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Avatar Cal-PM 2023 Update 89

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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
Avatar CWS 2023 Update 94
RADplus 2023 Monthly Release 2023.04.00

Product Update Description

The following changes are made: 1) The new field 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' is added to the form 'Service Codes' to designate whether a distinct add-on service for this service code should generate for each co-practitioner listed in the note. 2) The 'Service Code Upload Process' form is updated to support the new fields.

Required Updates

None

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, 70, 71, 79, 81, 82, 83, 84, 87, 88

Details
NEW2 CHANGED0 FIXED0
New (2)
Service Codes
The new field 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' is added to the 'Service Code' form.
The 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' field is initially disabled and will only be enabled if the 'Service Code Category' field is set to anything other than 'Primary Code'.
Value Added: The 'Service Code' form is updated to control the add-on generation for the selected serve code type.
Topics
• Progress Notes • Service Codes
 
Service Codes
The new field 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' supports multiple add-on codes for the primary code.
Value Added: The multiple add-on codes for the primary code logic is updated to support the 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' field in the 'Service Codes' form.
Topics
• Progress Notes • Service Codes
 
Acceptance Tests
AV-93401 Summary | Details
Service Codes
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Crystal Report Viewer
  • Service Code Upload Accepted Codes (2)
  • Service Code Upload Process
  • Service Code Upload Rejected Codes (2)
  • Admission (Outpatient)
  • Client Ledger
  • Create Interim Billing Batch File
  • Diagnosis
  • Dictionary Update (PM)
  • Electronic Billing
  • Financial Eligibility
  • Program Maintenance
  • Progress Notes (Group and Individual)
  • ProgressNote Approval
  • Registry Settings (PM)
  • Service Fee/Cross Reference Maintenance
  • Site Specific Section Modeling (CWS)
  • Performing Provider Association - Error
Scenario 1: Service code upload process - Validating compile/post file
Specific Setup:
  • The following text files are created to upload the service code in the system with the value of new field 'Should Add-On Services Generate for Co-Practitioners for this Service Code?'. Note the file name and location of the file.
  • The file to upload the add-on code with the value 'Y' for the field. (i.e. Name of the file File1).
  • The file to upload the add-on code with the value 'N' for the field. (i.e. Name of the file File2).
  • The file to upload the add-on code without any value selected for the field. (i.e. Name of the file File3).
  • The file to upload the primary code with the value 'Y' for the field. (i.e. Name of the file File5).
  • The file to upload the primary code with the value 'Y' for the field. (i.e. Name of the file File6).
  • The file to upload the primary code without any value for the field. (i.e. Name of the file File7).
Steps
  1. Open the 'Service Code Upload Process' form.
  2. Click [Select File].
  3. Select File1 created in the setup.
  4. Select 'Compile' in the 'Compile Or Post' field.
  5. Select 'No' in the 'Override Existing Service Codes' field.
  6. Submit the form.
  7. Verify the message: "Compile completed. To View results review accepted reports".
  8. Click [OK].
  9. Open the 'Service Code Upload Accepted Codes' form without exiting out from the 'Service Code Upload Process' form.
  10. Click the drop down for the 'Select Desired service code import file name' field.
  11. Verify the recently compiled file displays in the drop down.
  12. Select the file.
  13. Click [Process].
  14. Verify the report launched successfully and all the data displays correctly as listed in the texted file.
  15. Close the report.
  16. Close the 'Service Code Upload Accepted Codes' form.
  17. Locate to the 'Service Code Upload Process' form
  18. Select 'Post' in the 'Compile Or Post' field.
  19. Verify the file posted successfully.
  20. Open the 'Service Code' form.
  21. Select the recently uploaded service code to edit.
  22. Verify the field 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' is set to desired value defined in the text file.
