Skip to main content

Avatar Cal-PM 2024 Monthly Release 2024.01.02 Acceptance Tests

  1. Last updated
  2. Save as PDF
Update 16 Summary | Details
Support tool stateless update
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Product Updates (PM)
  • Support Utility
Scenario 1: Cal-PM- Support Utilities - Validating 'Balance Bill Period' utility
Steps

**Internal Testing Only
Topics
• Support Utilities
Update 24 Summary | Details
Registry Settings
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Registry Settings (PM)
  • Service Codes
  • Service Code Upload Process
Scenario 1: Registry Setting = Unit Calculation with Minimum Duration - Service Codes.
Specific Setup:
  • Registry Settings:
  • Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  • Set the 'Registry Setting Value' to 'Y'.
Steps
  1. Open "Service Codes" form.
  2. Click [Add] in 'Add New Or Edit Existing'.
  3. Click [Primary Code] in 'Service Code Category'.
  4. Click [Evaluation Management] in 'Service Code Type'.
  5. Enter any value in 'Service Code Definition'.
  6. Click [Both] in 'Service Required By'.
  7. Select [Individual] from 'Type Of Service'.
  8. Click [User Defined] in 'Type Of Fee'.
  9. Enter any value in 'Minutes Per Unit'.
  10. Select desired value in 'Unit Rounding Logic'.
  11. Select desired value in 'Designated Degree Of Rounding'.
  12. Select any value from the 'Group Code'.
  13. Select any value from the 'Covered Charge Category'.
  14. Select desired value in 'Is This Service A Procedure'.
  15. Select desired value in 'Is This A Balance Forward Service Code'.
  16. Select desired value in 'Does This Code Have A Professional Component'.
  17. Select desired value in 'Is This Service A Visit'.
  18. Enter any value in 'Maximum Duration (Minutes)'.
  19. Select desired value in 'Is This Service An Intervention?'.
  20. Enter any value in 'Minimum Duration for Unit Calculation' that is greater than 'Maximum Duration (Minutes)'.
  21. Validate the message 'Minimum Duration for Unit Calculation cannot be greater than Maximum Duration'.
  22. Click [OK].
  23. Enter any value in 'Maximum Duration (Minutes)' that is less than 'Minimum Duration for Unit Calculation'.
  24. Validate the message 'Maximum duration cannot be less than Minimum Duration for Unit Calculation'.
  25. Click [OK].
  26. Enter any value in 'Maximum Duration (Minutes)'.
  27. Enter any value in 'Minimum Duration for Unit Calculation'.
  28. Click [File Service Code].
  29. Click [Discard].
  30. Validate dialog 'Confirm Close'.
  31. Click [Yes].
  32. Open "Registry Settings" form.
  33. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  34. Set the 'Registry Setting Value' to 'YE'.
  35. Click [Submit].
  36. Open "Service Codes" form.
  37. Click [Edit] in 'Add New Or Edit Existing'.
  38. Enter the 'Service Code' created above.
  39. Enter any value in 'Maximum Duration (Minutes)'.
  40. Enter any value in 'Minimum Duration for Unit Calculation' that is greater than 'Maximum Duration (Minutes)'.
  41. Validate the message 'Maximum duration cannot be less than Minimum Duration for Unit Calculation'.
  42. Click [OK].
  43. Enter any value in 'Maximum Duration (Minutes)' that is less than 'Minimum Duration for Unit Calculation'.
  44. Validate the message 'Minimum Duration for Unit Calculation cannot be greater than Maximum Duration'.
  45. Enter any value in 'Maximum Duration (Minutes)'.
  46. Enter any value in 'Minimum Duration for Unit Calculation (Minutes)'.
  47. Click [File Service Code].
  48. Click [Discard].
  49. Validate dialog 'Confirm Close'.
  50. Click [Yes].
  51. Open "Registry Settings" form.
  52. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  53. Set the 'Registry Setting Value' to 'YW'.
  54. Click [Submit].
  55. Repeat steps 36-50, to validate the error message.
  56. Open "Registry Settings" form.
  57. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  58. Set the 'Registry Setting Value' to 'N'.
  59. Click [Submit].
  60. Open "Service Codes" form.
  61. Click [Edit] in 'Add New Or Edit Existing'.
  62. Enter the 'Service Code' created above.
  63. Validate the 'Minimum Duration for Unit Calculation' field does not exist.
  64. Click [Submit].
  65. Click [No].
Scenario 2: Registry Setting = Unit Calculation with Minimum Duration - Service Code Upload Process.
