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Avatar Cal-PM 2023 Update 84

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Product Requirements and Recommendations

Avatar Cal-PM required
RADplus required

Recommended Update Level

Avatar Cal-PM 2023 Monthly Release 2023.03.01
Avatar Cal-PM 2023 Update 69
Avatar CareFabric 2023 Update 40
RADplus 2023 Monthly Release 2023.03.01

Product Update Description

The following provider directory (274) updates are made: 1) Support is added for plan type 'DMC-ODS'. 2) Support is added for provider directory APIs via Fhir. Note that Avatar CareFabric 2023 Update 40 is also necessary for full support. 3) Support of 'Site Specific Section Modeling' is removed. 4) An issue concerning the file naming convention used for files created on the server is resolved. 5) An issue concerning support of field 'Type Of Service (2100DA-N2-02)' is resolved.

Required Updates

Avatar Cal-PM 2023 Update 4

Included Updates

3, 4, 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, 71, 79, 82

Details
NEW3 CHANGED0 FIXED0
New (3)
Avatar Cal-PM '274 - Provider Directory Definition' Fhir Support
Support is added for Provider Directory APIs via Fhir.
The Avatar Cal-PM '274 - Provider Directory Definition' form/records are updated for Provider Directory API support via Fhir. Note - Avatar CareFabric 2023 Update 40 is also required for full support of Provider Directory APIs.
Value Added: Adds Fhir Support for Avatar Cal-PM '274 - Provider Directory Definition' APIs
Topics
• 274 - Provider Directory • Dictionary
 
274 Provider Functionality
Functionality for the 274 Provider process has been modified: 1) Support of 'Site Specific Section Modeling' is removed. 2) Support of field 'Type Of Service (2100DA-N2-02)' has been modified. 3) File Import has been updated to support new functionally.
The following fields have been added to various 'SYSTEM.hcpd274' tables. Please review the release notes for more information. plan_type_code, plan_type_value, modality_type_code, modality_type_sh_value, modality_type_value, delete_data_entry_by, delete_data_entry_date, delete_data_entry_time, delete_data_entry_user_id, delete_data_entry_user_name, delete_option_desc, and delete_option_id.
Value Added: Allows users to use the form without requiring Site Specific Section Modeling fields.
Topics
• 274 - Provider Directory • File Import
 
274 - Provider Directory Submission
274 Functionality has been modified: 1) Support is added for the 'Plan Type' of Drug Medi-Cal Organized Delivery System ('DMC-ODS'). 2) Support is added for the naming convention of files created on the server.
Value Added: Allows greater reporting abilities.
Topics
• 274 - Provider Directory • File Import
 
Acceptance Tests
AV-91140 Summary | Details
Avatar Cal-PM '274 - Provider Directory Definition' Fhir Support
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Dictionary Update (PM)
Scenario 1: Avatar Cal-PM 'Dictionary Update' - Verification of '274 - Provider Directory Definition' Extended Dictionary Elements
Steps
  1. Open Avatar Cal-PM 'Dictionary Update' form.
  2. Navigate to 'Input Dictionary Code(s)' section of form.
  3. Select 'Client' file/indirect.
  4. Select Data Element/Dictionary '(10029) Language Code (ISO 639-3)'.
  5. Enter/select existing value for Dictionary Code/Value; ensure Extended Dictionary Data Element '(274195) Fhir Language Code' is available for assignment/selection.
  6. Note - Default 'Fhir Language Code' Extended Dictionary values will be assigned to existing 'Language Code (ISO 639-3)' Dictionary Codes/Values where applicable to Fhir Provider Directory API support in conjunction with Avatar CareFabric.
  7. Select 'Other Tables Files' file/indirect.
  8. Select Data Element/Dictionary '(274113) Facility Type (2100DA-N2-01)'.
  9. Enter/select value for Dictionary Code/Value; ensure Extended Dictionary Data Element '(274193) Fhir Location Role Type' is available for assignment/selection.
  10. Note - Default 'Fhir Location Role Type' Extended Dictionary values will be assigned to existing 'Facility Type (2100DA-N2-01)' Dictionary Codes/Values where applicable to Fhir Provider Directory API support in conjunction with Avatar CareFabric.
  11. Select Data Element/Dictionary '(274190) Office Hours Code'.
  12. Enter/select value for Dictionary Code/Value; ensure Extended Dictionary Data Element '(274194) Fhir Office Hours Code' is available for assignment/selection.
  13. Note - Default 'Fhir Office Hours Code' Extended Dictionary values will be assigned to existing 'Office Hours Code' Dictionary Codes/Values where applicable to Fhir Provider Directory API support in conjunction with Avatar CareFabric.
  14. Select Data Element/Dictionary '(274248) Language Proficiency Indicator - 1 (2100EA-LUI-05)'.
  15. Enter/select value for Dictionary Code/Value; ensure Extended Dictionary Data Element '(274196) Fhir Language Proficiency Code' is available for assignment/selection.
  16. Note - Default 'Fhir Language Proficiency Code' Extended Dictionary values will be assigned to existing 'Language Proficiency Indicator - 1 (2100EA-LUI-05)' Dictionary Codes/Values where applicable to Fhir Provider Directory API support in conjunction with Avatar CareFabric.
  17. Select Data Element/Dictionary '(274246) English Proficiency Indicator (2100EA-LUI-05)'.
  18. Enter/select value for Dictionary Code/Value; ensure Extended Dictionary Data Element '(274196) Fhir Language Proficiency Code' is available for assignment/selection.
  19. Note - Default 'Fhir Language Proficiency Code' Extended Dictionary values will be assigned to existing 'English Proficiency Indicator (2100EA-LUI-05)' Dictionary Codes/Values where applicable to Fhir Provider Directory API support in conjunction with Avatar CareFabric.
  20. Select Data Element/Dictionary '(274224) Service Type (2100EA-N2-02)'.
  21. Enter/select value for Dictionary Code/Value; ensure the following Extended Dictionary Data Elements are available for assignment/selection:
  22. '(274290) Fhir Healthcare Service Category'
  23. '(274291) Fhir Healthcare Service Type'
  24. '(274292) Fhir Appointment Required'
  25. '(274293) Fhir Delivery Methods and Modalities'
  26. Note - Default values will not be defined for these Extended Dictionary Data Elements for existing 'Service Type' Dictionary Codes/Values.
Topics
• 274 - Provider Directory • Dictionary
AV-93510 Summary | Details
274 Provider Functionality
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • 274 - Provider Directory Definition
  • Crystal Report Viewer
  • File Import
  • User Definition
  • 274 - Provider Directory Defaults
  • 274 - Provider Directory Submission
Scenario 1: 274 - Provider Directory Defaults
Specific Setup:
  • Tester has been given access to the ‘274 - Provider Directory Defaults’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’.
