Avatar Cal-PM 2024 Monthly Release 2024.00.00 Acceptance Tests

• Admit an outpatient client with an active diagnosis and financial eligibility.
• Render several services to the newly created client.
• Create an interim billing batch.

1. Open the 'Close Charges' form.
2. Set the "Liability Update Or Close Charges" field to " Close Charges".
3. Set a date in the "Thru Date" field that includes some, but not all services in the interim batch.
4. Select "Individual" in the "Individual, All, Or Interim Batch Cycle" field.
5. Enter a name or ID in the "Client ID" field.
6. Select an episode in the "Episode Number" field.
7. Submit the form to close all charges for the client and thru date specified.
8. Validate the client ledger to ensure the services closed,
9. Open the 'Close Charges' form.
10. Set the "Liability Update Or Close Charges" field to " Close Charges".
11. Set a date in the "Thru Date" field.
12. Select "Interim Batch Cycle" in the "Individual, All, Or Interim Batch Cycle" field.
13. Select an Interim Batch Number in the "Interim Batch Number" field.
14. Submit the form to close all charges for the client and thru date specified.
15. Validate the client ledger to ensure the services closed.

• Clients:
• Client A:
• Admit an outpatient client with an active diagnosis and financial eligibility.
• Render four services for four different dates using the Client Charge Input form.
• Client B:
• Admit an outpatient client with an active diagnosis and financial eligibility.
• Render four services for four different dates using the Client Charge Input form.
• Interim Billing Batch:
• Batch A:
• Create an interim billing batch that covers Client A and only covers the first two services.
• Batch B:
• Create an interim billing batch that covers Client B and all four services.
• Registry Setting(s):
• The "Close Charges By Program And Guarantor Of Batch Only" registry setting should be set to the value 'B'.

1. Open the 'Close Charges' form.
2. Set the "Liability Update Or Close Charges" field to " Close Charges".
3. Leave the "Thru Date" field blank.
4. Select "Interim Batch Cycle" in the "Individual, All, Or Interim Batch Cycle" field.
5. Select Interim 'Batch A' from the "Interim Batch Number" field.
6. Submit the form to close all charges with the Interim Batch and "Thru Date" not specified.
7. Open the 'Client Ledger' form.
8. Select Client A in the "Client ID" field.
9. Select "All Episodes" in the "Claim/Episode/All Episodes" field.
10. Select "Simple" in the "Ledger Type" field.
11. Select "Process".
12. Validate that only the services that are covered by Interim 'Batch A' are Closed.
13. Close the report.
14. Select "No".
15. Open the 'Open Closed Charges' form.
16. Select "Individual" in the "Individual, All, Or Interim Batch Cycle" field.
17. Select Client A in the "Client ID" field.
18. Select the Episode from the "Episode" field.
19. Select the "Select Charges To Open" button.
20. Select all the services by checking them in the 'Open Closed Charges' window.
21. Click "OK".
22. Select "Submit".
23. Select "Yes".
24. Select "No".
25. Open the 'Close Charges' form.
26. Set the "Liability Update Or Close Charges" field to " Close Charges".
27. Select "T" in the "Thru Date" field.
28. Select "Interim Batch Cycle" in the "Individual, All, Or Interim Batch Cycle" field.
29. Select Interim 'Batch A' from the "Interim Batch Number" field.
30. Submit the form to close all charges with the Interim Batch and "Thru Date" specified as Today.
31. Open the 'Client Ledger' form.
32. Select Client A in the "Client ID" field.
33. Select "All Episodes" in the "Claim/Episode/All Episodes" field.
34. Select "Simple" in the "Ledger Type" field.
35. Select "Process".
36. Validate that only the services that are covered by Interim 'Batch A' are closed.
37. Close the report.
38. Select "No".
39. Open the 'Close Charges' form.
40. Set the "Liability Update Or Close Charges" field to " Close Charges".
41. Leave the "Thru Date" field blank.
42. Select "Interim Batch Cycle" in the "Individual, All, Or Interim Batch Cycle" field.
43. Select Interim Batch B from the "Interim Batch Number" field.
44. Submit the form to close all charges with the Interim Batch and "Thru Date" not specified.
45. Open the 'Client Ledger' form.
46. Select Client B in the "Client ID" field.
47. Select "All Episodes" in the "Claim/Episode/All Episodes" field.
48. Select "Simple" in the "Ledger Type" field.
49. Select "Process".
50. Validate that all the services that are covered by Interim ;Batch B' are Closed.
51. Close the report.
52. Select "No".
53. Open the 'Open Closed Charges' form.
54. Select "Individual" in the "Individual, All, Or Interim Batch Cycle" field.
55. Select Client B in the "Client ID" field.
56. Select the Episode from the "Episode" field.
57. Select the "Select Charges To Open" button.
58. Select all the services by checking them in the 'Open Closed Charges' window.
59. Click "OK".
60. Select "Submit".
61. Select "Yes".
62. Select "No".
63. Open the 'Close Charges' form.
64. Set the "Liability Update Or Close Charges" field to " Close Charges".
65. Set the "Thru Date" field with a date that does not cover a few services from 'Batch B'.
66. Select "Interim Batch Cycle" in the "Individual, All, Or Interim Batch Cycle" field.
67. Select Interim Batch B from the "Interim Batch Number" field.
68. Submit the form to close all charges with the Interim Batch and "Thru Date" not specified.
69. Open the 'Client Ledger' form.
70. Select Client B in the "Client ID" field.
71. Select "All Episodes" in the "Claim/Episode/All Episodes" field.
72. Select "Simple" in the "Ledger Type" field.
73. Select "Process".
74. Validate that only the services of Interim 'Batch B' that are covered under the "Thru Date" specified are closed.
75. Close the report.
76. Select "No".