Specific Setup:
  • Registry Settings:
  • Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  • Set the 'Registry Setting Value' to 'Y'.
  • Service Code Upload:
  • 'File A' has been saved locally with values in 'Maximum Duration (Minutes)' and 'Minimum Duration for Unit Calculation'. Note the service code.
  • 'File B' file has been saved locally with a value in 'Maximum Duration (Minutes)' less than value in 'Minimum Duration for Unit Calculation'. Note the service code.
Steps
  1. Open "Service Code Upload Process" form.
  2. Enter 'File A' in 'Filename'.
  3. Click [Compile] in 'Compile Or Post'.
  4. Click [No] in 'Override Existing Service Codes'.
  5. Click [Submit].
  6. Validate the message 'Compile completed. To review results, review accepted report'.
  7. Click [OK].
  8. Click [Post] in 'Compile Or Post'.
  9. Click [Submit].
  10. Validate the filing message 'Posting Completed'.
  11. Click [OK].
  12. Click [Discard].
  13. Validate dialog Confirm Close.
  14. Click [Yes].
  15. Open "Service Code Upload Accepted Codes" form.
  16. Select 'File A' in 'Select Desired Service Code Import File Name'.
  17. Click [Process].
  18. Validate the report displays data from 'File A' correctly.
  19. Click [Close Report].
  20. Validate Form Return dialog.
  21. Click [No].
  22. Open "Service Codes" form.
  23. Click [Edit] in 'Add New or Edit Existing'.
  24. Enter the 'Service Code' from the 'File A'.
  25. Validate the data from 'File A' is populated in the form.
  26. Validate the field 'Minimum Duration for Unit Calculation' exists and is populated with value from 'File A'.
  27. Click [Discard].
  28. Validate Confirm Close dialog.
  29. Click [Yes].
  30. Open "Service Code Upload Process" form.
  31. Enter 'File B' in 'Filename'.
  32. Click [Compile] in 'Compile Or Post'.
  33. Click [No] in 'Override Existing Service Codes'.
  34. Click [Submit].
  35. Validate the filing error 'No accepted data compiled. To review results, review rejected report'.
  36. Click [OK].
  37. Click [Discard].
  38. Validate Confirm Close dialog.
  39. Click [Yes].
  40. Open "Service Code Upload Rejected Codes" form.
  41. Select the desired file.
  42. Click [Process].
  43. Validate the error message in report 'Maximum duration cannot be less than Minimum Duration for Unit Calculation. Invalid Entry: Maximum Duration (Minutes)'.
  44. Click [Close Report].
  45. Validate the Form Return dialog.
  46. Click [No].
  47. Open "Registry Settings" form.
  48. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  49. Set the 'Registry Setting Value' to 'YE'.
  50. Click [Submit].
  51. Repeat Steps 30-46 to validate the error message.
  52. Open "Registry Settings" form.
  53. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  54. Set the 'Registry Setting Value' to 'YW'.
  55. Click [Submit].
  56. Repeat Steps 30-46 to validate the error message.
  57. Open "Registry Settings" form.
  58. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  59. Set the 'Registry Setting Value' to 'N'.
  60. Click [Submit].
  61. Repeat Steps 30-46 to validate the error message 'The 'Unit Calculation with Minimum Duration' registry setting is not enabled. Invalid Entry: Minimum Duration for Unit Calculation'.
Registry Settings
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Registry Settings (PM)
  • Service Codes
  • Client Charge Input
  • File Import
Scenario 1: Registry Setting = Unit Calculation with Minimum Duration - Client Charge Input.
Specific Setup:
  • Registry Settings:
  • Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  • Set the 'Registry Setting Value' to 'Y'.
  • Client 1:
  • Identify an existing client or create a new client (Client 1). Note the client’s admission date.
  • Service Code:
  • ‘An existing service code (Service Code 1) is identified that has a value defined for the 'Minimum Duration for Unit Calculation' field.
Steps
  1. Open "Client Charge Input" form.
  2. Enter any value in 'Date Of Service'.
  3. Enter 'Client 1' created in setup in 'Client ID'.
  4. Enter 'Service Code 1' in 'Service Code'.
  5. Enter any value in 'Practitioner'.
  6. Enter any value in 'Duration(Minutes)' that is less than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  7. Click [Submit].