  23. Close the form.
  24. Repeat steps 1 through 20 for the File1, File2, File3, and File7.
  25. Run the query to retrieve data from the 'SYSTEM.batchload_tx_accepted' sql table.
  26. Verify the 'generate_add_on_services_code' and 'generate_add_on_services_value' are added in the table.
  27. Open the 'Service Code Upload Process' form.
  28. Click [Select File].
  29. Select File5 created in the setup.
  30. Select 'Compile' in the 'Compile Or Post' field.
  31. Select 'No' in the 'Override Existing Service Codes' field.
  32. Submit the form.
  33. Verify that the file should not be compiled successfully.
  34. Verify the message: 'No accepted data compiled. To view results review rejected report'.
  35. Click [OK].
  36. Open the 'Service Code Upload Rejected Codes' form without exiting out from the 'Service Code Upload Process' form.
  37. Click the drop down for the 'Select Desired service code import file name' field.
  38. Verify the recently compiled is available in the drop down.
  39. Select the file.
  40. Click [Process].
  41. Verify the report launched successfully.
  42. Verify the report displays the error message 'The 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' field can only be valued when field 'Service Code Category' is not a primary code'.
  43. Close the report.
  44. Close the 'Service Code Upload Rejected Codes' form.
  45. Exit out of the 'Service Code Upload Rejected Codes' form.
  46. Close the form.
  47. Repeat steps from 22 through 35 for File6.
  48. Open the 'Crystal Report' or SQL data viewer.
  49. Run the query to retrieve data from the 'SYSTEM.billing_tx_master_table' sql table.
  50. Verify the 'generate_add_on_services_code' and 'generate_add_on_services_value' are added in the table.
  51. Verify the 'generate_add_on_services_code' and 'generate_add_on_services_value' contains correct value for the ‘Should Add-On Services Generate for Co-Practitioners for this Service Code?' field as set up in the 'Service Code' form.
  52. Run the 'select * from SYSTEM.batchload_tx_accepted' to retrieve data from the 'SYSTEM.batchload_tx_accepted' sql table.
  53. Verify the 'generate_add_on_services_code' and 'generate_add_on_services_value' are added in the table.
  54. Verify the 'generate_add_on_services_code' and 'generate_add_on_services_value' contains correct value for the ‘Should Add-On Services Generate for Co-Practitioners for this Service Code?' field as set up in the text file uploaded through the 'Service Code Upload Process' form.
  55. Close the report.
Scenario 2: Validating co-practitioner services - 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' = Y, N or Null and 'Create Co-Practitioner Services From Progress Notes' = Y
Specific Setup:
  • Registry Setting:
  • The 'Enable Co-Practitioner Services From Progress Notes' registry setting is set to 'Y'.
  • Program Maintenance:
  • The 'Create Co-Practitioner Services From Progress Notes' field is set to 'Yes'.
  • Site Specific Section modeling:
  • Add-On service, Save Add-On, Add-On Duration, Co-Practitioner, Co-Practitioner Duration fields are added to the Progress Note form if they are not available on the form.
  • Dictionary Update:
  • File= 'Other Tabled File,
  • Data Element -291, Service Code Type'
  • Dictionary Code = 1
  • Dictionary Value = Evaluation Management
  • Extended Dictionary = 'Allow Multiple Add-On Code Definition'
  • Extended Dictionary Value (Single Dictionary) = Yes
  • Service Codes:
  • A primary service code is created to have desired number of add-on with the following:
  • Service Code Category = Primary Code
  • Service Code Type = desired value
  • Type of Fee = desired value.
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • A primary add-on service code is created with the following:
  • Service Code Category = Primary Add-On Code
  • Service Code Type = desired value
  • Type of Fee = desired value.
  • Should Add-On Services Generate for Co-Practitioners for this Service Code? = No
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Another add-on service code is created with the following:
  • Service Code Category = Add-On Code
  • Service Code Type = desired value
  • Type of Fee = desired value.
  • Should Add-On Services Generate for Co-Practitioners for this Service Code? = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • An interactive complexity add-on service code is created with the following:
  • Service Code Category =Interactive Complexity code
  • Service Code Type = desired value
  • Type of Fee = desired value.
