed and the discharge date file in step 41.
  82. Close the report.
  83. Click [No].
  84. Open the 'Guarantor/Program Billing Defaults' form.
  85. Select 'Edit Template'.
  86. Select "Template 1" from the 'Select Template' dropdown.
  87. Select '837 Institutional'.
  88. Set the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' to 'Yes (Inpatient Only)'.
  89. Click [Submit].
  90. Click [No].
  91. Open 'Electronic Billing'.
  92. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  93. Set 'First Date Of Service To Include' with the date before the 'Coverage Effective Date' filed in step 21.
  94. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  95. Click [Process].
  96. Validate that the compile completes successfully.
  97. Click [OK].
  98. Select 'Dump File' from 'Billing Options'.
  99. Select 'Print' from 'Print Or Delete Report'.
  100. Select the file compiled in step 85.
  101. Click [Process].
  102. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first date of the service being billed and the discharge date file in step 41.
  103. Close the report.
  104. Click [No].
  105. Open the 'Guarantor/Program Billing Defaults' form.
  106. Select 'Edit Template'.
  107. Select "Template 1" from the 'Select Template' dropdown.
  108. Select '837 Institutional'.
  109. Set the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' to 'Yes (Inpatient Only)'.
  110. Click [Submit].
  111. Click [No].
  112. Open 'Electronic Billing'.
  113. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  114. Set 'First Date Of Service To Include' with the date before the 'Coverage Effective Date' filed in step 21.
  115. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  116. Click [Process].
  117. Validate that the compile completes successfully.
  118. Click [OK].
  119. Select 'Dump File' from 'Billing Options'.
  120. Select 'Print' from 'Print Or Delete Report'.
  121. Select the file compiled in step 105.
  122. Click [Process].
  123. Validate that the discharge date is not included instead, the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first and last dates of the services being billed.
  124. Close the report.
  125. Click [No].
  126. Open the 'Guarantor/Program Billing Defaults' form.
  127. Select 'Edit Template'.
  128. Select "Template 1" from the 'Select Template' dropdown.
  129. Select '837 Institutional'.
  130. Set the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' to 'No (Inpatient/Outpatient)'.
  131. Click [Submit].
  132. Click [No].
  133. Open 'Electronic Billing'.
  134. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  135. Set 'First Date Of Service To Include' with the date before the 'Coverage Effective Date' filed in step 21.
  136. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  137. Click [Process].
  138. Validate that the compile completes successfully.
  139. Click [OK].
  140. Select 'Dump File' from 'Billing Options'.
  141. Select 'Print' from 'Print Or Delete Report'.
  142. Select the file compiled in step 105.
  143. Click [Process].
  144. Validate that the discharge date is not included instead, the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first and last dates of the services being billed.
  145. Close the report.
  146. Click [No].
  147. Query the tables below and validate that the new columns 'inc_dis_dt_2300_dtp_code' and 'inc_dis_dt_2300_dtp_value' are shown with the field 'Include Discharge Date In Statement To Date (2300-DTP)' value,
  148. SYSTEM.file_import_gpbdt_i837
  149. SYSTEM.table_837_i_facility_prov_num
  150. Close the SQL query window.
Scenario 2: File Import - Guarantor Program Billing Defaults - New field validations
Specific Setup:
  • At least one 'Guarantor/Program Billing Defaults' template exists, "Template 1", and the 837 Professional and Institutional sections contain data.
  • Files can be saved to the local desktop, "File A", edited, and imported back into Avatar through 'File Import'.
  • Registry setting '837I-Dates To Populate 2300 DTP' value set as '1'.
Steps
  1. Open 'Guarantor/Program Billing Defaults'.
  2. Edit the ‘837 Institutional’ section of "Template 1".
  3. Validate that the new field has no values selected.
  4. Click [Submit].
  5. Export the template in 'Edit' mode, saving it to the desktop with a unique name "File A".
  6. Edit the 'Edit' mode template to have a value defined for piece 130- 'Include Discharge Date In Statement To Date (2300-DTP)' and save it.
  7. Open 'File Import'.
  8. Import/Compile/Post the 'Edit' mode template "File A" in the 'Guarantor/Program Billing Defaults Template' file type.
  9. Select 'Print File'.
  10. Print the file posted in step 8 by selecting it and clicking 'Process Action'.
  11. Validate that the Crystal report is included with the new field 'Include Discharge Date In Statement To Date (2300-DTP)' and it's value we selected in step 6 for file import for 837 Institutional.
  12. Open 'Guarantor/Program Billing Defaults'.
  13. Select 'Edit Template'.
  14. Select the 'Edit mode template', "Template 1".
  15. Select the ‘837 Professional’ section. The field, 'Include Discharge Date In Statement To Date (2300-DTP)' will have the value used in step 6.
  16. Click [Submit].
  17. Click [No].
Scenario 3: 837I Compile - With '837I-Dates To Populate 2300 DTP' RS 2
Specific Setup:
  • Guarantor:
  • An active guarantor is identified or created - "Guarantor 1".
  • Guarantor/Program Billing Defaults Template:
  • An active 'Guarantor/Program Billing Defaults' template is identified or created that includes "Guarantor 1" - "Template 1".
Steps
  1. Open the 'Registry Settings' form.
  2. Set the 'Limit Registry Settings to the Following Search Criteria' text input box to "837I-Dates To Populate 2300 DTP".
  3. Select 'Yes' in 'Include Hidden Registry Settings'.
  4. Click [View Registry Settings].
  5. Validate that the registry setting exists and show the respective values.
  6. Set the 'Registry Setting Value' field to '2'.
  7. Click [Submit].
  8. Click [OK].
  9. Click [No].
  10. Open the 'Guarantor/Program Billing Defaults' form.
  11. Select 'Edit Template'.
  12. Select "Template 1" from the 'Select Template' dropdown.
  13. Select '837 Institutional'.
  14. Validate that the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' is not shown.
  15. Click [Submit].
  16. Click [No].
  17. Open the 'Admission' form.
  18. Admit an Inpatient client - "Client 1".
  19. Using the 'Diagnosis' form, File an active diagnosis record for "Client 1".
  20. File the 'Financial Eligibility' form for "Client 1", with "Guarantor 1".
  21. Specify the 'Coverage Effective Date' and 'Coverage Expiration Date' in the financial eligibility.
  22. Create charges for "Client 1" for more than one date(s), that fall between the dates saved in step 21.
  23. Create a new Interim Billing Batch File "Batch 1" which covers the services created for "Client 1" in step 22.
  24. Close the charges using the Interim Billing Batch File "Batch 1".
  25. Open 'Client Ledger'.
  26. Select "Client 1" and the respective Episode.
  27. Validate that all the services are closed.
  28. Open 'Electronic Billing'.
  29. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  30. Set 'First Date Of Service To Include' with the date earlier than the 'Coverage Effective Date' filed in step 21.
  31. Set 'Last Date Of Service To Include' with a date later than the 'Coverage Expiration Date' filed in step 21.
  32. Click [Process].
  33. Validate that the compile completes successfully.
  34. Click [OK].
  35. Select 'Dump File' from 'Billing Options'.
  36. Select 'Print' from 'Print Or Delete Report'.
  37. Select the file compiled in step 31.
  38. Click [Process].
  39. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the 'Coverage Effective date' filed in step 21 and the 'Last Date Of Service To Include' selected in step 29(b).
  40. Close the report.
  41. Click [No].
  42. Open 'Discharge' form.
  43. Set the 'Date Of Discharge' field to a date that is greater than the 'Coverage Expiration Date' filed in step 21.
  44. Fill in all the required fields and select [Submit].
  45. Open 'Electronic Billing'.
  46. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  47. Set 'First Date Of Service To Include' with the date earlier than the 'Coverage Effective Date' filed in step 21.
  48. Set 'Last Date Of Service To Include' with a date later than the 'Coverage Expiration Date' filed in step 21.
  49. Click [Process].
  50. Validate that the compile completes successfully.
  51. Click [OK].
  52. Select 'Dump File' from 'Billing Options'.
  53. Select 'Print' from 'Print Or Delete Report'.
  54. Select the file compiled in step 46.
  55. Click [Process].
  56. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the 'Coverage Effective Date' and 'Coverage Expiration Date' filed in step 21.