  8. Click [No].
  9. Open "Client Ledger" form.
  10. Enter 'Client 1' created in setup in 'Client ID'.
  11. Click [All Episodes] in 'Claim/Episode/All Episodes'.
  12. Click [Simple] in 'Ledger Type'.
  13. Click [Yes] in 'Include Zero Charges'.
  14. Click [Process].
  15. Validate the Client Ledger Report, if charges are zero.
  16. Click [X].
  17. Click [No].
  18. Repeat Steps 1-14 with value in 'Duration(Minutes)' greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  19. Validate the Ledger, check charges and units assigned.
  20. Click [X].
  21. Click [No].
  22. Open the "Registry Settings" form.
  23. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  24. Set the 'Registry Setting Value' to 'YE'.
  25. Repeat Steps 1-6 to file a service through 'Client Charge Input' form.
  26. Validate the error message displayed: 'The service [Service Code 1] does not meet the minimum duration requirements for unit calculation and cannot be filed. A unit will only be calculated once the duration is at least X minutes.
  27. Click [OK].
  28. Enter any value in 'Duration(Minutes)' that is greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  29. Click [Submit].
  30. Open "Client Ledger" form.
  31. Enter 'Client 1' created in setup in 'Client ID'.
  32. Click [All Episodes] in 'Claim/Episode/All Episodes'.
  33. Click [Simple] in 'Ledger Type'.
  34. Click [Yes] in 'Include Zero Charges'.
  35. Click [Process].
  36. Validate the Ledger Report to check charges and units assigned.
  37. Click [X].
  38. Click [No].
  39. Open the "Registry Settings" form.
  40. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  41. Set the 'Registry Setting Value' to 'YW'.
  42. Repeat Steps 1-6, to file a service through 'Client Charge Input' form.
  43. Validate the error message displayed: 'The service [Service Code 1] does not meet the minimum duration requirements for unit calculation. A unit will only be calculated once the duration is at least X minutes.
  44. Click [OK].
  45. Enter any value in 'Duration(Minutes)' that is greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  46. Click [Submit].
  47. Repeat Steps 30-38 to validate Client Ledger Report data.
Scenario 2: File Import - Client Charge Input
Specific Setup:
  • Registry Settings:
  • Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  • Set the 'Registry Setting Value' to 'Y'.
  • Service Code:
  • ‘An existing service code is identified that has a value defined for the 'Minimum Duration for Unit Calculation' field (Service Code 1).
  • File Import:
  • Create an import file with 'Duration(Minutes)' in Client Charge Input less than the 'Minimum Duration for Unit Calculation' field in Service Code 1-"File A".
  • Create an import file with 'Duration(Minutes)' in Client Charge Input greater than the 'Minimum Duration for Unit Calculation' field in Service Code 1 -"File B".
  • Client 1:
  • Identify an existing client or create a new client (Client 1). Note the client’s admission date.
Steps
  1. Open the "File Import" form.
  2. Select "Client Charge Input" in the 'File Type'.
  3. Select "Upload New File" in the 'Action'.
  4. Click [Process Action].
  5. Select "File A".
  6. Select "Compile/Validate File" in the 'Action'.
  7. Select "File A" in the 'Files(s)'.
  8. Click [Process Action].
  9. Select "File A".
  10. Select "Compile/Validate File" in the 'Action'.
  11. Select "File A" in the 'Files(s)'.
  12. Click [Process Action].
  13. Validate the message = 'Compiled'.
  14. Click [OK].
  15. Select "Print File" in the 'Action'.
  16. Select "File A" in the 'Files(s)'.
  17. Click [Process Action].
  18. Validate the report data.
  19. Click [Close Report].
  20. Select "Post File" in the 'Action' field.
  21. Select "File A" in the 'Files(s)' field.
  22. Click [Process Action].
  23. Validate the message = 'Posted'.
  24. Click [OK].
  25. Click [Discard]
  26. Click [Yes].
  27. Open ''Client Ledger'' form.
  28. Enter the Client ID.
  29. Click [All Episodes] in 'Claim/Episode/All Episodes'.
  30. Click [Simple] in 'Ledger Type'.
  31. Click [Yes] in 'Include Zero Charges'.
  32. Click [Process].
  33. Validate the Ledger Report to check if charges are zero.
  34. Click [X].
  35. Click [No].
  36. Repeat Steps 7- 35 to import service using "File B" and validate Client Ledger Report data.
  37. Validate the Ledger Report to check charges and units assigned.
  38. Click [No].
  39. Open the "Registry Settings" form.
  40. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  41. Set the 'Registry Setting Value' to 'YW'.