  • Should Add-On Services Generate for Co-Practitioners for this Service Code? = NULL
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/Cross Reference Maintenance:
  • A fee definition is created for all the service codes. Note the fee for each service code.
  • An active practitioner is identified. Note the practitioner ID.
  • Admission:
  • An active client is identified, or a new client is created. Note the client id, name.
  • Diagnosis:
  • The client has an active diagnosis record. Note the diagnosis codes.
  • Financial Eligibility:
  • The client has an active financial eligibility record. Note the financial class of the guarantor. Note the client ID. Note the episode and program.
Steps
  1. Select desired client from the 'My Clients' widget.
  2. Open the 'Progress Notes (Group and Individual)' form.
  3. Validate the 'Select Client' field contains the client selected from the 'My Clients' widget.’.
  4. Select desired episode from the 'Select Episode' field.
  5. Select ‘New Service’ from the 'Progress Notes For' field.
  6. Select any value from the 'Note Type' field.
  7. Enter any value in the 'Notes Field' field.
  8. Enter the desired date in the 'Date Of Service' field.
  9. Enter primary service code in the 'Service Charge Code' field.
  10. Validate the 'Service Program' field contains the Service Program associated to selected episode.
  11. Select desired practitioner.
  12. Enter desired service duration.
  13. Select desired co-practitioner.
  14. Select Co-Practitioner Duration.
  15. Select Add-On codes associated with the primary code and Add-On duration.
  16. Select ‘Final’ from the 'Draft/Final' field.
  17. Click [File Note].
  18. Validate a message is displayed stating: Note Filed.
  19. Click [OK].
  20. Close the form.
  21. Open the 'Client Ledger' for the client.
  22. Verify the client ledger contains primary and add-on services created for all the co-practitioner listed in the progress note if the field 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' is set to 'Yes' or Null for the add-on service code in the 'Service Code' form.
  23. Close the form.
  24. Open the 'Close Charges' form.
  25. Close all the charges distributed to the guarantor.
  26. Close the form.
  27. Open the 'Create Interim Billing Batch File' form.
  28. Create an interim billing batch that covers the client, guarantor and services rendered to the client. Note the batch number.
  29. Close the form.
  30. Open the 'Electronic Billing' form.
  31. Compile an 837 bill for the client.
  32. Verify the bill compiles successfully.
  33. Select 'Dump File' option from the billing options.
  34. Select the recently compiled 837 file.
  35. Review the file.
  36. Verify the primary and add-on services are created for all the co-practitioner listed in the progress note if the field 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' is set to 'Yes' or Null for the add-on service code in the 'Service Code' form.
  37. Close the report.
  38. Close the form.
Scenario 3: Validating co-practitioner services - 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' = Y, N or Null and 'Create Co-Practitioner Services From Progress Notes' = N
Specific Setup:
  • Registry Setting:
  • The 'Enable Co-Practitioner Services From Progress Notes' registry setting is set to 'Y'.
  • Program Maintenance:
  • The 'Create Co-Practitioner Services From Progress Notes' field is set to 'Yes'.
  • Site Specific Section modeling:
  • Add-On service, Save Add-On, Add-On Duration, Co-Practitioner, Co-Practitioner Duration fields are added to the Progress Note form if they are not available on the form.
  • Dictionary Update:
  • File= 'Other Tabled File,
  • Data Element -291, Service Code Type'
  • Dictionary Code = 1
  • Dictionary Value = Evaluation Therapy
  • Extended dictionary 'Allow Multiple Add-On Code' = Yes
  • Service Codes:
  • A primary service code is created to have desired number of add-on with the following:
  • Service Code Category = Primary Code
  • Service Code Type = desired value
  • Type of Fee = desired value.
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • A primary add-on service code is created with the following:
  • Service Code Category = Primary Add-On Code
  • Service Code Type = desired value
  • Type of Fee = desired value.