  57. Close the report.
  58. Click [No].
  59. Open 'Electronic Billing'.
  60. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  61. Set 'First Date Of Service To Include' with the date later than the 'Coverage Effective Date' filed in step 21.
  62. Set 'Last Date Of Service To Include' with a date earlier than the 'Coverage Expiration Date' filed in step 21.
  63. Click [Process].
  64. Validate that the compile completes successfully.
  65. Click [OK].
  66. Select 'Dump File' from 'Billing Options'.
  67. Select 'Print' from 'Print Or Delete Report'.
  68. Select the file compiled in step 46.
  69. Click [Process].
  70. Validate that the discharge date is not included instead, the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the First Date Of Service To Include' and 'Last Date Of Service To Include' dates used in the step 57(a, b).
  71. Close the report.
  72. Click [No].
Scenario 4: "Restrict Coverage Effective Date Edits to Prior Dates Only" registry setting functionality
Specific Setup:
  • Client: The client should be admitted and have an active episode - "Client A".
  • Financial Eligibility: "Client A" should have an already existing Financial Eligibility record with both Coverage Effective and Expiration dates.
Steps
  1. Open the 'Registry Settings' form.
  2. Set the 'Limit Registry Settings to the Following Search Criteria' to 'Restrict Coverage Effective Date Edits to Prior Dates Only'.
  3. Click [View Registry Settings].
  4. Validate that the respective registry setting shows up.
  5. Set the 'Avatar PM->Billing->Financial Eligibility->->->Restrict Coverage Effective Date Edits to Prior Dates Only' registry setting to a value other than 'Y' or 'N'.
  6. Verify an error message displays that the valid choices are 'Y or N' only.
  7. Set the 'Avatar PM->Billing->Financial Eligibility->->->Restrict Coverage Effective Date Edits to Prior Dates Only' registry setting to 'Y' and then submit to save.
  8. Open the 'Financial Eligibility' form.
  9. Search and select "Client A".
  10. Select the Episode from the grid.
  11. Select 'Guarantor Selection'.
  12. Check if the 'Coverage Effective Date' field is already showing the date in the file.
  13. Try to enter a date that is after the date that is already in the file and move away from the field.
  14. Validate that an error message appears when updating the 'Coverage Effective Date' field to a date that is later than the previously filed date.
  15. Validate the error text - 'The Coverage Effective Date cannot be updated to be later than the previously filed date.'.
  16. Click [OK].
  17. Validate that the 'Coverage Effective Date' field is restored with the last value saved.
  18. Set 'Coverage Effective Date' with a date that is before the date that is already in the file and move away from the field.
  19. Validate that there are no errors shown.
  20. Click [Submit].
  21. Open the 'Financial Eligibility' form.
  22. Search and select "Client A".
  23. Select the Episode from the grid.
  24. Select 'Guarantor Selection'.
  25. Check if the 'Coverage Effective Date' field is showing with the date we save in step 18.
  26. Click [Discard].
  27. Click [Yes].
  28. Open the 'Registry Settings' form.
  29. Set the 'Limit Registry Settings to the Following Search Criteria' to 'Restrict Coverage Effective Date Edits to Prior Dates Only'.
  30. Click [View Registry Settings].
  31. Set the 'Avatar PM->Billing->Financial Eligibility->->->Restrict Coverage Effective Date Edits to Prior Dates Only' registry setting to 'N' and then submit to save.
  32. Open the 'Financial Eligibility' form.
  33. Search and select "Client A".
  34. Select the Episode from the grid.
  35. Select 'Guarantor Selection'.
  36. Check if the 'Coverage Effective Date' field is showing with the date we save in step 18.
  37. Try to enter a date that is after the date that is already in the file and move away from the field.
  38. Validate that there are no errors shown.
  39. Click [Submit].
  40. Open the 'Financial Eligibility' form.
  41. Search and select "Client A".
  42. Select the Episode from the grid.
  43. Select 'Guarantor Selection'.
  44. Check if the 'Coverage Effective Date' field is showing with the date we save in step 37.
  45. Click [Discard].
  46. Click [Yes].
Scenario 5: Update Financial Eligibility - 'Coverage Effective Date' - Webservice
Specific Setup:
  • Client: The client should be admitted and have an active episode - "Client A"
  • Financial Eligibility: "Client A" should have an already existing Financial Eligibility record with both Coverage Effective and Expiration dates.
  • Registry Setting: Set the 'Restrict Coverage Effective Date Edits to Prior Dates Only' setting value as 'Y'.
Steps
  1. Open SoapUI or any other web service testing tool.
  2. Create a web service request to update the Financial Eligibility information.
  3. Enter the same value in the "SYSTEMCODE" which is used to sign into Avatar.
  4. Enter the same value in the "USERNAME" which is used to sign into Avatar.
  5. Set the value for 'CoverageEffectiveDate' with a date that is after the date already in the file for "Client A".
  6. Enter values for all other required fields.
  7. Submit the request.
  8. Verify that the service failed to post with the error message: "The Coverage Effective Date cannot be updated to be later than the previously filed date."
  9. Set the value for 'CoverageEffectiveDate' with a date that is before the date already in the file for "Client A".
  10. Submit the request.
  11. Verify that the service was posted successfully with the message: "Financial Eligibility web service has been filed successfully."
  12. Open 'Financial Eligibility' for the "Client A".
  13. Select 'Guarantor Selection'.
  14. Validate that the 'Coverage Effective Date' is showing the value that we posted in step 9.
  15. Click [Discard].
  16. Click [Yes].
Topics
• Electronic Billing • File Import • Financial Eligibility • Guarantor/Program Billing Defaults • Registry Settings • Web Services
AV-92683 Summary | Details
Registry Setting
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Admission
  • Client Charge Input
  • Client Ledger
  • Create Interim Billing Batch File
  • Diagnosis
  • Discharge
  • Electronic Billing
  • Financial Eligibility
  • Registry Settings (PM)
  • File Import
Scenario 1: 837I Compile - With '837I-Dates To Populate 2300 DTP' RS 1
Specific Setup:
  • Guarantor:
  • An active guarantor is identified or created - "Guarantor 1".
  • Guarantor/Program Billing Defaults Template:
  • An active 'Guarantor/Program Billing Defaults' template is identified or created that includes "Guarantor 1" - "Template 1".
Steps
  1. Open the 'Registry Settings' form.
  2. Set the 'Limit Registry Settings to the Following Search Criteria' text input box to "837I-Dates To Populate 2300 DTP".
  3. Select 'Yes' in 'Include Hidden Registry Settings'.
  4. Click [View Registry Settings].
  5. Validate that the registry setting exists and show the respective values.
  6. Set the 'Registry Setting Value' field to '1'.
  7. Click [Submit].
  8. Click [OK].
  9. Click [No].
  10. Open the 'Guarantor/Program Billing Defaults' form.
  11. Select 'Edit Template'.
  12. Select "Template 1" from the 'Select Template' dropdown.
  13. Select '837 Institutional'.
  14. Validate that the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' is shown with the following options, (none selected by default):
  15. Yes (Inpatient/Outpatient)
  16. Yes (Outpatient Only)
  17. Yes (Inpatient Only)
  18. No (Inpatient/Outpatient)
  19. Click [Submit].
  20. Click [No].
  21. Open the 'Admission' form.
  22. Admit an Inpatient client - "Client 1".
  23. Using the 'Diagnosis' form, File an active diagnosis record for "Client 1".
  24. File the 'Financial Eligibility' form for "Client 1", with "Guarantor 1".
  25. Specify the 'Coverage Effective Date' and 'Coverage Expiration Date' in the financial eligibility.
  26. Create charges for "Client 1" for more than one date, with the dates between the dates saved in step 21.
  27. Create a new Interim Billing Batch File, "Batch 1", which covers the services created for "Client 1" in step 22.
  28. Close the charges using the Interim Billing Batch File, "Batch 1".
  29. Open 'Client Ledger'.
  30. Select "Client 1" and the respective Episode.
  31. Validate that all the services are closed.
  32. Open 'Electronic Billing'.
  33. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  34. Set 'First Date Of Service To Include' with a date before the 'Coverage Effective Date' filed in step 21.