Registry Settings:

• Set the registry setting 'UMDAP Housing Adjustment Percentage' as any desired percentage value within the range of 1 to 100.

Form designer:

• Add the hidden elements 'Housing Costs' and 'Housing Adjustment' under the Third Subsection of the UMDAP Information Tab.

Clients:

• More than one existing client is identified or new ones are created to be used in the family registration process.
• Client 1
• Client 2

Family:

• An existing family with no member(s) and with all the UMDAP data should be identified or created.
• Family A

1. Open the "Family Registration" form.
2. Enter a desired name for the Family - 'Family B'.
3. Click [New Family].
4. Fill in all the needed field values in the "Family Registration" section.
5. Click on the "Family Members" section.
6. Select the [Add New Item].
7. Add 'Client 1' and 'Client 2' as the members.
8. Fill in all the needed field values in the "Family Members" section.
9. Verify the "Type of Family Member" column displayed in the "Family Membership Information" grid. Note: as this grid contains many fields, you may need to drag the border between fields to widen the view of this, or any of the other, fields in the grid.
10. Select the "UMDAP Information" section.
11. Click [Add New Item].
12. Validate that the fields "Housing Costs" & "Housing Adjustment" are present in the form.
13. Fill in all the mandatory field values along with the other desired optional field values.
14. Click [Submit].
15. Create an SQL query to the below tables and validate that the above-filed data are saved and shown in the respective cache storage tables,
16. Validate the Family Demographics information in "SYSTEM.family_current_demographics",
17. Validate the Member information(s) in "SYSTEM.family_membership_information",
18. Validate the UMDAP information in "SYSTEM.family_umdap_info".
19. Close the SQL, return to the NX window, and open the 'Family Registration' form.
20. Select 'Family A'.
21. Click on the "Family Members" section.
22. Verify that no members are existing in the grid.
23. Select the [Add New Item].
24. Add 'Client 1' as a member.
25. Verify that we see an error message stating that there is a Date Range Overlap found with Another Family Assignment for the date range.
26. Click [OK].
27. Click [Discard].
28. Click [Yes].
29. Open the 'Family Registration' form.
30. Select 'Family B'.
31. Click on the "Family Members" section.
32. Select 'Client 1' from the grid.
33. Click [Edit Selected Item].
34. Enter a future date value for the field 'End Date Of Family Membership date'.
35. Click [Submit].
36. Create an SQL query to the below table for 'Family B' and validate that 'Client 1' is updated with the 'fam_memb_end_date' value,
37. "SYSTEM.family_membership_information".
38. Close the SQL, return to the NX window, and open the 'Family Registration' form.
39. Select 'Family A'.
40. Click on the "Family Members" section.
41. Verify that no members are existing in the grid.
42. Select the [Add New Item].
43. Add 'Client 1' as a member.
44. Enter a date value that falls between the 'Start Date Of Family Membership date' and 'End Date Of Family Membership date' range of 'Client 1' in 'Family B'.
45. Verify that we see an error message for 'Date Range Overlaps Another Family AssignmentFamily'.
46. Click [OK].
47. Enter a date value that is outside the 'Start Date Of Family Membership date' and 'End Date Of Family Membership date' range of 'Client 1' in 'Family B'.
48. Click [Submit].
49. Create an SQL query to the below table for Family A and validate that Client 1 is added as a member of the family.
50. "SYSTEM.family_membership_information".
51. Create an SQL query to the below table for Family B and validate that Client 1 is also showing with the 'fam_memb_end_date' value.
52. "SYSTEM.family_membership_information".
53. Close the SQL.