Steps
  1. Open '274 - Provider Directory Defaults'.
  2. Validate that 'Plan Type' is the only required field.
  3. Select 'Mental Health Plan' in 'Plan Type'.
  4. Validate that 'Healthcare Plan Code' is now required.
  5. Add data to the form.
  6. Click [Submit].
  7. Open '274 - Provider Directory Defaults'.
  8. Validate that 'Plan Type' is the only required field.
  9. Select 'Mental Health Plan' in 'Plan Type'.
  10. Validate that the submitted data displays correctly.
  11. Edit at least on field, noting the edited value.
  12. Click [Submit].
  13. Open '274 - Provider Directory Defaults'.
  14. Validate that 'Plan Type' is the only required field.
  15. Select 'Mental Health Plan' in 'Plan Type'.
  16. Validate that the edited data displays correctly.
  17. Close the form.
  18. Repeat steps 1 - 17 for the 'Plan Type' of 'Drug Medi-Cal Organized Delivery System.
Scenario 2: 274 - Provider Directory Definition - Site Definition
Specific Setup:
  • Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’.
  • A 'Group Definition' exists in the '274 - Provider Directory Definition’ form.
Steps
  1. Open ‘274 - Provider Directory Definition’.
  2. Select the 'Site Definition’ section.
  3. Validate that ‘Plan Type’ is the only required field on the form.
  4. Select 'Mental Health Plan' in ' ‘Plan Type’.
  5. Validate that ‘Add or Edit Site’ is now required.
  6. Select ‘Add’ in ‘Add or Edit Site’.
  7. Validate that ‘Site or Location of Service Name (2100A-NM1-03)', ‘Provider Group’ and ‘Active’ are now required fields.
  8. Add desired data to the form.
  9. Click [File Site Details].
  10. Click [OK].
  11. Select 'Mental Health Plan' in ' ‘Plan Type’.
  12. Select ‘Edit’ in ‘Add or Edit Site’.
  13. Select the filed Site and validate that the data displays correctly.
  14. Edit at least one field, noting the edited value.
  15. Click [File Site Details].
  16. Click [OK].
  17. Select 'Mental Health Plan' in ' ‘Plan Type’.
  18. Select ‘Edit’ in ‘Add or Edit Site’.
  19. Select the filed Site and validate that the edited data displays correctly.
  20. Repeat steps 1 - 19 for Plan Type' of 'Drug Medi-Cal Organized Delivery System'.
  21. Close the form.
Scenario 3: 274 - Provider Directory Definition - Provider Definition
Specific Setup:
  • Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’.
  • 274 Provider Directory Definition:
  • A minimum of one 'Group Definition' exists.
  • A minimum of one 'Site Definition' exists.
Steps
  1. Open ‘274 - Provider Directory Definition’.
  2. Validate that the form opened to the ‘Group Definition’ section.
  3. Select the ‘Provider Definition’ section.
  4. Validate that ‘Plan Type’ is the only required field on the form.
  5. Select 'Mental Health Plan' in 'Plan Type'.
  6. Validate that 'Provider' is now required.
  7. Select a ‘Provider’.
  8. Validate that ‘Associated Site’ and ‘Active’ are now required fields.
  9. Select the ‘Associated Site’.
  10. Select a value in ‘Active’.
  11. Add desired data to the form.
  12. Click [File Provider Details].
  13. Click [OK].
  14. Select 'Mental Health Plan' in 'Plan Type'.
  15. Select the same provider and site.
  16. Validate that the submitted date displays correctly.
  17. Edit at least one field, noting the value.
  18. Click [File Provider Details].
  19. Click [OK].
  20. Select 'Mental Health Plan' in 'Plan Type'.
  21. Select the same provider and site.
  22. Validate that the edited data displays.
  23. Select a new value in ‘Associated Site’.
  24. Validate that a ‘Provider-Site Records On File’ item displays the message ‘Record to default Information From’ and contains a drop down list of ‘Sites’.
  25. Select a site and click [OK].
  26. Validate that the data defaulted into the fields.
  27. Click [File Provider Details].
  28. Click [OK].
  29. Select 'Drug Medi-Cal Organized Delivery System' in 'Plan Type'.
  30. Select the same provider and validate that the 'Currently Associated Sites' field is blank.
  31. Repeat steps 9 - 22 for the 'Plan Type' of 'Drug Medi-Cal Organized Delivery System'.
  32. Close the form.
Scenario 4: File Import – 274 Group Definition
Specific Setup:
  • Note the value of the following registry setting for use in creating the file import item: Avatar PM->System Maintenance->File Import->->->Import File Delimiter.
  • The ‘File Import’ spreadsheet has been included in the update zip file.
  • Note: In addition to fields that are required in the spreadsheet, individual agencies may require fields through 'TABLE27400 (274 = Provider Directory Definition) Group Definition’ in 'Site Specific Section Modeling’. Verify if the agency is requiring additional fields.
  • A ‘274 Group Definition’ file has been created, with the correct delimiter, according to the ‘File Import’ spreadsheet guidelines, and agency required fields. Note the location of the file.
  • Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’.
Steps
  1. Open ‘File Import’.
  2. Select ‘274 Group Definition’ in ‘File Type’.
  3. The ‘Action’ field is required and defaults to ‘Upload New File’.
  4. Click [Process Action].
  5. Navigate to the location of the file in the file explorer and select the file.
  6. Click [Open].
  7. Select ‘Compile/Validate File’ in ‘Action’.
  8. Select the file in ‘Files’.
  9. Click [Process Action].
  10. A message will be received stating that the file compiled or that there were errors.
  11. Click [OK].
  12. If there are errors, select ‘Print Errors’ in action.
  13. Select the file in ‘Files’.
  14. Click [Process Action].
  15. Review the error report and update the file to correct the error.
  16. Select ‘Delete File’ in ‘Action’.
  17. Select the file in ‘Files’.
  18. Click [Process Action].
  19. A ‘Delete File’ message is received stating: Are you sure?
  20. Click [Yes].
  21. An ‘Information’ message is received stating: Deleted.
  22. Click [OK].
  23. Select ‘Upload New File’ in ‘Action’.
  24. Click [Process Action].
  25. Navigate to the location of the file in the file explorer and select the file.
  26. Click [Open].
  27. Select ‘Compile/Validate File’ in ‘Action’.
  28. Select the file in ‘Files’.
  29. Click [Process Action].
  30. A message will be received stating that the file compiled or that there were errors.
  31. Click [OK].
  32. If the file compiled, select ‘Print File’ in ‘Action’.
  33. Select the file in ‘Files’.
  34. Click [Process Action].
  35. Validate the data in the report.
  36. Close the report.
  37. Select ‘Post File’ in ‘Action’.
  38. Select the file in ‘Files’.
  39. Click [Process Action].
  40. The ‘Information’ message will contain: Posted.
  41. Click [OK].
  42. Open ‘274 – Provider Directory Definition’.
  43. Select ‘Edit’ in ‘Add or Edit Group’.
  44. Select the ‘Provider Group’ that was imported.
  45. Note the ‘Provider Group’ value in the parenthesis. This is the ‘Provider Group ID’.
  46. Validate the data.
  47. Close the form.
  48. If desired, edit the ‘274 Group Definition’ file, giving it a new name. At a minimum add the 'Provider Group ID’ to position two and edit one item.