  42. Repeat Steps 1-39, to import service and validate Client Ledger.
  43. Open the "Registry Settings" form.
  44. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  45. Set the 'Registry Setting Value' to 'YE'.
  46. Repeat Steps 1-17 to import a service.
  47. Validate the error message: File A contains one or more errors. These errors can be reviewed using 'Print Errors' action.
  48. Click [OK].
  49. Select "Print Errors" in the 'Action'.
  50. Select "File A" in the 'Files(s)'.
  51. Click [Process Action].
  52. Validate the report shows 'The service [Service Code 1] does not meet the minimum duration requirements for unit calculation and cannot be filed. A unit will only be calculated once the duration is at least X minutes.'.
  53. Click [Close Report].
  54. Select "Delete File" in the 'Action'.
  55. Select "File A" in the 'Files(s)' field.
  56. Click [Process Action].
  57. Click [Yes].
  58. Click [OK].
  59. Repeat Steps 7- 35 to import service using "File B" and validate Client Ledger.
  60. Validate the Ledger Report to check charges and units assigned.
  61. Click [X].
  62. Click [No].
Scenario 3: Registry Setting = Unit Calculation with Minimum Duration - Edit Service Information
Specific Setup:
  • Registry Settings:
  • Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  • Set the 'Registry Setting Value' to 'Y'.
  • Client 1:
  • Identify an existing client or create a new client (Client 1). Note the client’s admission date.
  • Service Code:
  • ‘An existing service code is identified that has a value defined for the 'Minimum Duration for Unit Calculation' field (Service Code 1).
Steps
  1. Open "Edit Service Information" form.
  2. Enter 'Client 1' in 'Client ID'.
  3. Click [Select Service(s) To Edit].
  4. Select desired service form the grid.
  5. Click [OK].
  6. Enter any value in 'Duration (Minutes)' that is below the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  7. Click [Submit].
  8. Click [No].
  9. Open "Client Ledger" form.
  10. Enter 'Client 1' in 'Client ID'.
  11. Click [All Episodes] in 'Claim/Episode/All Episodes'.
  12. Click [Simple] in 'Ledger Type'.
  13. Click [Yes] in 'Include Zero Charges'.
  14. Click [Process].
  15. Validate the 'Client Ledger' report that the distributed charges are zero.
  16. Click [X].
  17. Click [Yes].
  18. Click [Discard].
  19. Repeat Steps 1-14, with value in 'Duration (Minutes)' greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  20. Validate 'Client Ledger' report that the distributed charges contain the correct units and amounts.
  21. Click [X].
  22. Click [Yes].
  23. Click [Discard].
  24. Open the "Registry Settings" form.
  25. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  26. Set the 'Registry Setting Value' to 'YW'.
  27. Click [Submit].
  28. Repeat Steps 1-6, to edit service in 'Edit Service Information' form.
  29. Validate the error message: The service [SERVICE CODE 1] does not meet the minimum duration requirements for unit calculation. A unit will only be calculated once the duration is at least X minutes.
  30. Enter any value in 'Duration (Minutes)' greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  31. Click [Submit].
  32. Click [No].
  33. Open "Client Ledger" form.
  34. Enter 'Client 1' in 'Client ID'.
  35. Click [All Episodes] in 'Claim/Episode/All Episodes'.
  36. Click [Simple] in 'Ledger Type'.
  37. Click [Yes] in 'Include Zero Charges'.
  38. Click [Process].
  39. Validate 'Client Ledger' report that the distributed charges contain the correct units and amounts.
  40. Click [X].
  41. Click [Yes].
  42. Click [Discard].
  43. Open the "Registry Settings" form.
  44. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  45. Set the 'Registry Setting Value' to 'YE'.
  46. Click [Submit].
  47. Repeat Steps1-6, to edit service in 'Edit Service Information' form.
  48. Validate the error message: The service [Service Code 1] does not meet the minimum duration requirements for unit calculation and cannot be filed. A unit will only be calculated once the duration is at least X minutes.