Family Registration:

• A family with more than one member and with all the UMDAP data should be identified or created.
• Family A:
• Member 1 (Client 1)
• Member 2 (Client 2)

Clients:

• Adding to the above clients, An existing client is identified or a new one is created for the Client Merge process. The client identified/created should have the same information (except for the program) as the member whom we want to merge with.
• Client 3

1. Open the "Family Registration" form.
2. Enter the Family ID for - 'Family A'.
3. Select Family A.
4. Click on the "Family Members" item.
5. Verify that the members exist and are shown in the grid.
6. Select 'Member 2' from the grid.
7. Click [Delete Selected Item].
8. Click [Yes].
9. Verify that the member we deleted is removed from the grid, upon successful delete.
10. Select the "UMDAP Information" item.
11. Verify that the existing UMDAP record(s) are shown in the grid.
12. Click [Submit].
13. Create an SQL query to the below table for Family A and validate that there are no records found for 'Client 2',
14. "SYSTEM.family_membership_information".
15. Create an SQL query to the below table for 'Family A' and validate that there are UMDAP data available, which is the same as the data we filed using the 'Family Registration form',
16. "SYSTEM.family_umdap_info".
17. Close the querying window and return to the NX window.
18. Open the "Family Registration" form.
19. Enter the Family ID for - 'Family A'.
20. Select 'Family A'.
21. Click on the "Family Members" item.
22. Verify that the members exist and are shown in the grid.
23. Click [Add New Item].
24. Enter the 'Client ID' field with 'Client 1' and select it.
25. Verify that we see a popup that says that there is a Date Range Overlap found with the Previous Entry For ClientStart and End Date(s).
26. Click [OK].
27. Enter the 'Client ID' field with 'Client 2' and select it.
28. Fill in all the needed values.
29. Verify that the new member is now added and shown in the grid.
30. Select the "UMDAP Information" item.
31. Select the existing record from the 'UMDAP Information' grid.
32. Click [Delete Selected Item].
33. Click [Yes].
34. Verify that there are no records in the 'UMDAP Information' grid.
35. Click [Submit].
36. Create an SQL query to the below table for 'Family A' and validate that there is an existing record found for 'Client 2',
37. "SYSTEM.family_membership_information".
38. Create an SQL query to the below table for 'Family A' and validate that there are no UMDAP data available,
39. "SYSTEM.family_umdap_info".
40. Close the querying window and return to the NX window.
41. Open the "Change MR#" form.
42. Enter the 'Client ID' field with 'Client 2' and select it.
43. Click [Assign MR#].
44. Click [Yes].
45. Validate that the 'New Client ID#' input box contains a new ID - 'New Client 2'.
46. Click [Submit].
47. Open the "Family Registration" form.
48. Enter the Family ID for - 'Family A'.
49. Select 'Family A'.
50. Click on the "Family Members" item.
51. Verify that the members exist and are shown in the grid.
52. Select 'Member 2' from the grid.
53. Click [Edit Selected Item].
54. Validate that the Client ID is replaced with the new MR#. (i.e. 'New Client 2').
55. Click [Discard].
56. Click [Yes].
57. Create an SQL query to the below table for Family A and validate that there are no records found for 'Client 2',
58. "SYSTEM.family_membership_information".
59. Verify that we do have a record for 'New Client 2' in the table for 'Family A'.
60. Close the querying window and return to the NX window.
61. Open the "Client Merge" form.
62. Enter the 'Client ID' field with 'New Client 2' and select it.
63. Select the Episode value from the 'Source Client Episode' dropdown field.
64. Enter the 'Client ID' field with 'Client 3' and select it.
65. Click [File].
66. Click [Yes].
67. Click [OK].
68. Click [Discard].
69. Click [Yes].
70. Open the "Family Registration" form.
71. Enter the Family ID for - 'Family A'.
72. Select 'Family A'.
73. Click on the "Family Members" item.
74. Verify that the members exist and are shown in the grid.
75. Select 'Member 2' from the grid.
76. Click [Edit Selected Item].
77. Validate that the Client ID is replaced with 'Client 3'.
78. Click [Discard].
79. Click [Yes].
80. Create an SQL query to the below table for 'Family A' and validate that there are no records found for 'New Client 2',
81. "SYSTEM.family_membership_information".
82. Verify that we do have a record for 'Client 3' in the table for 'Family A'.
83. Close the SQL.