  35. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  36. Click [Process].
  37. Validate that the compile completes successfully.
  38. Click [OK].
  39. Select 'Dump File' from 'Billing Options'.
  40. Select 'Print' from 'Print Or Delete Report'.
  41. Select the file compiled in step 31.
  42. Click [Process].
  43. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first and last dates of the services being billed.
  44. Close the report.
  45. Click [No].
  46. Open 'Discharge' form.
  47. Set the 'Date Of Discharge' field to a date that is the day after the last day of service.
  48. Fill in all the required fields and select [Submit].
  49. Open 'Electronic Billing'.
  50. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  51. Set 'First Date Of Service To Include' with the date before the 'Coverage Effective Date' filed in step 21.
  52. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  53. Click [Process].
  54. Validate that the compile completes successfully.
  55. Click [OK].
  56. Select 'Dump File' from 'Billing Options'.
  57. Select 'Print' from 'Print Or Delete Report'.
  58. Select the file compiled in step 46.
  59. Click [Process].
  60. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first date of the service being billed and the discharge date file in step 41.
  61. Close the report.
  62. Click [No].
  63. Open the 'Guarantor/Program Billing Defaults' form.
  64. Select 'Edit Template'.
  65. Select "Template 1" from the 'Select Template' dropdown.
  66. Select '837 Institutional'.
  67. Set the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' to 'Yes (Inpatient/Outpatient)'.
  68. Click [Submit].
  69. Click [No].
  70. Open 'Electronic Billing'.
  71. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  72. Set 'First Date Of Service To Include' a date before the 'Coverage Effective Date' filed in step 21.
  73. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  74. Click [Process].
  75. Validate that the compile completes successfully.
  76. Click [OK].
  77. Select 'Dump File' from 'Billing Options'.
  78. Select 'Print' from 'Print Or Delete Report'.
  79. Select the file compiled in step 65.
  80. Click [Process].
  81. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first date of the service being billed and the discharge date file in step 41.
  82. Close the report.
  83. Click [No].
  84. Open the 'Guarantor/Program Billing Defaults' form.
  85. Select 'Edit Template'.
  86. Select "Template 1" from the 'Select Template' dropdown.
  87. Select '837 Institutional'.
  88. Set the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' to 'Yes (Inpatient Only)'.
  89. Click [Submit].
  90. Click [No].
  91. Open 'Electronic Billing'.
  92. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  93. Set 'First Date Of Service To Include' with the date before the 'Coverage Effective Date' filed in step 21.
  94. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  95. Click [Process].
  96. Validate that the compile completes successfully.
  97. Click [OK].
  98. Select 'Dump File' from 'Billing Options'.
  99. Select 'Print' from 'Print Or Delete Report'.
  100. Select the file compiled in step 85.
  101. Click [Process].
  102. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first date of the service being billed and the discharge date file in step 41.
  103. Close the report.
  104. Click [No].
  105. Open the 'Guarantor/Program Billing Defaults' form.
  106. Select 'Edit Template'.
  107. Select "Template 1" from the 'Select Template' dropdown.
  108. Select '837 Institutional'.
  109. Set the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' to 'Yes (Inpatient Only)'.
  110. Click [Submit].
  111. Click [No].
  112. Open 'Electronic Billing'.
  113. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  114. Set 'First Date Of Service To Include' with the date before the 'Coverage Effective Date' filed in step 21.
  115. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  116. Click [Process].
  117. Validate that the compile completes successfully.
  118. Click [OK].
  119. Select 'Dump File' from 'Billing Options'.
  120. Select 'Print' from 'Print Or Delete Report'.
  121. Select the file compiled in step 105.
  122. Click [Process].
  123. Validate that the discharge date is not included instead, the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first and last dates of the services being billed.
  124. Close the report.
  125. Click [No].
  126. Open the 'Guarantor/Program Billing Defaults' form.
  127. Select 'Edit Template'.
  128. Select "Template 1" from the 'Select Template' dropdown.
  129. Select '837 Institutional'.
  130. Set the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' to 'No (Inpatient/Outpatient)'.
  131. Click [Submit].
  132. Click [No].
  133. Open 'Electronic Billing'.
  134. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  135. Set 'First Date Of Service To Include' with the date before the 'Coverage Effective Date' filed in step 21.
  136. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  137. Click [Process].
  138. Validate that the compile completes successfully.
  139. Click [OK].
  140. Select 'Dump File' from 'Billing Options'.
  141. Select 'Print' from 'Print Or Delete Report'.
  142. Select the file compiled in step 105.
  143. Click [Process].
  144. Validate that the discharge date is not included instead, the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first and last dates of the services being billed.
  145. Close the report.
  146. Click [No].
  147. Query the tables below and validate that the new columns 'inc_dis_dt_2300_dtp_code' and 'inc_dis_dt_2300_dtp_value' are shown with the field 'Include Discharge Date In Statement To Date (2300-DTP)' value,
  148. SYSTEM.file_import_gpbdt_i837
  149. SYSTEM.table_837_i_facility_prov_num
  150. Close the SQL query window.
Scenario 2: File Import - Guarantor Program Billing Defaults - New field validations
Specific Setup:
  • At least one 'Guarantor/Program Billing Defaults' template exists, "Template 1", and the 837 Professional and Institutional sections contain data.
  • Files can be saved to the local desktop, "File A", edited, and imported back into Avatar through 'File Import'.
  • Registry setting '837I-Dates To Populate 2300 DTP' value set as '1'.
Steps
  1. Open 'Guarantor/Program Billing Defaults'.
  2. Edit the ‘837 Institutional’ section of "Template 1".
  3. Validate that the new field has no values selected.
  4. Click [Submit].
  5. Export the template in 'Edit' mode, saving it to the desktop with a unique name "File A".
  6. Edit the 'Edit' mode template to have a value defined for piece 130- 'Include Discharge Date In Statement To Date (2300-DTP)' and save it.
  7. Open 'File Import'.
  8. Import/Compile/Post the 'Edit' mode template "File A" in the 'Guarantor/Program Billing Defaults Template' file type.
  9. Select 'Print File'.
  10. Print the file posted in step 8 by selecting it and clicking 'Process Action'.
  11. Validate that the Crystal report is included with the new field 'Include Discharge Date In Statement To Date (2300-DTP)' and it's value we selected in step 6 for file import for 837 Institutional.
  12. Open 'Guarantor/Program Billing Defaults'.
  13. Select 'Edit Template'.
  14. Select the 'Edit mode template', "Template 1".
  15. Select the ‘837 Professional’ section. The field, 'Include Discharge Date In Statement To Date (2300-DTP)' will have the value used in step 6.
  16. Click [Submit].
  17. Click [No].
Scenario 3: 837I Compile - With '837I-Dates To Populate 2300 DTP' RS 2
Specific Setup:
  • Guarantor:
  • An active guarantor is identified or created - "Guarantor 1".
  • Guarantor/Program Billing Defaults Template:
  • An active 'Guarantor/Program Billing Defaults' template is identified or created that includes "Guarantor 1" - "Template 1".
Steps
  1. Open the 'Registry Settings' form.
  2. Set the 'Limit Registry Settings to the Following Search Criteria' text input box to "837I-Dates To Populate 2300 DTP".
  3. Select 'Yes' in 'Include Hidden Registry Settings'.
  4. Click [View Registry Settings].
  5. Validate that the registry setting exists and show the respective values.
  6. Set the 'Registry Setting Value' field to '2'.
  7. Click [Submit].
  8. Click [OK].
  9. Click [No].
  10. Open the 'Guarantor/Program Billing Defaults' form.
  11. Select 'Edit Template'.
  12. Select "Template 1" from the 'Select Template' dropdown.
  13. Select '837 Institutional'.
  14. Validate that the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' is not shown.
  15. Click [Submit].
  16. Click [No].
  17. Open the 'Admission' form.
  18. Admit an Inpatient client - "Client 1".
  19. Using the 'Diagnosis' form, File an active diagnosis record for "Client 1".
  20. File the 'Financial Eligibility' form for "Client 1", with "Guarantor 1".
  21. Specify the 'Coverage Effective Date' and 'Coverage Expiration Date' in the financial eligibility.
  22. Create charges for "Client 1" for more than one date(s), that fall between the dates saved in step 21.
  23. Create a new Interim Billing Batch File "Batch 1" which covers the services created for "Client 1" in step 22.
  24. Close the charges using the Interim Billing Batch File "Batch 1".
  25. Open 'Client Ledger'.
  26. Select "Client 1" and the respective Episode.
  27. Validate that all the services are closed.
  28. Open 'Electronic Billing'.
  29. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  30. Set 'First Date Of Service To Include' with the date earlier than the 'Coverage Effective Date' filed in step 21.