  49. Select ‘Upload New File’ in ‘Action’.
  50. Click [Process Action].
  51. Navigate to the location of the edited file in the file explorer and select the file.
  52. Click [Open].
  53. Select ‘Compile/Validate File’ in ‘Action’.
  54. Select the file in ‘Files’.
  55. Click [Process Action].
  56. Click [OK] on the ‘Compiled’ message.
  57. Select ‘Print File’ in ‘Action’.
  58. Select the file in ‘Files’.
  59. Click [Process Action].
  60. Validate the data in the report.
  61. Close the report.
  62. Select ‘Post File’ in ‘Action’.
  63. Select the file in ‘Files’.
  64. Click [Process Action].
  65. An ‘Information’ message is received stating: Posted.
  66. Click [OK].
  67. If desired, select ‘Delete File’ in ‘Action’.
  68. Select the file in ‘Files’.
  69. Click [Process Action].
  70. A ‘Delete File’ message is received stating: Are you sure?
  71. Click [No].
  72. Validate that the message closed.
  73. Click [Process Action].
  74. A ‘Delete File’ message is received stating: Are you sure?
  75. Click [Yes].
  76. An ‘Information’ message is received stating: Deleted.
  77. Click [OK].
  78. Open ‘274 – Provider Directory Definition’.
  79. Select ‘Edit’ in ‘Add or Edit Group’.
  80. Select the ‘Provider Group’ that was edited.
  81. Validate the edited data.
  82. Close the form.
Scenario 5: File Import – 274 Site Definition
Specific Setup:
  • Note the value of the following registry setting for use in creating the file import item: Avatar PM->System Maintenance->File Import->->->Import File Delimiter.
  • The ‘File Import’ spreadsheet has been included in the update zip file.
  • Note: In addition to fields that are required in the spreadsheet, individual agencies may require fields through 'TABLE27400 (274 = Provider Directory Definition) Site Definition’ in 'Site Specific Section Modeling’. Verify if the agency is requiring additional fields.
  • A ‘274 Site Definition’ file has been created, with the correct delimiter, according to the ‘File Import’ spreadsheet guidelines, and agency required fields. Note the location of the file.
  • Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’.
Steps
  1. Open ‘File Import’.
  2. Select ‘274 Site Definition’ in ‘File Type’.
  3. The ‘Action’ field is required and defaults to ‘Upload New File’.
  4. Click [Process Action].
  5. Navigate to the location of the file in the file explorer and select the file.
  6. Click [Open].
  7. Select ‘Compile/Validate File’ in ‘Action’.
  8. Select the file in ‘Files’.
  9. Click [Process Action].
  10. A message will be received stating that the file compiled or that there were errors.
  11. Click [OK].
  12. If there are errors, select ‘Print Errors’ in action.
  13. Select the file in ‘Files’.
  14. Click [Process Action].
  15. Review the error report and update the file to correct the error.
  16. Select ‘Delete File’ in ‘Action’.
  17. Select the file in ‘Files’.
  18. Click [Process Action].
  19. A ‘Delete File’ message is received stating: Are you sure?
  20. Click [Yes].
  21. An ‘Information’ message is received stating: Deleted.
  22. Click [OK].
  23. Select ‘Upload New File’ in ‘Action’.
  24. Click [Process Action].
  25. Navigate to the location of the file in the file explorer and select the file.
  26. Click [Open].
  27. Select ‘Compile/Validate File’ in ‘Action’.
  28. Select the file in ‘Files’.
  29. Click [Process Action].
  30. A message will be received stating that the file compiled or that there were errors.
  31. Click [OK].
  32. If the file compiled, select ‘Print File’ in ‘Action’.
  33. Select the file in ‘Files’.
  34. Click [Process Action].
  35. Validate the data in the report.
  36. Close the report.
  37. Select ‘Post File’ in ‘Action’.
  38. Select the file in ‘Files’.
  39. Click [Process Action].
  40. The ‘Information’ message will contain: Posted.
  41. Click [OK].
  42. Click [X].
  43. Open ‘274 – Provider Directory Definition’.
  44. Select the 'Site Definition' section.
  45. Select ‘Edit’ in ‘Add or Edit Site’.
  46. Select the ‘Site Definition’ that was imported.
  47. Note the ‘Site Definition’ value in the parenthesis. This is the ‘Site ID’.
  48. Validate the data.
  49. Close the form.
  50. If desired, edit the ‘274 Site Definition’ file, giving it a new name. At a minimum add the 'Site ID’ to position two and edit one item.
  51. Select ‘Upload New File’ in ‘Action’.
  52. Click [Process Action].
  53. Navigate to the location of the edited file in the file explorer and select the file.
  54. Click [Open].
  55. Select ‘Compile/Validate File’ in ‘Action’.
  56. Select the file in ‘Files’.
  57. Click [Process Action].
  58. Click [OK] on the ‘Compiled’ message.
  59. Select ‘Print File’ in ‘Action’.
  60. Select the file in ‘Files’.
  61. Click [Process Action].
  62. Validate the data in the report.
  63. Close the report.
  64. Select ‘Post File’ in ‘Action’.
  65. Select the file in ‘Files’.
  66. Click [Process Action].
  67. An ‘Information’ message is received stating: Posted.
  68. Click [OK].
  69. If desired, select ‘Delete File’ in ‘Action’.
  70. Select the file in ‘Files’.
  71. Click [Process Action].
  72. A ‘Delete File’ message is received stating: Are you sure?
  73. Click [No].
  74. Validate that the message closed.
  75. Click [Process Action].
  76. A ‘Delete File’ message is received stating: Are you sure?
  77. Click [Yes].
  78. An ‘Information’ message is received stating: Deleted.
  79. Click [OK].
  80. Click [X].
  81. Open ‘274 – Provider Directory Definition’.
  82. Select the 'Site Definition' section.
  83. Select ‘Edit’ in ‘Add or Edit Site’.
  84. Select the ‘Site Definition’ that was edited.
  85. Validate the edited data.
  86. Close the form.
Scenario 6: File Import – 274 Provider Definition
Specific Setup:
  • Note the value of the following registry setting for use in creating the file import item: Avatar PM->System Maintenance->File Import->->->Import File Delimiter.