  49. Enter any value in 'Duration (Minutes)' greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  50. Click [Submit].
  51. Click [No].
  52. Repeat Steps 33-42 to validate 'Client Ledger' report data.
Scenario 4: Client Charge Input via WEBSVC ClientChargeInput
Specific Setup:
  • Registry Settings:
  • Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  • Set the 'Registry Setting Value' to : 'YE'.
  • Client 1:
  • Identify an existing client or create a new client (Client 1). Note the client’s admission date.
  • Service Code:
  • ‘An existing service code is identified that has a value defined for the 'Minimum Duration for Unit Calculation' field (Service Code 1).
Steps
  1. Using desired web service tool, create a request for 'WEBSVC ClientChargeInput'.
  2. Enter the System Code in 'System Code' Field.
  3. Enter the user name in the 'User Name' field.
  4. Enter the password in the 'Password' field.
  5. Enter any 'Client 1' in 'ClientID'.
  6. Enter any value in 'Date of Service'.
  7. Enter value in 'Duration' less than Minimum Duration for Unit Calculation in Service Codes form.
  8. Enter any value in 'Episode Number'.
  9. Enter any value in 'Location'.
  10. Enter any value in 'Practitioner'.
  11. Enter any value in 'Program'.
  12. Enter 'Service Code 1' in 'Service Code'.
  13. Click [Run].
  14. Verify Response - 'Duration (Minutes): The service [Service Code 1] does not meet the minimum duration requirements for unit calculation and cannot be filed. A unit will only be calculated once the duration is at least 'xx' minutes.
  15. Enter value in 'Duration' greater than 'Minimum Duration for Unit Calculation' in Service Codes form.
  16. Click [Run].
  17. Verify Response - 'Client Charge Input web service has been filed successfully'.
  18. Open "Client Ledger" form.
  19. Enter 'Client 1' in 'Client ID'.
  20. Click [All Episodes] in 'Claim/Episode/All Episodes'.
  21. Click [Simple] in 'Ledger Type'.
  22. Click [Yes] in 'Include Zero Charges'.
  23. Click [Process].
  24. Validate the report data to validate that the charges and units were created correctly.
  25. Click [X].
  26. Click [Yes].
  27. Click [Discard].
  28. Open the "Registry Settings" form.
  29. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  30. Set the 'Registry Setting Value' to 'Y'.
  31. Repeat Steps 7- 27 to file a service and validate 'Client Ledger' report data.
  32. Open the "Registry Settings" form.
  33. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  34. Set the 'Registry Setting Value' to 'YW'.
  35. Repeat Steps 7- 27 to file a service and validate 'Client Ledger' report data.
Registry Settings
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Registry Settings (PM)
  • Service Codes
  • Client Charge Input
  • File Import
Scenario 1: Registry Setting = Unit Calculation with Minimum Duration - Client Charge Input.
Specific Setup:
  • Registry Settings:
  • Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  • Set the 'Registry Setting Value' to 'Y'.
  • Client 1:
  • Identify an existing client or create a new client (Client 1). Note the client’s admission date.
  • Service Code:
  • ‘An existing service code (Service Code 1) is identified that has a value defined for the 'Minimum Duration for Unit Calculation' field.
Steps
  1. Open "Client Charge Input" form.
  2. Enter any value in 'Date Of Service'.
  3. Enter 'Client 1' created in setup in 'Client ID'.
  4. Enter 'Service Code 1' in 'Service Code'.
  5. Enter any value in 'Practitioner'.
  6. Enter any value in 'Duration(Minutes)' that is less than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  7. Click [Submit].
  8. Click [No].
  9. Open "Client Ledger" form.
  10. Enter 'Client 1' created in setup in 'Client ID'.
  11. Click [All Episodes] in 'Claim/Episode/All Episodes'.
  12. Click [Simple] in 'Ledger Type'.
  13. Click [Yes] in 'Include Zero Charges'.
  14. Click [Process].
  15. Validate the Client Ledger Report, if charges are zero.
  16. Click [X].
  17. Click [No].
  18. Repeat Steps 1-14 with value in 'Duration(Minutes)' greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  19. Validate the Ledger, check charges and units assigned.