• The user has access to a Web services tool.

1. Access the Web services tool and select the WSDL for the 'ClientAdmission' - 'AddAdmission' web service.
2. Enter the system code that will be used to log into Avatar in the 'SystemCode' field.
3. Enter the user name that will be used to log into Avatar in the 'UserName' field.
4. Enter the password that will be used to log into Avatar in the 'Password' field.
5. Enter the desired date in the 'AdmissionDate' field.
6. Enter the desired time in the 'AdmissionTime' field.
7. Enter the desired practitioner in the 'AdmittingPractitioner' field.
8. Enter the desired value in the 'ClientFirstName' field.
9. Enter the desired value in the 'ClientLastName' field.
10. Enter the desired value in the 'ClientMiddleName' field.
11. Enter the corresponding name in the 'ClientName' field.
12. Enter the desired value in the 'ESignatureConsentOnFile' field. Note: "Y" and "N" are accepted values.
13. Enter the desired value in the 'Program' field.
14. Enter the desired value in the 'Sex' field.
15. Enter the desired value in the "Time Zone for Appointment Reminders" field.
16. Set the "PreferredAppointmentSite" to the desired site.
17. Populate any other required and desired fields.
18. Enter the desired value in the 'Address Type' field.
19. Click [Run].
20. Validate the 'Confirmation' field contains a value such as: "Client Unique ID: # Unique ID: #".
21. Validate the 'Message' field contains: "Client Admission web service has been filed successfully".
22. Select the client filed in the previous steps and access the 'Admission' form.
23. Select the record filed in the previous steps and click [Edit].
24. Validate all populated fields are displayed.
25. Select the "Demographics" section.
26. Validate the 'Client Last Name' field contains the value filed in the previous steps.
27. Validate the 'Client First Name' field contains the value filed in the previous steps.
28. Validate the 'Client Middle Name' field contains the value filed in the previous steps.
29. Validate the 'Consent On File For Use of Integrated eSignature' field contains the value filed in the previous steps.
30. Validate 'Time Zone for Appointment Reminders' field contains the value filed in the previous steps.
31. Validate the 'Preferred Appointment Site' field contains the value filed in the previous steps.
32. Validate the 'Address Type' field contains the value filed in the previous steps.
33. Close the form.

• Avatar PM Registry Setting 'Enable Pricing/Re-Pricing Information' must be enabled/set to value '2' or '3'
• Avatar PM 'Guarantor/Program Billing Defaults Template' import file containing one or more valid '837 Professional' and/or '837 Institutional' import data rows (Updated import file layout document 'Avatar_PM_File_Import_Record_Layouts.xls' included with update package)
• Crystal Reports or other SQL reporting tool