  • Should Add-On Services Generate for Co-Practitioners for this Service Code? = No
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Another add-on service code is created with the following:
  • Service Code Category = Add-On Code
  • Service Code Type = desired value
  • Type of Fee = desired value.
  • Should Add-On Services Generate for Co-Practitioners for this Service Code? = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • An interactive complexity add-on service code is created with the following:
  • Service Code Category =Interactive Complexity code
  • Service Code Type = desired value
  • Type of Fee = desired value.
  • Should Add-On Services Generate for Co-Practitioners for this Service Code? = NULL
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • The Add-On service codes created above is selected as an add-on code for the primary service code selected.
  • Service Fee/Cross Reference Maintenance:
  • A fee definition is created for all the service codes. Note the fee for each service code.
  • An active practitioner is identified. Note the practitioner ID.
  • Admission:
  • An active client is identified, or a new client is created. Note the client id, name.
  • Diagnosis:
  • The client has an active diagnosis record. Note the diagnosis codes.
  • Financial Eligibility:
  • The client has an active financial eligibility record. Note the financial class of the guarantor. Note the client ID. Note the episode and program.
Steps
  1. Select desired client from the 'My Clients' widget.
  2. Access the 'Progress Notes (Group and Individual)' form.
  3. Validate the 'Select Client' field contains the client selected from the 'My Clients' widget.’.
  4. Select desired episode from the 'Select Episode' field.
  5. Select ‘New Service’ from the 'Progress Notes For' field.
  6. Select any value from the 'Note Type' field.
  7. Enter any value in the 'Notes Field' field.
  8. Enter the desired date in the 'Date Of Service' field.
  9. Enter primary service code in the 'Service Charge Code' field.
  10. Validate the 'Service Program' field contains the Service Program associated to selected episode.
  11. Select desired practitioner.
  12. Enter desired service duration.
  13. Select desired co-practitioner.
  14. Select Co-Practitioner Duration.
  15. Please note: User can add multiple co-practitioner to the note.
  16. Select Add-On codes associated with the primary code.
  17. Enter Add-On duration for the selected Add-On code.
  18. Click [Save Add-On Service].
  19. Select ‘Final’ from the 'Draft/Final' field.
  20. Click [File Note].
  21. Validate a message is displayed stating: Note Filed.
  22. Click [OK].
  23. Close the form.
  24. Open the 'Client Ledger' for the client.
  25. Verify the client ledger does not contain add-on services created for the co-practitioners added in the progress note. (Please note: The field 'Create Co-Practitioner Services From Progress Notes' in the 'Program Maintenance' form is set to 'No' and it takes precedence over the setting of the 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' field in the 'Service Code' form).
  26. Close the form.
  27. Open the 'Close Charges' form.
  28. Close all the charges distributed to the guarantor.
  29. Close the form.
  30. Open the 'Create Interim Billing Batch File' form.
  31. Create an interim billing batch that covers the client, guarantor and services rendered to the client. Note the batch number.
  32. Close the form.
  33. Open the 'Electronic Billing' form.
  34. Compile an 837 bill for the client.
  35. Verify the bill compiles successfully.
  36. Select 'Dump File' option and select the recently compiled 837 file.
  37. Review the file.
  38. Verify the primary and add-on services are created only for the practitioner. The bill does not display any Add-on services or primary services created for the co-practitioner listed in the progress note. (Please note: The field 'Create Co-Practitioner Services From Progress Notes' in the 'Program Maintenance' form is set to 'No' and it takes precedence over the setting of the 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' field in the 'Service Code' form).
  39. Close the report.
  40. Close the form.
Scenario 4: Cal-PM - Service Codes - Field validation
Specific Setup:
  • Registry Setting:
  • The Avatar PM->System Maintenance->Service Code Maintenance->->->Enable Multiple Add-On Code Per Primary Code Functionality is set to 'Y'.