  20. Click [X].
  21. Click [No].
  22. Open the "Registry Settings" form.
  23. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  24. Set the 'Registry Setting Value' to 'YE'.
  25. Repeat Steps 1-6 to file a service through 'Client Charge Input' form.
  26. Validate the error message displayed: 'The service [Service Code 1] does not meet the minimum duration requirements for unit calculation and cannot be filed. A unit will only be calculated once the duration is at least X minutes.
  27. Click [OK].
  28. Enter any value in 'Duration(Minutes)' that is greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  29. Click [Submit].
  30. Open "Client Ledger" form.
  31. Enter 'Client 1' created in setup in 'Client ID'.
  32. Click [All Episodes] in 'Claim/Episode/All Episodes'.
  33. Click [Simple] in 'Ledger Type'.
  34. Click [Yes] in 'Include Zero Charges'.
  35. Click [Process].
  36. Validate the Ledger Report to check charges and units assigned.
  37. Click [X].
  38. Click [No].
  39. Open the "Registry Settings" form.
  40. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  41. Set the 'Registry Setting Value' to 'YW'.
  42. Repeat Steps 1-6, to file a service through 'Client Charge Input' form.
  43. Validate the error message displayed: 'The service [Service Code 1] does not meet the minimum duration requirements for unit calculation. A unit will only be calculated once the duration is at least X minutes.
  44. Click [OK].
  45. Enter any value in 'Duration(Minutes)' that is greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  46. Click [Submit].
  47. Repeat Steps 30-38 to validate Client Ledger Report data.
Scenario 2: File Import - Client Charge Input
Specific Setup:
  • Registry Settings:
  • Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  • Set the 'Registry Setting Value' to 'Y'.
  • Service Code:
  • ‘An existing service code is identified that has a value defined for the 'Minimum Duration for Unit Calculation' field (Service Code 1).
  • File Import:
  • Create an import file with 'Duration(Minutes)' in Client Charge Input less than the 'Minimum Duration for Unit Calculation' field in Service Code 1-"File A".
  • Create an import file with 'Duration(Minutes)' in Client Charge Input greater than the 'Minimum Duration for Unit Calculation' field in Service Code 1 -"File B".
  • Client 1:
  • Identify an existing client or create a new client (Client 1). Note the client’s admission date.
Steps
  1. Open the "File Import" form.
  2. Select "Client Charge Input" in the 'File Type'.
  3. Select "Upload New File" in the 'Action'.
  4. Click [Process Action].
  5. Select "File A".
  6. Select "Compile/Validate File" in the 'Action'.
  7. Select "File A" in the 'Files(s)'.
  8. Click [Process Action].
  9. Select "File A".
  10. Select "Compile/Validate File" in the 'Action'.
  11. Select "File A" in the 'Files(s)'.
  12. Click [Process Action].
  13. Validate the message = 'Compiled'.
  14. Click [OK].
  15. Select "Print File" in the 'Action'.
  16. Select "File A" in the 'Files(s)'.
  17. Click [Process Action].
  18. Validate the report data.
  19. Click [Close Report].
  20. Select "Post File" in the 'Action' field.
  21. Select "File A" in the 'Files(s)' field.
  22. Click [Process Action].
  23. Validate the message = 'Posted'.
  24. Click [OK].
  25. Click [Discard]
  26. Click [Yes].
  27. Open ''Client Ledger'' form.
  28. Enter the Client ID.
  29. Click [All Episodes] in 'Claim/Episode/All Episodes'.
  30. Click [Simple] in 'Ledger Type'.
  31. Click [Yes] in 'Include Zero Charges'.
  32. Click [Process].
  33. Validate the Ledger Report to check if charges are zero.
  34. Click [X].
  35. Click [No].
  36. Repeat Steps 7- 35 to import service using "File B" and validate Client Ledger Report data.
  37. Validate the Ledger Report to check charges and units assigned.
  38. Click [No].
  39. Open the "Registry Settings" form.
  40. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  41. Set the 'Registry Setting Value' to 'YW'.
  42. Repeat Steps 1-39, to import service and validate Client Ledger.
  43. Open the "Registry Settings" form.
  44. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  45. Set the 'Registry Setting Value' to 'YE'.
  46. Repeat Steps 1-17 to import a service.
  47. Validate the error message: File A contains one or more errors. These errors can be reviewed using 'Print Errors' action.