  • The ‘File Import’ spreadsheet has been included in the update zip file.
  • Note: In addition to fields that are required in the spreadsheet, individual agencies may require fields through 'TABLE27400 (274 = Provider Directory Definition) Provider Definition’ in 'Site Specific Section Modeling’. Verify if the agency is requiring additional fields.
  • A ‘274 Provider Definition’ file has been created, with the correct delimiter, according to the ‘File Import’ spreadsheet guidelines, and agency required fields. Note the location of the file.
  • Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’.
Steps
  1. Open ‘File Import’.
  2. Select ‘274 Provider Definition’ in ‘File Type’.
  3. The ‘Action’ field is required and defaults to ‘Upload New File’.
  4. Click [Process Action].
  5. Navigate to the location of the file in the file explorer and select the file.
  6. Click [Open].
  7. Select ‘Compile/Validate File’ in ‘Action’.
  8. Select the file in ‘Files’.
  9. Click [Process Action].
  10. A message will be received stating that the file compiled or that there were errors.
  11. Click [OK].
  12. If there are errors, select ‘Print Errors’ in action.
  13. Select the file in ‘Files’.
  14. Click [Process Action].
  15. Review the error report and update the file to correct the error.
  16. Select ‘Delete File’ in ‘Action’.
  17. Select the file in ‘Files’.
  18. Click [Process Action].
  19. A ‘Delete File’ message is received stating: Are you sure?
  20. Click [Yes].
  21. An ‘Information’ message is received stating: Deleted.
  22. Click [OK].
  23. Select ‘Upload New File’ in ‘Action’.
  24. Click [Process Action].
  25. Navigate to the location of the file in the file explorer and select the file.
  26. Click [Open].
  27. Select ‘Compile/Validate File’ in ‘Action’.
  28. Select the file in ‘Files’.
  29. Click [Process Action].
  30. A message will be received stating that the file compiled or that there were errors.
  31. Click [OK].
  32. If the file compiled, select ‘Print File’ in ‘Action’.
  33. Select the file in ‘Files’.
  34. Click [Process Action].
  35. Validate the data in the report.
  36. Close the report.
  37. Select ‘Post File’ in ‘Action’.
  38. Select the file in ‘Files’.
  39. Click [Process Action].
  40. The ‘Information’ message will contain: Posted.
  41. Click [OK].
  42. Open ‘274 – Provider Directory Definition’.
  43. Select the 'Provider Definition’.
  44. Select the ‘Provider’ that was imported.
  45. Note the value in the parenthesis. This is the ‘Practitioner/Provider ID'.
  46. Validate the data.
  47. Close the form.
  48. If desired, edit the ‘274 Provider Definition’ file, giving it a new name. At a minimum add the 'Provider Group ID’ to position two and edit one item.
  49. Select ‘Upload New File’ in ‘Action’.
  50. Click [Process Action].
  51. Navigate to the location of the edited file in the file explorer and select the file.
  52. Click [Open].
  53. Select ‘Compile/Validate File’ in ‘Action’.
  54. Select the file in ‘Files’.
  55. Click [Process Action].
  56. Click [OK] on the ‘Compiled’ message.
  57. Select ‘Print File’ in ‘Action’.
  58. Select the file in ‘Files’.
  59. Click [Process Action].
  60. Validate the data in the report.
  61. Close the report.
  62. Select ‘Post File’ in ‘Action’.
  63. Select the file in ‘Files’.
  64. Click [Process Action].
  65. An ‘Information’ message is received stating: Posted.
  66. Click [OK].
  67. If desired, select ‘Delete File’ in ‘Action’.
  68. Select the file in ‘Files’.
  69. Click [Process Action].
  70. A ‘Delete File’ message is received stating: Are you sure?
  71. Click [No].
  72. Validate that the message closed.
  73. Click [Process Action].
  74. A ‘Delete File’ message is received stating: Are you sure?
  75. Click [Yes].
  76. An ‘Information’ message is received stating: Deleted.
  77. Click [OK].
  78. Open ‘274 – Provider Directory Definition’.
  79. Select the 'Provider Definition’.
  80. Select the ‘Provider’ that was edited.
  81. Validate the edited data.
  82. Close the form.
Scenario 7: 274 - Provider Directory Definition - Group Definition
Specific Setup:
  • Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’.
Steps
  1. Open ‘274 - Provider Directory Definition’.
  2. Validate that the form opened to the ‘Group Definition’ section.
  3. Validate that ‘Plan Type' is the only required field on the form.
  4. Select 'Mental Health Plan' in 'Plan Type'.
  5. Validate that ‘Add or Edit Group’ is now required.
  6. Select ‘Add’ in ‘Add or Edit Group’.
  7. Validate that ‘Active’ and ‘Provider Group Name (2100CA-NM1-03)’ are now required fields.
  8. Add desired data to the form, noting the value in 'Provider Group'.
  9. Click [File Group Details].
  10. Click [OK].
  11. Select 'Drug Medi-Cal Organized Delivery System' in 'Plan Type'.
  12. Select ‘Edit’ in ‘Add or Edit Group’.
  13. Set 'Provider Group' to the value noted above.
  14. Verify that no search results are returned.
  15. Select 'Mental Health Plan' in 'Plan Type'.
  16. Select ‘Edit’ in ‘Add or Edit Group’.
  17. Set 'Provider Group' to the value noted above.
  18. Select the search result for the 'Provider Group' added above.
  19. Review the data and edit at least one field, noting the edited value(s).
  20. Click [File Group Details].
  21. Click [OK].
  22. Select 'Mental Health Plan' in 'Plan Type'.
  23. Select ‘Edit’ in ‘Add or Edit Group’.
  24. Set 'Provider Group' to the value noted above.
  25. Select the search result for the 'Provider Group' added above.
  26. Review the edited field(s) and validate that the edited data was retained.
  27. Repeat steps 1 - 26 for 'Plan Type' of 'Drug Medi-Cal Organized Delivery System'.
  28. Close the form.
Scenario 8: 274 - Provider Directory Submission - form validation
Specific Setup:
  • An output directory has been defined in ‘Facility Defaults’ field ‘Output Path On Server For State Reporting Files’.
  • The '274 Provider Directory Definition form has been used to create groups, sites, and providers for Plan Types of 'Mental Health Plan' and 'Drug Med-Cal Organized Delivery System'.