  • Dictionary Update:
  • File= 'Other Tabled File,
  • Data Element -291, Service Code Type
  • Dictionary Code = 1
  • Dictionary Value = Evaluation Therapy
  • Extended dictionary 'Allow Multiple Add-On Code' = Yes
  • Service Codes:
  • A primary service code is created to have desired number of add-on with the following:
  • Service Code Category = Primary Code
  • Service Code Type = desired value
  • Type of Fee = desired value.
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • A primary add-on service code is created with the following:
  • Service Code Category = Primary Add-On Code
  • Service Code Type = desired value
  • Type of Fee = desired value.
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • An add-on service code is created with the following:
  • Service Code Category = Add-On Code
  • Service Code Type = desired value
  • Type of Fee = desired value.
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Another add-on service code is created with the following:
  • Service Code Category = Interactive Complexity Code
  • Service Code Type = desired value
  • Type of Fee = desired value.
  • All other fields are populated as required/needed.
  • Note the code and definition.
Steps
  1. Open the 'Service Codes' form.
  2. Verify the ‘Should Add-On Services Generate for Co-Practitioners for this Service Code?’ is added to the form.
  3. Verify the field is initially disabled.
  4. Select 'Edit' in the 'Add New Or Edit Existing' field.
  5. Select the primary add-on code created in the setup section.
  6. Verify the field is enabled. (Please note: The field is enabled If the “Service Code Category” field is set to something other than ‘Primary Code‘ i.e. 'Service Code Category' field must equal ‘Add-On Code’, ‘Interactive Complexity’, or ‘Primary Add-On Code’).
  7. Verify the help message text is -If this field is set to 'Yes', when this service is entered as an add-on service in a progress note with co-practitioners, a distinct add-on service for this service code will generate for each co-practitioner listed in the note. If this field is set to 'No', an add-on service will only generate for the Primary Practitioner in the note. The default logic for this field is 'Yes' - unless 'No' is selected, the add-on service will generate for each co-practitioner in the note. Note - services only generate for co-practitioners if the 'Create Co-Practitioner Services from Progress Notes' field in the Program Maintenance form is set to 'Yes.'.
  8. Verify the field is optional and not the required field.
  9. Select 'Yes' in the ‘Should Add-On Services Generate for Co-Practitioners for this Service Code?’ field.
  10. Click [File Service Code].
  11. Validate 'Edit' is selected in the 'Add New Or Edit Existing' field.
  12. Select the second add-on code created in the setup section.
  13. Verify the field is enabled. (Please note: The field is enabled If the “Service Code Category” field is set to something other than ‘Primary Code‘ i.e. 'Service Code Category' field must equal ‘Add-On Code’, ‘Interactive Complexity’, or ‘Primary Add-On Code’)
  14. Verify the field is optional and not the required field.
  15. Select 'No' in the ‘Should Add-On Services Generate for Co-Practitioners for this Service Code?’ field.
  16. Click [File Service Code].
  17. Validate 'Edit' is selected in the 'Add New Or Edit Existing' field.
  18. Select the interactive complexity code created in the setup section.
  19. Verify the ‘Should Add-On Services Generate for Co-Practitioners for this Service Code?' field is enabled. (Please note: The field is enabled If the 'Service Code Category' field is set to something other than ‘Primary Code‘ i.e. 'Service Code Category' field must equal ‘Add-On Code’, ‘Interactive Complexity’, or ‘Primary Add-On Code’)
  20. Verify the field is optional and not the required field.
  21. Do not select any value in the ‘Should Add-On Services Generate for Co-Practitioners for this Service Code?’ field.
  22. Click [File Service Code].
  23. Validate 'Edit' is selected in the 'Add New Or Edit Existing' field.
  24. Select the primary code created in the setup section.
  25. Verify the ‘Should Add-On Services Generate for Co-Practitioners for this Service Code?' field is not enabled. (Please note: The field is enabled If the 'Service Code Category' field is set to something other than ‘Primary Code‘ i.e. 'Service Code Category' field must equal ‘Add-On Code’, ‘Interactive Complexity’, or ‘Primary Add-On Code’)
  26. Click [File Service Code].
  27. Validate 'Edit' is selected in the 'Add New Or Edit Existing' field.
  28. Select the primary add-on code created in the setup section.
  29. Verify the ‘Should Add-On Services Generate for Co-Practitioners for this Service Code?’ field is enabled and set to 'Yes'.