1. Open Avatar PM 'File Import' form.
2. Select File Type 'Guarantor/Program Billing Defaults Template'.
3. Select 'Upload New File' in the 'Action' field and Click 'Process Action' button.
4. Select Avatar PM 'Guarantor/Program Billing Defaults Template' import file and click 'Open' button.
5. Select 'Compile/Validate File' in 'Action' field.
6. Select loaded import file and click 'Process Action' button.
7. Ensure that 'Compile/Validate File' action completes, and message 'Compiled' or '(File Name) contains one or more errors. These errors can be reviewed using 'Print Errors' action' is displayed.
8. Click 'OK' button.
9. Select 'Post File' in 'Action' field to post successfully compiled import data; Select compiled import file, but don't post.
10. Open another "File Import" form.
11. Select File Type 'Guarantor/Program Billing Defaults Template'.
12. Select 'Post File'.
13. Select the same File from Step 9 to Post.
14. Select 'Process Action'.
15. Validate import completes without error.
16. Select 'Discard'.
17. Open the File Import form which we first kept opened in Step 9.
18. Ensure that message 'Posted' and/or 'The selected file contains one or more lines with compilation errors. Only those lines without compilation errors will be posted' is displayed.
19. Open Avatar PM 'Guarantor/Program Billing Defaults' form.
20. Select 'Edit Template' and select existing Defaults Template added/updated via 'File Import'.
21. Navigate to '837 Professional' section of form.
22. Ensure values for the following fields from 837 Professional 'Guarantor/Program Billing Defaults Template' import file data row are present in 837 Professional defaults section of 'Guarantor/Program Billing Defaults' form:
23. 'Provider Taxonomy Code to Display (2000A-PRV-03)'
24. 'Billing Provider Tax ID to Display (2010AA-REF-02)'
25. 'Include Repricer Received Date (2300-DTP)'
26. 'Default Total Claim Charge Amount (2300-HCP-02)'
27. 'Default Cost of Service/Units (2400-HCP-02/11/12)'
28. Navigate to '837 Institutional' section of form.
29. Ensure values for the following fields from 837 Institutional 'Guarantor/Program Billing Defaults Template' import file data row are present in 837 Institutional defaults section of 'Guarantor/Program Billing Defaults' form:
30. 'Provider Taxonomy Code to Display (2000A-PRV-03)'
31. 'Billing Provider Tax ID to Display (2010AA-REF-02)'
32. 'Include Repricer Received Date (2300-DTP)'
33. 'Default Total Claim Charge Amount (2300-HCP-02)'
34. 'Default Cost of Service/Units (2400-HCP-02/11/12)'
35. Open Crystal Reports or other SQL reporting tool.
36. In Avatar PM SQL table 'SYSTEM.file_import_gpbdt_p837', ensure that the following fields are present and contain values filed via 837 Professional 'Guarantor/Program Billing Defaults Template' File Import:
37. prov_taxon_to_disp_code / prov_taxon_to_disp_value
38. prov_taxid_to_disp_code / prov_taxid_to_disp_value
39. inc_repric_rec_date_code / inc_repric_rec_date_value
40. def_tot_clm_chg_amt_code / def_tot_clm_chg_amt_value
41. def_cost_svc_units_code / def_cost_svc_units_value
42. In Avatar PM SQL table 'SYSTEM.file_import_gpbdt_i837', ensure that the following fields are present and contain values filed via 837 Institutional 'Guarantor/Program Billing Defaults Template' File Import:
43. prov_taxon_to_disp_code / prov_taxon_to_disp_value
44. prov_taxid_to_disp_code / prov_taxid_to_disp_value
45. inc_repric_rec_date_code / inc_repric_rec_date_value
46. def_tot_clm_chg_amt_code / def_tot_clm_chg_amt_value
47. def_cost_svc_units_code / def_cost_svc_units_value

• A Client Charge Input File Import file must be created to test with. In the file, record units of service (field 11) as 1:00.

1. Open the "File Import" form.
2. Import the file set up in pre-conditions.
3. The following error message is received. "File XXX.txt contains one or more errors. These errors can be reviewed using the "Print Errors" action.".
4. Manually modify the sample import file. Change the units of service field (field 11) to "1.00".
5. Import the file.
6. Validate import completes without error.
7. Manually modify the sample import file. Change the units of service field (field 11) to "1".
8. Compile the file.
9. Select the File to Post, but don't post.
10. Open another "File Import" form.
11. Select the "Client Charge Input" in the File type.
12. Select "Post File".
13. Select the same File from Step 9 to Post.
14. Select "Process Action".
15. Validate import completes without error.
16. Select "Discard".
17. Open the File Import form which we first kept opened in Step 9.
18. Select "Process Action".
19. Validate import is not happening with the same file that is already imported.
20. Validate that we get the error message saying, "File is already posted." with the "OK" button.
21. Select "OK".
22. Open "Client Ledger".
23. Run the report.
24. Validate that the service(s) were added to the client's ledger and there are no duplicates added for the same date(s).