  31. Set 'Last Date Of Service To Include' with a date later than the 'Coverage Expiration Date' filed in step 21.
  32. Click [Process].
  33. Validate that the compile completes successfully.
  34. Click [OK].
  35. Select 'Dump File' from 'Billing Options'.
  36. Select 'Print' from 'Print Or Delete Report'.
  37. Select the file compiled in step 31.
  38. Click [Process].
  39. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the 'Coverage Effective date' filed in step 21 and the 'Last Date Of Service To Include' selected in step 29(b).
  40. Close the report.
  41. Click [No].
  42. Open 'Discharge' form.
  43. Set the 'Date Of Discharge' field to a date that is greater than the 'Coverage Expiration Date' filed in step 21.
  44. Fill in all the required fields and select [Submit].
  45. Open 'Electronic Billing'.
  46. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  47. Set 'First Date Of Service To Include' with the date earlier than the 'Coverage Effective Date' filed in step 21.
  48. Set 'Last Date Of Service To Include' with a date later than the 'Coverage Expiration Date' filed in step 21.
  49. Click [Process].
  50. Validate that the compile completes successfully.
  51. Click [OK].
  52. Select 'Dump File' from 'Billing Options'.
  53. Select 'Print' from 'Print Or Delete Report'.
  54. Select the file compiled in step 46.
  55. Click [Process].
  56. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the 'Coverage Effective Date' and 'Coverage Expiration Date' filed in step 21.
  57. Close the report.
  58. Click [No].
  59. Open 'Electronic Billing'.
  60. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  61. Set 'First Date Of Service To Include' with the date later than the 'Coverage Effective Date' filed in step 21.
  62. Set 'Last Date Of Service To Include' with a date earlier than the 'Coverage Expiration Date' filed in step 21.
  63. Click [Process].
  64. Validate that the compile completes successfully.
  65. Click [OK].
  66. Select 'Dump File' from 'Billing Options'.
  67. Select 'Print' from 'Print Or Delete Report'.
  68. Select the file compiled in step 46.
  69. Click [Process].
  70. Validate that the discharge date is not included instead, the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the First Date Of Service To Include' and 'Last Date Of Service To Include' dates used in the step 57(a, b).
  71. Close the report.
  72. Click [No].
Scenario 4: "Restrict Coverage Effective Date Edits to Prior Dates Only" registry setting functionality
Specific Setup:
  • Client: The client should be admitted and have an active episode - "Client A".
  • Financial Eligibility: "Client A" should have an already existing Financial Eligibility record with both Coverage Effective and Expiration dates.
Steps
  1. Open the 'Registry Settings' form.
  2. Set the 'Limit Registry Settings to the Following Search Criteria' to 'Restrict Coverage Effective Date Edits to Prior Dates Only'.
  3. Click [View Registry Settings].
  4. Validate that the respective registry setting shows up.
  5. Set the 'Avatar PM->Billing->Financial Eligibility->->->Restrict Coverage Effective Date Edits to Prior Dates Only' registry setting to a value other than 'Y' or 'N'.
  6. Verify an error message displays that the valid choices are 'Y or N' only.
  7. Set the 'Avatar PM->Billing->Financial Eligibility->->->Restrict Coverage Effective Date Edits to Prior Dates Only' registry setting to 'Y' and then submit to save.
  8. Open the 'Financial Eligibility' form.
  9. Search and select "Client A".
  10. Select the Episode from the grid.
  11. Select 'Guarantor Selection'.
  12. Check if the 'Coverage Effective Date' field is already showing the date in the file.
  13. Try to enter a date that is after the date that is already in the file and move away from the field.
  14. Validate that an error message appears when updating the 'Coverage Effective Date' field to a date that is later than the previously filed date.
  15. Validate the error text - 'The Coverage Effective Date cannot be updated to be later than the previously filed date.'.
  16. Click [OK].
  17. Validate that the 'Coverage Effective Date' field is restored with the last value saved.
  18. Set 'Coverage Effective Date' with a date that is before the date that is already in the file and move away from the field.
  19. Validate that there are no errors shown.
  20. Click [Submit].
  21. Open the 'Financial Eligibility' form.
  22. Search and select "Client A".
  23. Select the Episode from the grid.
  24. Select 'Guarantor Selection'.
  25. Check if the 'Coverage Effective Date' field is showing with the date we save in step 18.
  26. Click [Discard].
  27. Click [Yes].
  28. Open the 'Registry Settings' form.
  29. Set the 'Limit Registry Settings to the Following Search Criteria' to 'Restrict Coverage Effective Date Edits to Prior Dates Only'.
  30. Click [View Registry Settings].
  31. Set the 'Avatar PM->Billing->Financial Eligibility->->->Restrict Coverage Effective Date Edits to Prior Dates Only' registry setting to 'N' and then submit to save.
  32. Open the 'Financial Eligibility' form.
  33. Search and select "Client A".
  34. Select the Episode from the grid.
  35. Select 'Guarantor Selection'.
  36. Check if the 'Coverage Effective Date' field is showing with the date we save in step 18.
  37. Try to enter a date that is after the date that is already in the file and move away from the field.
  38. Validate that there are no errors shown.
  39. Click [Submit].
  40. Open the 'Financial Eligibility' form.
  41. Search and select "Client A".
  42. Select the Episode from the grid.
  43. Select 'Guarantor Selection'.
  44. Check if the 'Coverage Effective Date' field is showing with the date we save in step 37.
  45. Click [Discard].
  46. Click [Yes].
Topics
• Electronic Billing • File Import • Financial Eligibility • Guarantor/Program Billing Defaults • Registry Settings
AV-92684 Summary | Details
Registry Setting
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Admission
  • Client Charge Input
  • Client Ledger
  • Create Interim Billing Batch File
  • Diagnosis
  • Discharge
  • Electronic Billing
  • Financial Eligibility
  • Registry Settings (PM)
  • File Import
Scenario 1: 837I Compile - With '837I-Dates To Populate 2300 DTP' RS 1
Specific Setup:
  • Guarantor:
  • An active guarantor is identified or created - "Guarantor 1".
  • Guarantor/Program Billing Defaults Template:
  • An active 'Guarantor/Program Billing Defaults' template is identified or created that includes "Guarantor 1" - "Template 1".
Steps
  1. Open the 'Registry Settings' form.
  2. Set the 'Limit Registry Settings to the Following Search Criteria' text input box to "837I-Dates To Populate 2300 DTP".
  3. Select 'Yes' in 'Include Hidden Registry Settings'.
  4. Click [View Registry Settings].
  5. Validate that the registry setting exists and show the respective values.
  6. Set the 'Registry Setting Value' field to '1'.
  7. Click [Submit].
  8. Click [OK].
  9. Click [No].
  10. Open the 'Guarantor/Program Billing Defaults' form.
  11. Select 'Edit Template'.
  12. Select "Template 1" from the 'Select Template' dropdown.
  13. Select '837 Institutional'.
  14. Validate that the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' is shown with the following options, (none selected by default):
  15. Yes (Inpatient/Outpatient)
  16. Yes (Outpatient Only)
  17. Yes (Inpatient Only)
  18. No (Inpatient/Outpatient)
  19. Click [Submit].
  20. Click [No].
  21. Open the 'Admission' form.
  22. Admit an Inpatient client - "Client 1".
  23. Using the 'Diagnosis' form, File an active diagnosis record for "Client 1".
  24. File the 'Financial Eligibility' form for "Client 1", with "Guarantor 1".
  25. Specify the 'Coverage Effective Date' and 'Coverage Expiration Date' in the financial eligibility.
  26. Create charges for "Client 1" for more than one date, with the dates between the dates saved in step 21.
  27. Create a new Interim Billing Batch File, "Batch 1", which covers the services created for "Client 1" in step 22.
  28. Close the charges using the Interim Billing Batch File, "Batch 1".
  29. Open 'Client Ledger'.
  30. Select "Client 1" and the respective Episode.
  31. Validate that all the services are closed.
  32. Open 'Electronic Billing'.
  33. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  34. Set 'First Date Of Service To Include' with a date before the 'Coverage Effective Date' filed in step 21.