  30. Validate 'Edit' is selected in the 'Add New Or Edit Existing' field.
  31. Select the add-on code created in the setup section.
  32. Verify the ‘Should Add-On Services Generate for Co-Practitioners for this Service Code?’ field is enabled and set to 'No'.
  33. Select 'Yes' in the ‘Should Add-On Services Generate for Co-Practitioners for this Service Code?’ field.
  34. Select 'Edit' in the 'Add New Or Edit Existing' field.
  35. Select the interactive complexity code created in the setup section.
  36. Verify the ‘Should Add-On Services Generate for Co-Practitioners for this Service Code?' field is enabled and nothing is selected in the field.
  37. Select 'Edit' in the 'Add New Or Edit Existing' field.
  38. Select the primary code created in the setup section.
  39. Verify the ‘Should Add-On Services Generate for Co-Practitioners for this Service Code?' field is not enabled.
  40. Verify the 'Service Code Report' is updated to include the new field 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' and display its value from the form.
  41. Close the report
  42. Close the form.
  43. Open the 'Crystal Report' or SQL data viewer.
  44. Run the query to retrieve data from the 'SYSTEM.billing_tx_master_table' sql table.
  45. Verify the 'generate_add_on_services_code' and 'generate_add_on_services_value' are added in the table.
  46. Verify the 'generate_add_on_services_code' and 'generate_add_on_services_value' contains correct value for the ‘Should Add-On Services Generate for Co-Practitioners for this Service Code?' field as set up in the 'Service Code' form.
Topics
• Progress Notes • Service Codes
AV-95682 Summary | Details
Service Codes
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Crystal Report Viewer
  • Service Code Upload Accepted Codes (2)
  • Service Code Upload Process
  • Service Code Upload Rejected Codes (2)
  • Admission (Outpatient)
  • Client Ledger
  • Create Interim Billing Batch File
  • Diagnosis
  • Dictionary Update (PM)
  • Electronic Billing
  • Financial Eligibility
  • Program Maintenance
  • Progress Notes (Group and Individual)
  • ProgressNote Approval
  • Registry Settings (PM)
  • Service Fee/Cross Reference Maintenance
  • Site Specific Section Modeling (CWS)
Scenario 1: Service code upload process - Validating compile/post file
Specific Setup:
  • The following text files are created to upload the service code in the system with the value of new field 'Should Add-On Services Generate for Co-Practitioners for this Service Code?'. Note the file name and location of the file.
  • The file to upload the add-on code with the value 'Y' for the field. (i.e. Name of the file File1).
  • The file to upload the add-on code with the value 'N' for the field. (i.e. Name of the file File2).
  • The file to upload the add-on code without any value selected for the field. (i.e. Name of the file File3).
  • The file to upload the primary code with the value 'Y' for the field. (i.e. Name of the file File5).
  • The file to upload the primary code with the value 'Y' for the field. (i.e. Name of the file File6).
  • The file to upload the primary code without any value for the field. (i.e. Name of the file File7).