Steps
  1. Open ‘274 - Provider Directory Submission’.
  2. Validate that the ‘Plan Type' field is required.
  3. Select 'Mental Health Plan' in 'Plan Type'.
  4. Select ‘Compile File’ in ‘Options’.
  5. Enter the desired value in ‘Reporting Period (MM/YY)’.
  6. Enter the desired value in ‘File Description’.
  7. Click [Process File].
  8. The ‘Health Care Provider Directory’ report will open. The report can contain the following links: ‘274 Submission’, ‘Required Data Missing/Invalid - Directory Defaults’, ‘Required Data Missing/Invalid - Group’, ‘Required Data Missing/Invalid – Site’, ‘‘Required Data Missing/Invalid – Provider’, and ‘‘Required Data Missing/Invalid – Other’.
  9. Click on the link for any ‘Required Data Missing/Invalid’ links and review the data in the sub report. Correct the data as desired.
  10. Click on the link for ‘274 Submission’ and review the data in the report. Providers will not display for the sites in which they are inactive.
  11. Close the report.
  12. Select ‘Dump File’ in ‘Options’.
  13. Validate that ‘Select File’ in now required.
  14. Select the file compiled above in ‘Select File’.
  15. Click [Process File].
  16. The ‘Health Care Provider Directory’ report will open and display the data that will be included in the dump file.
  17. Close the report.
  18. Select ‘Create File On Server For Submission’ in ‘Options’.
  19. Select the file compiled above in ‘Select File’.
  20. Click [Process File].
  21. The ‘Create File’ item is received with the message ‘Process Completed’.
  22. Click [OK].
  23. Select ‘Run Report’ Select ‘Create File On Server For Submission’ in ‘Options’.
  24. Select the file compiled above in ‘Select File’.
  25. Click [Process File].
  26. The ‘Health Care Provider Directory’ report will open and contain the same links the previously opened.
  27. Close the report.
  28. ‘Options’ contains ‘Delete File’. If deleting a file is desired, select ‘Delete File’.
  29. Select the file compiled above in ‘Select File’.
  30. Click [Process File].
  31. Close the form.
  32. Repeat steps 1 - 31 for the 'Plan Type' of 'Drug Med-Cal Organized Delivery System'.
Topics
• 274 - Provider Directory • File Import
AV-93511 Summary | Details
274 - Provider Directory Submission
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • 274 - Provider Directory Definition
  • Crystal Report Viewer
  • File Import
  • User Definition
  • 274 - Provider Directory Defaults
  • 274 - Provider Directory Submission
Scenario 1: 274 - Provider Directory Defaults
Specific Setup:
  • Tester has been given access to the ‘274 - Provider Directory Defaults’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’.
Steps
  1. Open '274 - Provider Directory Defaults'.
  2. Validate that 'Plan Type' is the only required field.
  3. Select 'Mental Health Plan' in 'Plan Type'.
  4. Validate that 'Healthcare Plan Code' is now required.
  5. Add data to the form.
  6. Click [Submit].
  7. Open '274 - Provider Directory Defaults'.
  8. Validate that 'Plan Type' is the only required field.
  9. Select 'Mental Health Plan' in 'Plan Type'.
  10. Validate that the submitted data displays correctly.
  11. Edit at least on field, noting the edited value.
  12. Click [Submit].
  13. Open '274 - Provider Directory Defaults'.
  14. Validate that 'Plan Type' is the only required field.
  15. Select 'Mental Health Plan' in 'Plan Type'.
  16. Validate that the edited data displays correctly.
  17. Close the form.
  18. Repeat steps 1 - 17 for the 'Plan Type' of 'Drug Medi-Cal Organized Delivery System.
Scenario 2: 274 - Provider Directory Definition - Site Definition
Specific Setup:
  • Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’.
  • A 'Group Definition' exists in the '274 - Provider Directory Definition’ form.
Steps
  1. Open ‘274 - Provider Directory Definition’.
  2. Select the 'Site Definition’ section.
  3. Validate that ‘Plan Type’ is the only required field on the form.
  4. Select 'Mental Health Plan' in ' ‘Plan Type’.
  5. Validate that ‘Add or Edit Site’ is now required.
  6. Select ‘Add’ in ‘Add or Edit Site’.
  7. Validate that ‘Site or Location of Service Name (2100A-NM1-03)', ‘Provider Group’ and ‘Active’ are now required fields.
  8. Add desired data to the form.
  9. Click [File Site Details].
  10. Click [OK].
  11. Select 'Mental Health Plan' in ' ‘Plan Type’.
  12. Select ‘Edit’ in ‘Add or Edit Site’.
  13. Select the filed Site and validate that the data displays correctly.
  14. Edit at least one field, noting the edited value.
  15. Click [File Site Details].
  16. Click [OK].
  17. Select 'Mental Health Plan' in ' ‘Plan Type’.
  18. Select ‘Edit’ in ‘Add or Edit Site’.
  19. Select the filed Site and validate that the edited data displays correctly.
  20. Repeat steps 1 - 19 for Plan Type' of 'Drug Medi-Cal Organized Delivery System'.
  21. Close the form.
Scenario 3: 274 - Provider Directory Definition - Provider Definition
Specific Setup:
  • Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’.
  • 274 Provider Directory Definition:
  • A minimum of one 'Group Definition' exists.
  • A minimum of one 'Site Definition' exists.
Steps
  1. Open ‘274 - Provider Directory Definition’.
  2. Validate that the form opened to the ‘Group Definition’ section.
  3. Select the ‘Provider Definition’ section.
  4. Validate that ‘Plan Type’ is the only required field on the form.
  5. Select 'Mental Health Plan' in 'Plan Type'.
  6. Validate that 'Provider' is now required.
  7. Select a ‘Provider’.
  8. Validate that ‘Associated Site’ and ‘Active’ are now required fields.
  9. Select the ‘Associated Site’.
  10. Select a value in ‘Active’.
  11. Add desired data to the form.
  12. Click [File Provider Details].
  13. Click [OK].
  14. Select 'Mental Health Plan' in 'Plan Type'.
  15. Select the same provider and site.
  16. Validate that the submitted date displays correctly.
  17. Edit at least one field, noting the value.
  18. Click [File Provider Details].
  19. Click [OK].
  20. Select 'Mental Health Plan' in 'Plan Type'.
  21. Select the same provider and site.
  22. Validate that the edited data displays.
  23. Select a new value in ‘Associated Site’.
  24. Validate that a ‘Provider-Site Records On File’ item displays the message ‘Record to default Information From’ and contains a drop down list of ‘Sites’.