  35. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  36. Click [Process].
  37. Validate that the compile completes successfully.
  38. Click [OK].
  39. Select 'Dump File' from 'Billing Options'.
  40. Select 'Print' from 'Print Or Delete Report'.
  41. Select the file compiled in step 31.
  42. Click [Process].
  43. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first and last dates of the services being billed.
  44. Close the report.
  45. Click [No].
  46. Open 'Discharge' form.
  47. Set the 'Date Of Discharge' field to a date that is the day after the last day of service.
  48. Fill in all the required fields and select [Submit].
  49. Open 'Electronic Billing'.
  50. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  51. Set 'First Date Of Service To Include' with the date before the 'Coverage Effective Date' filed in step 21.
  52. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  53. Click [Process].
  54. Validate that the compile completes successfully.
  55. Click [OK].
  56. Select 'Dump File' from 'Billing Options'.
  57. Select 'Print' from 'Print Or Delete Report'.
  58. Select the file compiled in step 46.
  59. Click [Process].
  60. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first date of the service being billed and the discharge date file in step 41.
  61. Close the report.
  62. Click [No].
  63. Open the 'Guarantor/Program Billing Defaults' form.
  64. Select 'Edit Template'.
  65. Select "Template 1" from the 'Select Template' dropdown.
  66. Select '837 Institutional'.
  67. Set the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' to 'Yes (Inpatient/Outpatient)'.
  68. Click [Submit].
  69. Click [No].
  70. Open 'Electronic Billing'.
  71. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  72. Set 'First Date Of Service To Include' a date before the 'Coverage Effective Date' filed in step 21.
  73. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  74. Click [Process].
  75. Validate that the compile completes successfully.
  76. Click [OK].
  77. Select 'Dump File' from 'Billing Options'.
  78. Select 'Print' from 'Print Or Delete Report'.
  79. Select the file compiled in step 65.
  80. Click [Process].
  81. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first date of the service being billed and the discharge date file in step 41.
  82. Close the report.
  83. Click [No].
  84. Open the 'Guarantor/Program Billing Defaults' form.
  85. Select 'Edit Template'.
  86. Select "Template 1" from the 'Select Template' dropdown.
  87. Select '837 Institutional'.
  88. Set the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' to 'Yes (Inpatient Only)'.
  89. Click [Submit].
  90. Click [No].
  91. Open 'Electronic Billing'.
  92. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  93. Set 'First Date Of Service To Include' with the date before the 'Coverage Effective Date' filed in step 21.
  94. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  95. Click [Process].
  96. Validate that the compile completes successfully.
  97. Click [OK].
  98. Select 'Dump File' from 'Billing Options'.
  99. Select 'Print' from 'Print Or Delete Report'.
  100. Select the file compiled in step 85.
  101. Click [Process].
  102. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first date of the service being billed and the discharge date file in step 41.
  103. Close the report.
  104. Click [No].
  105. Open the 'Guarantor/Program Billing Defaults' form.
  106. Select 'Edit Template'.
  107. Select "Template 1" from the 'Select Template' dropdown.
  108. Select '837 Institutional'.
  109. Set the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' to 'Yes (Inpatient Only)'.
  110. Click [Submit].
  111. Click [No].
  112. Open 'Electronic Billing'.
  113. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  114. Set 'First Date Of Service To Include' with the date before the 'Coverage Effective Date' filed in step 21.
  115. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  116. Click [Process].
  117. Validate that the compile completes successfully.
  118. Click [OK].
  119. Select 'Dump File' from 'Billing Options'.
  120. Select 'Print' from 'Print Or Delete Report'.
  121. Select the file compiled in step 105.
  122. Click [Process].
  123. Validate that the discharge date is not included instead, the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first and last dates of the services being billed.
  124. Close the report.
  125. Click [No].
  126. Open the 'Guarantor/Program Billing Defaults' form.
  127. Select 'Edit Template'.
  128. Select "Template 1" from the 'Select Template' dropdown.
  129. Select '837 Institutional'.
  130. Set the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' to 'No (Inpatient/Outpatient)'.
  131. Click [Submit].
  132. Click [No].
  133. Open 'Electronic Billing'.
  134. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  135. Set 'First Date Of Service To Include' with the date before the 'Coverage Effective Date' filed in step 21.
  136. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  137. Click [Process].
  138. Validate that the compile completes successfully.
  139. Click [OK].
  140. Select 'Dump File' from 'Billing Options'.
  141. Select 'Print' from 'Print Or Delete Report'.
  142. Select the file compiled in step 105.
  143. Click [Process].
  144. Validate that the discharge date is not included instead, the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first and last dates of the services being billed.
  145. Close the report.
  146. Click [No].
  147. Query the tables below and validate that the new columns 'inc_dis_dt_2300_dtp_code' and 'inc_dis_dt_2300_dtp_value' are shown with the field 'Include Discharge Date In Statement To Date (2300-DTP)' value,
  148. SYSTEM.file_import_gpbdt_i837
  149. SYSTEM.table_837_i_facility_prov_num
  150. Close the SQL query window.
Scenario 2: File Import - Guarantor Program Billing Defaults - New field validations
Specific Setup:
  • At least one 'Guarantor/Program Billing Defaults' template exists, "Template 1", and the 837 Professional and Institutional sections contain data.
  • Files can be saved to the local desktop, "File A", edited, and imported back into Avatar through 'File Import'.
  • Registry setting '837I-Dates To Populate 2300 DTP' value set as '1'.
Steps
  1. Open 'Guarantor/Program Billing Defaults'.
  2. Edit the ‘837 Institutional’ section of "Template 1".
  3. Validate that the new field has no values selected.
  4. Click [Submit].
  5. Export the template in 'Edit' mode, saving it to the desktop with a unique name "File A".
  6. Edit the 'Edit' mode template to have a value defined for piece 130- 'Include Discharge Date In Statement To Date (2300-DTP)' and save it.
  7. Open 'File Import'.
  8. Import/Compile/Post the 'Edit' mode template "File A" in the 'Guarantor/Program Billing Defaults Template' file type.
  9. Select 'Print File'.
  10. Print the file posted in step 8 by selecting it and clicking 'Process Action'.
  11. Validate that the Crystal report is included with the new field 'Include Discharge Date In Statement To Date (2300-DTP)' and it's value we selected in step 6 for file import for 837 Institutional.
  12. Open 'Guarantor/Program Billing Defaults'.
  13. Select 'Edit Template'.
  14. Select the 'Edit mode template', "Template 1".
  15. Select the ‘837 Professional’ section. The field, 'Include Discharge Date In Statement To Date (2300-DTP)' will have the value used in step 6.
  16. Click [Submit].
  17. Click [No].
Scenario 3: 837I Compile - With '837I-Dates To Populate 2300 DTP' RS 2
Specific Setup:
  • Guarantor:
  • An active guarantor is identified or created - "Guarantor 1".
  • Guarantor/Program Billing Defaults Template:
  • An active 'Guarantor/Program Billing Defaults' template is identified or created that includes "Guarantor 1" - "Template 1".
Steps
  1. Open the 'Registry Settings' form.
  2. Set the 'Limit Registry Settings to the Following Search Criteria' text input box to "837I-Dates To Populate 2300 DTP".