Steps
  1. Open the 'Service Code Upload Process' form.
  2. Click [Select File].
  3. Select File1 created in the setup.
  4. Select 'Compile' in the 'Compile Or Post' field.
  5. Select 'No' in the 'Override Existing Service Codes' field.
  6. Submit the form.
  7. Verify the message: "Compile completed. To View results review accepted reports".
  8. Click [OK].
  9. Open the 'Service Code Upload Accepted Codes' form without exiting out from the 'Service Code Upload Process' form.
  10. Click the drop down for the 'Select Desired service code import file name' field.
  11. Verify the recently compiled file displays in the drop down.
  12. Select the file.
  13. Click [Process].
  14. Verify the report launched successfully and all the data displays correctly as listed in the texted file.
  15. Close the report.
  16. Close the 'Service Code Upload Accepted Codes' form.
  17. Locate to the 'Service Code Upload Process' form
  18. Select 'Post' in the 'Compile Or Post' field.
  19. Verify the file posted successfully.
  20. Open the 'Service Code' form.
  21. Select the recently uploaded service code to edit.
  22. Verify the field 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' is set to desired value defined in the text file.
  23. Close the form.
  24. Repeat steps 1 through 20 for the File1, File2, File3, and File7.
  25. Run the query to retrieve data from the 'SYSTEM.batchload_tx_accepted' sql table.
  26. Verify the 'generate_add_on_services_code' and 'generate_add_on_services_value' are added in the table.
  27. Open the 'Service Code Upload Process' form.
  28. Click [Select File].
  29. Select File5 created in the setup.
  30. Select 'Compile' in the 'Compile Or Post' field.
  31. Select 'No' in the 'Override Existing Service Codes' field.
  32. Submit the form.
  33. Verify that the file should not be compiled successfully.
  34. Verify the message: 'No accepted data compiled. To view results review rejected report'.
  35. Click [OK].
  36. Open the 'Service Code Upload Rejected Codes' form without exiting out from the 'Service Code Upload Process' form.
  37. Click the drop down for the 'Select Desired service code import file name' field.
  38. Verify the recently compiled is available in the drop down.
  39. Select the file.
  40. Click [Process].
  41. Verify the report launched successfully.
  42. Verify the report displays the error message 'The 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' field can only be valued when field 'Service Code Category' is not a primary code'.
  43. Close the report.
  44. Close the 'Service Code Upload Rejected Codes' form.
  45. Exit out of the 'Service Code Upload Rejected Codes' form.
  46. Close the form.
  47. Repeat steps from 22 through 35 for File6.
  48. Open the 'Crystal Report' or SQL data viewer.
  49. Run the query to retrieve data from the 'SYSTEM.billing_tx_master_table' sql table.
  50. Verify the 'generate_add_on_services_code' and 'generate_add_on_services_value' are added in the table.
  51. Verify the 'generate_add_on_services_code' and 'generate_add_on_services_value' contains correct value for the ‘Should Add-On Services Generate for Co-Practitioners for this Service Code?' field as set up in the 'Service Code' form.
  52. Run the 'select * from SYSTEM.batchload_tx_accepted' to retrieve data from the 'SYSTEM.batchload_tx_accepted' sql table.
  53. Verify the 'generate_add_on_services_code' and 'generate_add_on_services_value' are added in the table.
  54. Verify the 'generate_add_on_services_code' and 'generate_add_on_services_value' contains correct value for the ‘Should Add-On Services Generate for Co-Practitioners for this Service Code?' field as set up in the text file uploaded through the 'Service Code Upload Process' form.
  55. Close the report.
Scenario 2: Validating co-practitioner services - 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' = Y, N or Null and 'Create Co-Practitioner Services From Progress Notes' = Y
Specific Setup:
  • Registry Setting:
  • The 'Enable Co-Practitioner Services From Progress Notes' registry setting is set to 'Y'.
  • Program Maintenance:
  • The 'Create Co-Practitioner Services From Progress Notes' field is set to 'Yes'.
  • Site Specific Section modeling:
  • Add-On service, Save Add-On, Add-On Duration, Co-Practitioner, Co-Practitioner Duration fields are added to the Progress Note form if they are not available on the form.
  • Dictionary Update:
  • File= 'Other Tabled File,
  • Data Element -291, Service Code Type'
  • Dictionary Code = 1
  • Dictionary Value = Evaluation Management
  • Extended Dictionary = 'Allow Multiple Add-On Code Definition'
  • Extended Dictionary Value (Single Dictionary) = Yes
  • Service Codes:
  • A primary service code is created to have desired number of add-on with the following:
  • Service Code Category = Primary Code
  • Service Code Type = desired value
  • Type of Fee = desired value.