  25. Select a site and click [OK].
  26. Validate that the data defaulted into the fields.
  27. Click [File Provider Details].
  28. Click [OK].
  29. Select 'Drug Medi-Cal Organized Delivery System' in 'Plan Type'.
  30. Select the same provider and validate that the 'Currently Associated Sites' field is blank.
  31. Repeat steps 9 - 22 for the 'Plan Type' of 'Drug Medi-Cal Organized Delivery System'.
  32. Close the form.
Scenario 4: File Import – 274 Group Definition
Specific Setup:
  • Note the value of the following registry setting for use in creating the file import item: Avatar PM->System Maintenance->File Import->->->Import File Delimiter.
  • The ‘File Import’ spreadsheet has been included in the update zip file.
  • Note: In addition to fields that are required in the spreadsheet, individual agencies may require fields through 'TABLE27400 (274 = Provider Directory Definition) Group Definition’ in 'Site Specific Section Modeling’. Verify if the agency is requiring additional fields.
  • A ‘274 Group Definition’ file has been created, with the correct delimiter, according to the ‘File Import’ spreadsheet guidelines, and agency required fields. Note the location of the file.
  • Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’.
Steps
  1. Open ‘File Import’.
  2. Select ‘274 Group Definition’ in ‘File Type’.
  3. The ‘Action’ field is required and defaults to ‘Upload New File’.
  4. Click [Process Action].
  5. Navigate to the location of the file in the file explorer and select the file.
  6. Click [Open].
  7. Select ‘Compile/Validate File’ in ‘Action’.
  8. Select the file in ‘Files’.
  9. Click [Process Action].
  10. A message will be received stating that the file compiled or that there were errors.
  11. Click [OK].
  12. If there are errors, select ‘Print Errors’ in action.
  13. Select the file in ‘Files’.
  14. Click [Process Action].
  15. Review the error report and update the file to correct the error.
  16. Select ‘Delete File’ in ‘Action’.
  17. Select the file in ‘Files’.
  18. Click [Process Action].
  19. A ‘Delete File’ message is received stating: Are you sure?
  20. Click [Yes].
  21. An ‘Information’ message is received stating: Deleted.
  22. Click [OK].
  23. Select ‘Upload New File’ in ‘Action’.
  24. Click [Process Action].
  25. Navigate to the location of the file in the file explorer and select the file.
  26. Click [Open].
  27. Select ‘Compile/Validate File’ in ‘Action’.
  28. Select the file in ‘Files’.
  29. Click [Process Action].
  30. A message will be received stating that the file compiled or that there were errors.
  31. Click [OK].
  32. If the file compiled, select ‘Print File’ in ‘Action’.
  33. Select the file in ‘Files’.
  34. Click [Process Action].
  35. Validate the data in the report.
  36. Close the report.
  37. Select ‘Post File’ in ‘Action’.
  38. Select the file in ‘Files’.
  39. Click [Process Action].
  40. The ‘Information’ message will contain: Posted.
  41. Click [OK].
  42. Open ‘274 – Provider Directory Definition’.
  43. Select ‘Edit’ in ‘Add or Edit Group’.
  44. Select the ‘Provider Group’ that was imported.
  45. Note the ‘Provider Group’ value in the parenthesis. This is the ‘Provider Group ID’.
  46. Validate the data.
  47. Close the form.
  48. If desired, edit the ‘274 Group Definition’ file, giving it a new name. At a minimum add the 'Provider Group ID’ to position two and edit one item.
  49. Select ‘Upload New File’ in ‘Action’.
  50. Click [Process Action].
  51. Navigate to the location of the edited file in the file explorer and select the file.
  52. Click [Open].
  53. Select ‘Compile/Validate File’ in ‘Action’.
  54. Select the file in ‘Files’.
  55. Click [Process Action].
  56. Click [OK] on the ‘Compiled’ message.
  57. Select ‘Print File’ in ‘Action’.
  58. Select the file in ‘Files’.
  59. Click [Process Action].
  60. Validate the data in the report.
  61. Close the report.
  62. Select ‘Post File’ in ‘Action’.
  63. Select the file in ‘Files’.
  64. Click [Process Action].
  65. An ‘Information’ message is received stating: Posted.
  66. Click [OK].
  67. If desired, select ‘Delete File’ in ‘Action’.
  68. Select the file in ‘Files’.
  69. Click [Process Action].
  70. A ‘Delete File’ message is received stating: Are you sure?
  71. Click [No].
  72. Validate that the message closed.
  73. Click [Process Action].
  74. A ‘Delete File’ message is received stating: Are you sure?
  75. Click [Yes].
  76. An ‘Information’ message is received stating: Deleted.
  77. Click [OK].
  78. Open ‘274 – Provider Directory Definition’.
  79. Select ‘Edit’ in ‘Add or Edit Group’.
  80. Select the ‘Provider Group’ that was edited.
  81. Validate the edited data.
  82. Close the form.
Scenario 5: File Import – 274 Site Definition
Specific Setup:
  • Note the value of the following registry setting for use in creating the file import item: Avatar PM->System Maintenance->File Import->->->Import File Delimiter.
  • The ‘File Import’ spreadsheet has been included in the update zip file.
  • Note: In addition to fields that are required in the spreadsheet, individual agencies may require fields through 'TABLE27400 (274 = Provider Directory Definition) Site Definition’ in 'Site Specific Section Modeling’. Verify if the agency is requiring additional fields.
  • A ‘274 Site Definition’ file has been created, with the correct delimiter, according to the ‘File Import’ spreadsheet guidelines, and agency required fields. Note the location of the file.
  • Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’.