  3. Select 'Yes' in 'Include Hidden Registry Settings'.
  4. Click [View Registry Settings].
  5. Validate that the registry setting exists and show the respective values.
  6. Set the 'Registry Setting Value' field to '2'.
  7. Click [Submit].
  8. Click [OK].
  9. Click [No].
  10. Open the 'Guarantor/Program Billing Defaults' form.
  11. Select 'Edit Template'.
  12. Select "Template 1" from the 'Select Template' dropdown.
  13. Select '837 Institutional'.
  14. Validate that the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' is not shown.
  15. Click [Submit].
  16. Click [No].
  17. Open the 'Admission' form.
  18. Admit an Inpatient client - "Client 1".
  19. Using the 'Diagnosis' form, File an active diagnosis record for "Client 1".
  20. File the 'Financial Eligibility' form for "Client 1", with "Guarantor 1".
  21. Specify the 'Coverage Effective Date' and 'Coverage Expiration Date' in the financial eligibility.
  22. Create charges for "Client 1" for more than one date(s), that fall between the dates saved in step 21.
  23. Create a new Interim Billing Batch File "Batch 1" which covers the services created for "Client 1" in step 22.
  24. Close the charges using the Interim Billing Batch File "Batch 1".
  25. Open 'Client Ledger'.
  26. Select "Client 1" and the respective Episode.
  27. Validate that all the services are closed.
  28. Open 'Electronic Billing'.
  29. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  30. Set 'First Date Of Service To Include' with the date earlier than the 'Coverage Effective Date' filed in step 21.
  31. Set 'Last Date Of Service To Include' with a date later than the 'Coverage Expiration Date' filed in step 21.
  32. Click [Process].
  33. Validate that the compile completes successfully.
  34. Click [OK].
  35. Select 'Dump File' from 'Billing Options'.
  36. Select 'Print' from 'Print Or Delete Report'.
  37. Select the file compiled in step 31.
  38. Click [Process].
  39. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the 'Coverage Effective date' filed in step 21 and the 'Last Date Of Service To Include' selected in step 29(b).
  40. Close the report.
  41. Click [No].
  42. Open 'Discharge' form.
  43. Set the 'Date Of Discharge' field to a date that is greater than the 'Coverage Expiration Date' filed in step 21.
  44. Fill in all the required fields and select [Submit].
  45. Open 'Electronic Billing'.
  46. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  47. Set 'First Date Of Service To Include' with the date earlier than the 'Coverage Effective Date' filed in step 21.
  48. Set 'Last Date Of Service To Include' with a date later than the 'Coverage Expiration Date' filed in step 21.
  49. Click [Process].
  50. Validate that the compile completes successfully.
  51. Click [OK].
  52. Select 'Dump File' from 'Billing Options'.
  53. Select 'Print' from 'Print Or Delete Report'.
  54. Select the file compiled in step 46.
  55. Click [Process].
  56. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the 'Coverage Effective Date' and 'Coverage Expiration Date' filed in step 21.
  57. Close the report.
  58. Click [No].
  59. Open 'Electronic Billing'.
  60. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  61. Set 'First Date Of Service To Include' with the date later than the 'Coverage Effective Date' filed in step 21.
  62. Set 'Last Date Of Service To Include' with a date earlier than the 'Coverage Expiration Date' filed in step 21.
  63. Click [Process].
  64. Validate that the compile completes successfully.
  65. Click [OK].
  66. Select 'Dump File' from 'Billing Options'.
  67. Select 'Print' from 'Print Or Delete Report'.
  68. Select the file compiled in step 46.
  69. Click [Process].
  70. Validate that the discharge date is not included instead, the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the First Date Of Service To Include' and 'Last Date Of Service To Include' dates used in the step 57(a, b).
  71. Close the report.
  72. Click [No].
Scenario 4: "Restrict Coverage Effective Date Edits to Prior Dates Only" registry setting functionality
Specific Setup:
  • Client: The client should be admitted and have an active episode - "Client A".
  • Financial Eligibility: "Client A" should have an already existing Financial Eligibility record with both Coverage Effective and Expiration dates.
Steps
  1. Open the 'Registry Settings' form.
  2. Set the 'Limit Registry Settings to the Following Search Criteria' to 'Restrict Coverage Effective Date Edits to Prior Dates Only'.
  3. Click [View Registry Settings].
  4. Validate that the respective registry setting shows up.
  5. Set the 'Avatar PM->Billing->Financial Eligibility->->->Restrict Coverage Effective Date Edits to Prior Dates Only' registry setting to a value other than 'Y' or 'N'.
  6. Verify an error message displays that the valid choices are 'Y or N' only.
  7. Set the 'Avatar PM->Billing->Financial Eligibility->->->Restrict Coverage Effective Date Edits to Prior Dates Only' registry setting to 'Y' and then submit to save.
  8. Open the 'Financial Eligibility' form.
  9. Search and select "Client A".
  10. Select the Episode from the grid.
  11. Select 'Guarantor Selection'.
  12. Check if the 'Coverage Effective Date' field is already showing the date in the file.
  13. Try to enter a date that is after the date that is already in the file and move away from the field.
  14. Validate that an error message appears when updating the 'Coverage Effective Date' field to a date that is later than the previously filed date.
  15. Validate the error text - 'The Coverage Effective Date cannot be updated to be later than the previously filed date.'.
  16. Click [OK].
  17. Validate that the 'Coverage Effective Date' field is restored with the last value saved.
  18. Set 'Coverage Effective Date' with a date that is before the date that is already in the file and move away from the field.
  19. Validate that there are no errors shown.
  20. Click [Submit].
  21. Open the 'Financial Eligibility' form.
  22. Search and select "Client A".
  23. Select the Episode from the grid.
  24. Select 'Guarantor Selection'.
  25. Check if the 'Coverage Effective Date' field is showing with the date we save in step 18.
  26. Click [Discard].
  27. Click [Yes].
  28. Open the 'Registry Settings' form.
  29. Set the 'Limit Registry Settings to the Following Search Criteria' to 'Restrict Coverage Effective Date Edits to Prior Dates Only'.
  30. Click [View Registry Settings].
  31. Set the 'Avatar PM->Billing->Financial Eligibility->->->Restrict Coverage Effective Date Edits to Prior Dates Only' registry setting to 'N' and then submit to save.
  32. Open the 'Financial Eligibility' form.
  33. Search and select "Client A".
  34. Select the Episode from the grid.
  35. Select 'Guarantor Selection'.
  36. Check if the 'Coverage Effective Date' field is showing with the date we save in step 18.
  37. Try to enter a date that is after the date that is already in the file and move away from the field.
  38. Validate that there are no errors shown.
  39. Click [Submit].
  40. Open the 'Financial Eligibility' form.
  41. Search and select "Client A".
  42. Select the Episode from the grid.
  43. Select 'Guarantor Selection'.
  44. Check if the 'Coverage Effective Date' field is showing with the date we save in step 37.
  45. Click [Discard].
  46. Click [Yes].
Topics
• Electronic Billing • File Import • Financial Eligibility • Guarantor/Program Billing Defaults • Registry Settings
AV-92688 Summary | Details
Registry Setting
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Admission
  • Client Charge Input
  • Client Ledger
  • Create Interim Billing Batch File
  • Diagnosis
  • Discharge
  • Electronic Billing
  • Financial Eligibility
  • Registry Settings (PM)
  • File Import
Scenario 1: 837I Compile - With '837I-Dates To Populate 2300 DTP' RS 1
Specific Setup:
  • Guarantor:
  • An active guarantor is identified or created - "Guarantor 1".
  • Guarantor/Program Billing Defaults Template:
  • An active 'Guarantor/Program Billing Defaults' template is identified or created that includes "Guarantor 1" - "Template 1".
Steps
  1. Open the 'Registry Settings' form.
  2. Set the 'Limit Registry Settings to the Following Search Criteria' text input box to "837I-Dates To Populate 2300 DTP".