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • A primary add-on service code is created with the following:
  • Service Code Category = Primary Add-On Code
  • Service Code Type = desired value
  • Type of Fee = desired value.
  • Should Add-On Services Generate for Co-Practitioners for this Service Code? = No
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Another add-on service code is created with the following:
  • Service Code Category = Add-On Code
  • Service Code Type = desired value
  • Type of Fee = desired value.
  • Should Add-On Services Generate for Co-Practitioners for this Service Code? = Yes
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • An interactive complexity add-on service code is created with the following:
  • Service Code Category =Interactive Complexity code
  • Service Code Type = desired value
  • Type of Fee = desired value.
  • Should Add-On Services Generate for Co-Practitioners for this Service Code? = NULL
  • All other fields are populated as required/needed.
  • Note the code and definition.
  • Service Fee/Cross Reference Maintenance:
  • A fee definition is created for all the service codes. Note the fee for each service code.
  • An active practitioner is identified. Note the practitioner ID.
  • Admission:
  • An active client is identified, or a new client is created. Note the client id, name.
  • Diagnosis:
  • The client has an active diagnosis record. Note the diagnosis codes.
  • Financial Eligibility:
  • The client has an active financial eligibility record. Note the financial class of the guarantor. Note the client ID. Note the episode and program.
Steps
  1. Select desired client from the 'My Clients' widget.
  2. Open the 'Progress Notes (Group and Individual)' form.
  3. Validate the 'Select Client' field contains the client selected from the 'My Clients' widget.’.
  4. Select desired episode from the 'Select Episode' field.
  5. Select ‘New Service’ from the 'Progress Notes For' field.
  6. Select any value from the 'Note Type' field.
  7. Enter any value in the 'Notes Field' field.
  8. Enter the desired date in the 'Date Of Service' field.
  9. Enter primary service code in the 'Service Charge Code' field.
  10. Validate the 'Service Program' field contains the Service Program associated to selected episode.
  11. Select desired practitioner.
  12. Enter desired service duration.
  13. Select desired co-practitioner.
  14. Select Co-Practitioner Duration.
  15. Select Add-On codes associated with the primary code and Add-On duration.
  16. Select ‘Final’ from the 'Draft/Final' field.
  17. Click [File Note].
  18. Validate a message is displayed stating: Note Filed.
  19. Click [OK].
  20. Close the form.
  21. Open the 'Client Ledger' for the client.
  22. Verify the client ledger contains primary and add-on services created for all the co-practitioner listed in the progress note if the field 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' is set to 'Yes' or Null for the add-on service code in the 'Service Code' form.
  23. Close the form.
  24. Open the 'Close Charges' form.
  25. Close all the charges distributed to the guarantor.
  26. Close the form.
  27. Open the 'Create Interim Billing Batch File' form.
  28. Create an interim billing batch that covers the client, guarantor and services rendered to the client. Note the batch number.
  29. Close the form.
  30. Open the 'Electronic Billing' form.
  31. Compile an 837 bill for the client.
  32. Verify the bill compiles successfully.
  33. Select 'Dump File' option from the billing options.
  34. Select the recently compiled 837 file.
  35. Review the file.
  36. Verify the primary and add-on services are created for all the co-practitioner listed in the progress note if the field 'Should Add-On Services Generate for Co-Practitioners for this Service Code?' is set to 'Yes' or Null for the add-on service code in the 'Service Code' form.
  37. Close the report.
  38. Close the form.
Topics
• Progress Notes • Service Codes
Table Changes
Table Column Change
billing_tx_master_table generate_add_on_services_code ADD
billing_tx_master_table generate_add_on_services_value ADD
batchload_tx_accepted generate_add_on_services_code ADD
batchload_tx_accepted generate_add_on_services_value ADD