Steps
  1. Open ‘File Import’.
  2. Select ‘274 Site Definition’ in ‘File Type’.
  3. The ‘Action’ field is required and defaults to ‘Upload New File’.
  4. Click [Process Action].
  5. Navigate to the location of the file in the file explorer and select the file.
  6. Click [Open].
  7. Select ‘Compile/Validate File’ in ‘Action’.
  8. Select the file in ‘Files’.
  9. Click [Process Action].
  10. A message will be received stating that the file compiled or that there were errors.
  11. Click [OK].
  12. If there are errors, select ‘Print Errors’ in action.
  13. Select the file in ‘Files’.
  14. Click [Process Action].
  15. Review the error report and update the file to correct the error.
  16. Select ‘Delete File’ in ‘Action’.
  17. Select the file in ‘Files’.
  18. Click [Process Action].
  19. A ‘Delete File’ message is received stating: Are you sure?
  20. Click [Yes].
  21. An ‘Information’ message is received stating: Deleted.
  22. Click [OK].
  23. Select ‘Upload New File’ in ‘Action’.
  24. Click [Process Action].
  25. Navigate to the location of the file in the file explorer and select the file.
  26. Click [Open].
  27. Select ‘Compile/Validate File’ in ‘Action’.
  28. Select the file in ‘Files’.
  29. Click [Process Action].
  30. A message will be received stating that the file compiled or that there were errors.
  31. Click [OK].
  32. If the file compiled, select ‘Print File’ in ‘Action’.
  33. Select the file in ‘Files’.
  34. Click [Process Action].
  35. Validate the data in the report.
  36. Close the report.
  37. Select ‘Post File’ in ‘Action’.
  38. Select the file in ‘Files’.
  39. Click [Process Action].
  40. The ‘Information’ message will contain: Posted.
  41. Click [OK].
  42. Click [X].
  43. Open ‘274 – Provider Directory Definition’.
  44. Select the 'Site Definition' section.
  45. Select ‘Edit’ in ‘Add or Edit Site’.
  46. Select the ‘Site Definition’ that was imported.
  47. Note the ‘Site Definition’ value in the parenthesis. This is the ‘Site ID’.
  48. Validate the data.
  49. Close the form.
  50. If desired, edit the ‘274 Site Definition’ file, giving it a new name. At a minimum add the 'Site ID’ to position two and edit one item.
  51. Select ‘Upload New File’ in ‘Action’.
  52. Click [Process Action].
  53. Navigate to the location of the edited file in the file explorer and select the file.
  54. Click [Open].
  55. Select ‘Compile/Validate File’ in ‘Action’.
  56. Select the file in ‘Files’.
  57. Click [Process Action].
  58. Click [OK] on the ‘Compiled’ message.
  59. Select ‘Print File’ in ‘Action’.
  60. Select the file in ‘Files’.
  61. Click [Process Action].
  62. Validate the data in the report.
  63. Close the report.
  64. Select ‘Post File’ in ‘Action’.
  65. Select the file in ‘Files’.
  66. Click [Process Action].
  67. An ‘Information’ message is received stating: Posted.
  68. Click [OK].
  69. If desired, select ‘Delete File’ in ‘Action’.
  70. Select the file in ‘Files’.
  71. Click [Process Action].
  72. A ‘Delete File’ message is received stating: Are you sure?
  73. Click [No].
  74. Validate that the message closed.
  75. Click [Process Action].
  76. A ‘Delete File’ message is received stating: Are you sure?
  77. Click [Yes].
  78. An ‘Information’ message is received stating: Deleted.
  79. Click [OK].
  80. Click [X].
  81. Open ‘274 – Provider Directory Definition’.
  82. Select the 'Site Definition' section.
  83. Select ‘Edit’ in ‘Add or Edit Site’.
  84. Select the ‘Site Definition’ that was edited.
  85. Validate the edited data.
  86. Close the form.
Scenario 6: File Import – 274 Provider Definition
Specific Setup:
  • Note the value of the following registry setting for use in creating the file import item: Avatar PM->System Maintenance->File Import->->->Import File Delimiter.
  • The ‘File Import’ spreadsheet has been included in the update zip file.
  • Note: In addition to fields that are required in the spreadsheet, individual agencies may require fields through 'TABLE27400 (274 = Provider Directory Definition) Provider Definition’ in 'Site Specific Section Modeling’. Verify if the agency is requiring additional fields.
  • A ‘274 Provider Definition’ file has been created, with the correct delimiter, according to the ‘File Import’ spreadsheet guidelines, and agency required fields. Note the location of the file.
  • Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’.
Steps
  1. Open ‘File Import’.
  2. Select ‘274 Provider Definition’ in ‘File Type’.
  3. The ‘Action’ field is required and defaults to ‘Upload New File’.
  4. Click [Process Action].
  5. Navigate to the location of the file in the file explorer and select the file.
  6. Click [Open].
  7. Select ‘Compile/Validate File’ in ‘Action’.
  8. Select the file in ‘Files’.
  9. Click [Process Action].
  10. A message will be received stating that the file compiled or that there were errors.
  11. Click [OK].
  12. If there are errors, select ‘Print Errors’ in action.
  13. Select the file in ‘Files’.
  14. Click [Process Action].
  15. Review the error report and update the file to correct the error.
  16. Select ‘Delete File’ in ‘Action’.
  17. Select the file in ‘Files’.
  18. Click [Process Action].
  19. A ‘Delete File’ message is received stating: Are you sure?
  20. Click [Yes].
  21. An ‘Information’ message is received stating: Deleted.
  22. Click [OK].
  23. Select ‘Upload New File’ in ‘Action’.
  24. Click [Process Action].
  25. Navigate to the location of the file in the file explorer and select the file.
  26. Click [Open].
  27. Select ‘Compile/Validate File’ in ‘Action’.
  28. Select the file in ‘Files’.
  29. Click [Process Action].
  30. A message will be received stating that the file compiled or that there were errors.
  31. Click [OK].
  32. If the file compiled, select ‘Print File’ in ‘Action’.
  33. Select the file in ‘Files’.
  34. Click [Process Action].
  35. Validate the data in the report.
  36. Close the report.
  37. Select ‘Post File’ in ‘Action’.
  38. Select the file in ‘Files’.
  39. Click [Process Action].
  40. The ‘Information’ message will contain: Posted.
  41. Click [OK].
  42. Open ‘274 – Provider Directory Definition’.
  43. Select the 'Provider Definition’.
  44. Select the ‘Provider’ that was imported.
  45. Note the value in the parenthesis. This is the ‘Practitioner/Provider ID'.
  46. Validate the data.
  47. Close the form.
  48. If desired, edit the ‘274 Provider Definition’ file, giving it a new name. At a minimum add the 'Provider Group ID’ to position two and edit one item.
  49. Select ‘Upload New File’ in ‘Action’.
  50. Click [Process Action].
  51. Navigate to the location of the edited file in the file explorer and select the file.
  52. Click [Open].
  53. Select ‘Compile/Validate File’ in ‘Action’.
  54. Select the file in ‘Files’.
  55. Click [Process Action].
  56. Click [OK] on the ‘Compiled’ message.
  57. Select ‘Print File’ in ‘Action’.
  58. Select the file in ‘Files’.
  59. Click [Process Action].
  60. Validate the data in the report.
  61. Close the report.
  62. Select ‘Post File’ in ‘Action’.
  63. Select the file in ‘Files’.
  64. Click [Process Action].
  65. An ‘Information’ message is received stating: Posted.
  66. Click [OK].
  67. If desired, select ‘Delete File’ in ‘Action’.
  68. Select the file in ‘Files’.
  69. Click [Process Action].
  70. A ‘Delete File’ message is received stating: Are you sure?
  71. Click [No].
  72. Validate that the message closed.
  73. Click [Process Action].
  74. A ‘Delete File’ message is received stating: Are you sure?
  75. Click [Yes].
  76. An ‘Information’ message is received stating: Deleted.
  77. Click [OK].
  78. Open ‘274 – Provider Directory Definition’.
  79. Select the 'Provider Definition’.
  80. Select the ‘Provider’ that was edited.
  81. Validate the edited data.
  82. Close the form.
Scenario 7: 274 - Provider Directory Definition - Group Definition
Specific Setup:
  • Tester has been given access to the ‘274 - Provider Directory Definition’ form in ‘User Definition’ under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’.