  3. Select 'Yes' in 'Include Hidden Registry Settings'.
  4. Click [View Registry Settings].
  5. Validate that the registry setting exists and show the respective values.
  6. Set the 'Registry Setting Value' field to '1'.
  7. Click [Submit].
  8. Click [OK].
  9. Click [No].
  10. Open the 'Guarantor/Program Billing Defaults' form.
  11. Select 'Edit Template'.
  12. Select "Template 1" from the 'Select Template' dropdown.
  13. Select '837 Institutional'.
  14. Validate that the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' is shown with the following options, (none selected by default):
  15. Yes (Inpatient/Outpatient)
  16. Yes (Outpatient Only)
  17. Yes (Inpatient Only)
  18. No (Inpatient/Outpatient)
  19. Click [Submit].
  20. Click [No].
  21. Open the 'Admission' form.
  22. Admit an Inpatient client - "Client 1".
  23. Using the 'Diagnosis' form, File an active diagnosis record for "Client 1".
  24. File the 'Financial Eligibility' form for "Client 1", with "Guarantor 1".
  25. Specify the 'Coverage Effective Date' and 'Coverage Expiration Date' in the financial eligibility.
  26. Create charges for "Client 1" for more than one date, with the dates between the dates saved in step 21.
  27. Create a new Interim Billing Batch File, "Batch 1", which covers the services created for "Client 1" in step 22.
  28. Close the charges using the Interim Billing Batch File, "Batch 1".
  29. Open 'Client Ledger'.
  30. Select "Client 1" and the respective Episode.
  31. Validate that all the services are closed.
  32. Open 'Electronic Billing'.
  33. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  34. Set 'First Date Of Service To Include' with a date before the 'Coverage Effective Date' filed in step 21.
  35. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  36. Click [Process].
  37. Validate that the compile completes successfully.
  38. Click [OK].
  39. Select 'Dump File' from 'Billing Options'.
  40. Select 'Print' from 'Print Or Delete Report'.
  41. Select the file compiled in step 31.
  42. Click [Process].
  43. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first and last dates of the services being billed.
  44. Close the report.
  45. Click [No].
  46. Open 'Discharge' form.
  47. Set the 'Date Of Discharge' field to a date that is the day after the last day of service.
  48. Fill in all the required fields and select [Submit].
  49. Open 'Electronic Billing'.
  50. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  51. Set 'First Date Of Service To Include' with the date before the 'Coverage Effective Date' filed in step 21.
  52. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  53. Click [Process].
  54. Validate that the compile completes successfully.
  55. Click [OK].
  56. Select 'Dump File' from 'Billing Options'.
  57. Select 'Print' from 'Print Or Delete Report'.
  58. Select the file compiled in step 46.
  59. Click [Process].
  60. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first date of the service being billed and the discharge date file in step 41.
  61. Close the report.
  62. Click [No].
  63. Open the 'Guarantor/Program Billing Defaults' form.
  64. Select 'Edit Template'.
  65. Select "Template 1" from the 'Select Template' dropdown.
  66. Select '837 Institutional'.
  67. Set the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' to 'Yes (Inpatient/Outpatient)'.
  68. Click [Submit].
  69. Click [No].
  70. Open 'Electronic Billing'.
  71. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  72. Set 'First Date Of Service To Include' a date before the 'Coverage Effective Date' filed in step 21.
  73. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  74. Click [Process].
  75. Validate that the compile completes successfully.
  76. Click [OK].
  77. Select 'Dump File' from 'Billing Options'.
  78. Select 'Print' from 'Print Or Delete Report'.
  79. Select the file compiled in step 65.
  80. Click [Process].
  81. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first date of the service being billed and the discharge date file in step 41.
  82. Close the report.
  83. Click [No].
  84. Open the 'Guarantor/Program Billing Defaults' form.
  85. Select 'Edit Template'.
  86. Select "Template 1" from the 'Select Template' dropdown.
  87. Select '837 Institutional'.
  88. Set the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' to 'Yes (Inpatient Only)'.
  89. Click [Submit].
  90. Click [No].
  91. Open 'Electronic Billing'.
  92. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  93. Set 'First Date Of Service To Include' with the date before the 'Coverage Effective Date' filed in step 21.
  94. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  95. Click [Process].
  96. Validate that the compile completes successfully.
  97. Click [OK].
  98. Select 'Dump File' from 'Billing Options'.
  99. Select 'Print' from 'Print Or Delete Report'.
  100. Select the file compiled in step 85.
  101. Click [Process].
  102. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first date of the service being billed and the discharge date file in step 41.
  103. Close the report.
  104. Click [No].
  105. Open the 'Guarantor/Program Billing Defaults' form.
  106. Select 'Edit Template'.
  107. Select "Template 1" from the 'Select Template' dropdown.
  108. Select '837 Institutional'.
  109. Set the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' to 'Yes (Inpatient Only)'.
  110. Click [Submit].
  111. Click [No].
  112. Open 'Electronic Billing'.
  113. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  114. Set 'First Date Of Service To Include' with the date before the 'Coverage Effective Date' filed in step 21.
  115. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  116. Click [Process].
  117. Validate that the compile completes successfully.
  118. Click [OK].
  119. Select 'Dump File' from 'Billing Options'.
  120. Select 'Print' from 'Print Or Delete Report'.
  121. Select the file compiled in step 105.
  122. Click [Process].
  123. Validate that the discharge date is not included instead, the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first and last dates of the services being billed.
  124. Close the report.
  125. Click [No].
  126. Open the 'Guarantor/Program Billing Defaults' form.
  127. Select 'Edit Template'.
  128. Select "Template 1" from the 'Select Template' dropdown.
  129. Select '837 Institutional'.
  130. Set the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' to 'No (Inpatient/Outpatient)'.
  131. Click [Submit].
  132. Click [No].
  133. Open 'Electronic Billing'.
  134. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  135. Set 'First Date Of Service To Include' with the date before the 'Coverage Effective Date' filed in step 21.
  136. Set ' Last Date Of Service To Include' with a date after the 'Coverage Expiration Date' filed in step 21.
  137. Click [Process].
  138. Validate that the compile completes successfully.
  139. Click [OK].
  140. Select 'Dump File' from 'Billing Options'.
  141. Select 'Print' from 'Print Or Delete Report'.
  142. Select the file compiled in step 105.
  143. Click [Process].
  144. Validate that the discharge date is not included instead, the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the first and last dates of the services being billed.
  145. Close the report.
  146. Click [No].
  147. Query the tables below and validate that the new columns 'inc_dis_dt_2300_dtp_code' and 'inc_dis_dt_2300_dtp_value' are shown with the field 'Include Discharge Date In Statement To Date (2300-DTP)' value,
  148. SYSTEM.file_import_gpbdt_i837
  149. SYSTEM.table_837_i_facility_prov_num
  150. Close the SQL query window.
Scenario 2: File Import - Guarantor Program Billing Defaults - New field validations
Specific Setup:
  • At least one 'Guarantor/Program Billing Defaults' template exists, "Template 1", and the 837 Professional and Institutional sections contain data.
  • Files can be saved to the local desktop, "File A", edited, and imported back into Avatar through 'File Import'.
  • Registry setting '837I-Dates To Populate 2300 DTP' value set as '1'.
Steps
  1. Open 'Guarantor/Program Billing Defaults'.
  2. Edit the ‘837 Institutional’ section of "Template 1".
  3. Validate that the new field has no values selected.
  4. Click [Submit].
  5. Export the template in 'Edit' mode, saving it to the desktop with a unique name "File A".
  6. Edit the 'Edit' mode template to have a value defined for piece 130- 'Include Discharge Date In Statement To Date (2300-DTP)' and save it.
  7. Open 'File Import'.
  8. Import/Compile/Post the 'Edit' mode template "File A" in the 'Guarantor/Program Billing Defaults Template' file type.
  9. Select 'Print File'.
  10. Print the file posted in step 8 by selecting it and clicking 'Process Action'.
  11. Validate that the Crystal report is included with the new field 'Include Discharge Date In Statement To Date (2300-DTP)' and it's value we selected in step 6 for file import for 837 Institutional.
  12. Open 'Guarantor/Program Billing Defaults'.
  13. Select 'Edit Template'.
  14. Select the 'Edit mode template', "Template 1".
  15. Select the ‘837 Professional’ section. The field, 'Include Discharge Date In Statement To Date (2300-DTP)' will have the value used in step 6.
  16. Click [Submit].
  17. Click [No].
Scenario 3: 837I Compile - With '837I-Dates To Populate 2300 DTP' RS 2
Specific Setup:
  • Guarantor:
  • An active guarantor is identified or created - "Guarantor 1".
  • Guarantor/Program Billing Defaults Template:
  • An active 'Guarantor/Program Billing Defaults' template is identified or created that includes "Guarantor 1" - "Template 1".
Steps
  1. Open the 'Registry Settings' form.
  2. Set the 'Limit Registry Settings to the Following Search Criteria' text input box to "837I-Dates To Populate 2300 DTP".
  3. Select 'Yes' in 'Include Hidden Registry Settings'.
  4. Click [View Registry Settings].
  5. Validate that the registry setting exists and show the respective values.
  6. Set the 'Registry Setting Value' field to '2'.
  7. Click [Submit].
  8. Click [OK].
  9. Click [No].
  10. Open the 'Guarantor/Program Billing Defaults' form.
  11. Select 'Edit Template'.
  12. Select "Template 1" from the 'Select Template' dropdown.
  13. Select '837 Institutional'.
  14. Validate that the new field, 'Include Discharge Date In Statement To Date (2300-DTP)' is not shown.
  15. Click [Submit].
  16. Click [No].
  17. Open the 'Admission' form.
  18. Admit an Inpatient client - "Client 1".
  19. Using the 'Diagnosis' form, File an active diagnosis record for "Client 1".
  20. File the 'Financial Eligibility' form for "Client 1", with "Guarantor 1".
  21. Specify the 'Coverage Effective Date' and 'Coverage Expiration Date' in the financial eligibility.
  22. Create charges for "Client 1" for more than one date(s), that fall between the dates saved in step 21.
  23. Create a new Interim Billing Batch File "Batch 1" which covers the services created for "Client 1" in step 22.
  24. Close the charges using the Interim Billing Batch File "Batch 1".
  25. Open 'Client Ledger'.
  26. Select "Client 1" and the respective Episode.
  27. Validate that all the services are closed.
  28. Open 'Electronic Billing'.
  29. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  30. Set 'First Date Of Service To Include' with the date earlier than the 'Coverage Effective Date' filed in step 21.
  31. Set 'Last Date Of Service To Include' with a date later than the 'Coverage Expiration Date' filed in step 21.
  32. Click [Process].
  33. Validate that the compile completes successfully.
  34. Click [OK].
  35. Select 'Dump File' from 'Billing Options'.
  36. Select 'Print' from 'Print Or Delete Report'.
  37. Select the file compiled in step 31.
  38. Click [Process].
  39. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the 'Coverage Effective date' filed in step 21 and the 'Last Date Of Service To Include' selected in step 29(b).
  40. Close the report.
  41. Click [No].
  42. Open 'Discharge' form.
  43. Set the 'Date Of Discharge' field to a date that is greater than the 'Coverage Expiration Date' filed in step 21.
  44. Fill in all the required fields and select [Submit].
  45. Open 'Electronic Billing'.
  46. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  47. Set 'First Date Of Service To Include' with the date earlier than the 'Coverage Effective Date' filed in step 21.
  48. Set 'Last Date Of Service To Include' with a date later than the 'Coverage Expiration Date' filed in step 21.
  49. Click [Process].
  50. Validate that the compile completes successfully.
  51. Click [OK].
  52. Select 'Dump File' from 'Billing Options'.
  53. Select 'Print' from 'Print Or Delete Report'.
  54. Select the file compiled in step 46.
  55. Click [Process].
  56. Validate that the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the 'Coverage Effective Date' and 'Coverage Expiration Date' filed in step 21.
  57. Close the report.
  58. Click [No].
  59. Open 'Electronic Billing'.
  60. Run the '837-Institutional' bill for the Interim Billing "Batch 1", for "Guarantor 1".
  61. Set 'First Date Of Service To Include' with the date later than the 'Coverage Effective Date' filed in step 21.
  62. Set 'Last Date Of Service To Include' with a date earlier than the 'Coverage Expiration Date' filed in step 21.
  63. Click [Process].
  64. Validate that the compile completes successfully.
  65. Click [OK].
  66. Select 'Dump File' from 'Billing Options'.
  67. Select 'Print' from 'Print Or Delete Report'.
  68. Select the file compiled in step 46.
  69. Click [Process].
  70. Validate that the discharge date is not included instead, the Statement From and To Date in the 2300-DTP-03 segment of the 837 Institutional file is overridden by the First Date Of Service To Include' and 'Last Date Of Service To Include' dates used in the step 57(a, b).
  71. Close the report.
  72. Click [No].
Scenario 4: "Restrict Coverage Effective Date Edits to Prior Dates Only" registry setting functionality
Specific Setup:
  • Client: The client should be admitted and have an active episode - "Client A".
  • Financial Eligibility: "Client A" should have an already existing Financial Eligibility record with both Coverage Effective and Expiration dates.
Steps
  1. Open the 'Registry Settings' form.
  2. Set the 'Limit Registry Settings to the Following Search Criteria' to 'Restrict Coverage Effective Date Edits to Prior Dates Only'.
  3. Click [View Registry Settings].
  4. Validate that the respective registry setting shows up.
  5. Set the 'Avatar PM->Billing->Financial Eligibility->->->Restrict Coverage Effective Date Edits to Prior Dates Only' registry setting to a value other than 'Y' or 'N'.
  6. Verify an error message displays that the valid choices are 'Y or N' only.
  7. Set the 'Avatar PM->Billing->Financial Eligibility->->->Restrict Coverage Effective Date Edits to Prior Dates Only' registry setting to 'Y' and then submit to save.
  8. Open the 'Financial Eligibility' form.
  9. Search and select "Client A".
  10. Select the Episode from the grid.
  11. Select 'Guarantor Selection'.
  12. Check if the 'Coverage Effective Date' field is already showing the date in the file.
  13. Try to enter a date that is after the date that is already in the file and move away from the field.
  14. Validate that an error message appears when updating the 'Coverage Effective Date' field to a date that is later than the previously filed date.
  15. Validate the error text - 'The Coverage Effective Date cannot be updated to be later than the previously filed date.'.
  16. Click [OK].
  17. Validate that the 'Coverage Effective Date' field is restored with the last value saved.
  18. Set 'Coverage Effective Date' with a date that is before the date that is already in the file and move away from the field.
  19. Validate that there are no errors shown.
  20. Click [Submit].
  21. Open the 'Financial Eligibility' form.
  22. Search and select "Client A".
  23. Select the Episode from the grid.
  24. Select 'Guarantor Selection'.
  25. Check if the 'Coverage Effective Date' field is showing with the date we save in step 18.
  26. Click [Discard].
  27. Click [Yes].
  28. Open the 'Registry Settings' form.
  29. Set the 'Limit Registry Settings to the Following Search Criteria' to 'Restrict Coverage Effective Date Edits to Prior Dates Only'.
  30. Click [View Registry Settings].
  31. Set the 'Avatar PM->Billing->Financial Eligibility->->->Restrict Coverage Effective Date Edits to Prior Dates Only' registry setting to 'N' and then submit to save.
  32. Open the 'Financial Eligibility' form.
  33. Search and select "Client A".
  34. Select the Episode from the grid.
  35. Select 'Guarantor Selection'.
  36. Check if the 'Coverage Effective Date' field is showing with the date we save in step 18.
  37. Try to enter a date that is after the date that is already in the file and move away from the field.
  38. Validate that there are no errors shown.
  39. Click [Submit].
  40. Open the 'Financial Eligibility' form.
  41. Search and select "Client A".
  42. Select the Episode from the grid.
  43. Select 'Guarantor Selection'.
  44. Check if the 'Coverage Effective Date' field is showing with the date we save in step 37.
  45. Click [Discard].
  46. Click [Yes].
Topics
• Electronic Billing • File Import • Financial Eligibility • Guarantor/Program Billing Defaults • Registry Settings
Table Changes
Table Column Change
table_837_i_facility_prov_num inc_dis_dt_2300_dtp_code ADD
table_837_i_facility_prov_num inc_dis_dt_2300_dtp_value ADD
file_import_gpbdt_i837 inc_dis_dt_2300_dtp_code ADD
file_import_gpbdt_i837 inc_dis_dt_2300_dtp_value ADD