Steps
  1. Open ‘274 - Provider Directory Definition’.
  2. Validate that the form opened to the ‘Group Definition’ section.
  3. Validate that ‘Plan Type' is the only required field on the form.
  4. Select 'Mental Health Plan' in 'Plan Type'.
  5. Validate that ‘Add or Edit Group’ is now required.
  6. Select ‘Add’ in ‘Add or Edit Group’.
  7. Validate that ‘Active’ and ‘Provider Group Name (2100CA-NM1-03)’ are now required fields.
  8. Add desired data to the form, noting the value in 'Provider Group'.
  9. Click [File Group Details].
  10. Click [OK].
  11. Select 'Drug Medi-Cal Organized Delivery System' in 'Plan Type'.
  12. Select ‘Edit’ in ‘Add or Edit Group’.
  13. Set 'Provider Group' to the value noted above.
  14. Verify that no search results are returned.
  15. Select 'Mental Health Plan' in 'Plan Type'.
  16. Select ‘Edit’ in ‘Add or Edit Group’.
  17. Set 'Provider Group' to the value noted above.
  18. Select the search result for the 'Provider Group' added above.
  19. Review the data and edit at least one field, noting the edited value(s).
  20. Click [File Group Details].
  21. Click [OK].
  22. Select 'Mental Health Plan' in 'Plan Type'.
  23. Select ‘Edit’ in ‘Add or Edit Group’.
  24. Set 'Provider Group' to the value noted above.
  25. Select the search result for the 'Provider Group' added above.
  26. Review the edited field(s) and validate that the edited data was retained.
  27. Repeat steps 1 - 26 for 'Plan Type' of 'Drug Medi-Cal Organized Delivery System'.
  28. Close the form.
Scenario 8: 274 - Provider Directory Submission - form validation
Specific Setup:
  • An output directory has been defined in ‘Facility Defaults’ field ‘Output Path On Server For State Reporting Files’.
  • The '274 Provider Directory Definition form has been used to create groups, sites, and providers for Plan Types of 'Mental Health Plan' and 'Drug Med-Cal Organized Delivery System'.
Steps
  1. Open ‘274 - Provider Directory Submission’.
  2. Validate that the ‘Plan Type' field is required.
  3. Select 'Mental Health Plan' in 'Plan Type'.
  4. Select ‘Compile File’ in ‘Options’.
  5. Enter the desired value in ‘Reporting Period (MM/YY)’.
  6. Enter the desired value in ‘File Description’.
  7. Click [Process File].
  8. The ‘Health Care Provider Directory’ report will open. The report can contain the following links: ‘274 Submission’, ‘Required Data Missing/Invalid - Directory Defaults’, ‘Required Data Missing/Invalid - Group’, ‘Required Data Missing/Invalid – Site’, ‘‘Required Data Missing/Invalid – Provider’, and ‘‘Required Data Missing/Invalid – Other’.
  9. Click on the link for any ‘Required Data Missing/Invalid’ links and review the data in the sub report. Correct the data as desired.
  10. Click on the link for ‘274 Submission’ and review the data in the report. Providers will not display for the sites in which they are inactive.
  11. Close the report.
  12. Select ‘Dump File’ in ‘Options’.
  13. Validate that ‘Select File’ in now required.
  14. Select the file compiled above in ‘Select File’.
  15. Click [Process File].
  16. The ‘Health Care Provider Directory’ report will open and display the data that will be included in the dump file.
  17. Close the report.
  18. Select ‘Create File On Server For Submission’ in ‘Options’.
  19. Select the file compiled above in ‘Select File’.
  20. Click [Process File].
  21. The ‘Create File’ item is received with the message ‘Process Completed’.
  22. Click [OK].
  23. Select ‘Run Report’ Select ‘Create File On Server For Submission’ in ‘Options’.
  24. Select the file compiled above in ‘Select File’.
  25. Click [Process File].
  26. The ‘Health Care Provider Directory’ report will open and contain the same links the previously opened.
  27. Close the report.
  28. ‘Options’ contains ‘Delete File’. If deleting a file is desired, select ‘Delete File’.
  29. Select the file compiled above in ‘Select File’.
  30. Click [Process File].
  31. Close the form.
  32. Repeat steps 1 - 31 for the 'Plan Type' of 'Drug Med-Cal Organized Delivery System'.
Topics
• 274 - Provider Directory • File Import
Table Changes
Table Column Change
SYSTEM.hcpd274directorydefaults plan_type_code ADD
SYSTEM.hcpd274directorydefaults plan_type_value ADD
SYSTEM.hcpd274file plan_type_code ADD
SYSTEM.hcpd274file plan_type_value ADD
SYSTEM.hcpd274groupdetails plan_type_code ADD
SYSTEM.hcpd274groupdetails plan_type_value ADD
SYSTEM.hcpd274providerdetails modality_type_code ADD
SYSTEM.hcpd274providerdetails modality_type_sh_value ADD
SYSTEM.hcpd274providerdetails modality_type_value ADD
SYSTEM.hcpd274providerdetails plan_type_code ADD
SYSTEM.hcpd274providerdetails plan_type_value ADD
SYSTEM.hcpd274rptheader delete_data_entry_by ADD
SYSTEM.hcpd274rptheader delete_data_entry_by_option ADD
SYSTEM.hcpd274rptheader delete_data_entry_date ADD
SYSTEM.hcpd274rptheader delete_data_entry_time ADD
SYSTEM.hcpd274rptheader delete_data_entry_user_id ADD
SYSTEM.hcpd274rptheader delete_data_entry_user_name ADD
SYSTEM.hcpd274rptheader delete_option_desc ADD
SYSTEM.hcpd274rptheader delete_option_id ADD
SYSTEM.hcpd274rptheader plan_type_code ADD
SYSTEM.hcpd274rptheader plan_type_value ADD
SYSTEM.hcpd274sitedetails modality_type_code ADD
SYSTEM.hcpd274sitedetails modality_type_sh_value ADD
SYSTEM.hcpd274sitedetails modality_type_value ADD
SYSTEM.hcpd274sitedetails plan_type_code ADD
SYSTEM.hcpd274sitedetails plan_type_value ADD