  48. Click [OK].
  49. Select "Print Errors" in the 'Action'.
  50. Select "File A" in the 'Files(s)'.
  51. Click [Process Action].
  52. Validate the report shows 'The service [Service Code 1] does not meet the minimum duration requirements for unit calculation and cannot be filed. A unit will only be calculated once the duration is at least X minutes.'.
  53. Click [Close Report].
  54. Select "Delete File" in the 'Action'.
  55. Select "File A" in the 'Files(s)' field.
  56. Click [Process Action].
  57. Click [Yes].
  58. Click [OK].
  59. Repeat Steps 7- 35 to import service using "File B" and validate Client Ledger.
  60. Validate the Ledger Report to check charges and units assigned.
  61. Click [X].
  62. Click [No].
Scenario 3: Registry Setting = Unit Calculation with Minimum Duration - Edit Service Information
Specific Setup:
  • Registry Settings:
  • Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  • Set the 'Registry Setting Value' to 'Y'.
  • Client 1:
  • Identify an existing client or create a new client (Client 1). Note the client’s admission date.
  • Service Code:
  • ‘An existing service code is identified that has a value defined for the 'Minimum Duration for Unit Calculation' field (Service Code 1).
Steps
  1. Open "Edit Service Information" form.
  2. Enter 'Client 1' in 'Client ID'.
  3. Click [Select Service(s) To Edit].
  4. Select desired service form the grid.
  5. Click [OK].
  6. Enter any value in 'Duration (Minutes)' that is below the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  7. Click [Submit].
  8. Click [No].
  9. Open "Client Ledger" form.
  10. Enter 'Client 1' in 'Client ID'.
  11. Click [All Episodes] in 'Claim/Episode/All Episodes'.
  12. Click [Simple] in 'Ledger Type'.
  13. Click [Yes] in 'Include Zero Charges'.
  14. Click [Process].
  15. Validate the 'Client Ledger' report that the distributed charges are zero.
  16. Click [X].
  17. Click [Yes].
  18. Click [Discard].
  19. Repeat Steps 1-14, with value in 'Duration (Minutes)' greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  20. Validate 'Client Ledger' report that the distributed charges contain the correct units and amounts.
  21. Click [X].
  22. Click [Yes].
  23. Click [Discard].
  24. Open the "Registry Settings" form.
  25. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  26. Set the 'Registry Setting Value' to 'YW'.
  27. Click [Submit].
  28. Repeat Steps 1-6, to edit service in 'Edit Service Information' form.
  29. Validate the error message: The service [SERVICE CODE 1] does not meet the minimum duration requirements for unit calculation. A unit will only be calculated once the duration is at least X minutes.
  30. Enter any value in 'Duration (Minutes)' greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  31. Click [Submit].
  32. Click [No].
  33. Open "Client Ledger" form.
  34. Enter 'Client 1' in 'Client ID'.
  35. Click [All Episodes] in 'Claim/Episode/All Episodes'.
  36. Click [Simple] in 'Ledger Type'.
  37. Click [Yes] in 'Include Zero Charges'.
  38. Click [Process].
  39. Validate 'Client Ledger' report that the distributed charges contain the correct units and amounts.
  40. Click [X].
  41. Click [Yes].
  42. Click [Discard].
  43. Open the "Registry Settings" form.
  44. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  45. Set the 'Registry Setting Value' to 'YE'.
  46. Click [Submit].
  47. Repeat Steps1-6, to edit service in 'Edit Service Information' form.
  48. Validate the error message: The service [Service Code 1] does not meet the minimum duration requirements for unit calculation and cannot be filed. A unit will only be calculated once the duration is at least X minutes.
  49. Enter any value in 'Duration (Minutes)' greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  50. Click [Submit].
  51. Click [No].
  52. Repeat Steps 33-42 to validate 'Client Ledger' report data.
Scenario 4: Client Charge Input via WEBSVC ClientChargeInput
Specific Setup:
  • Registry Settings:
  • Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  • Set the 'Registry Setting Value' to : 'YE'.
  • Client 1:
  • Identify an existing client or create a new client (Client 1). Note the client’s admission date.
  • Service Code:
  • ‘An existing service code is identified that has a value defined for the 'Minimum Duration for Unit Calculation' field (Service Code 1).
Steps
  1. Using desired web service tool, create a request for 'WEBSVC ClientChargeInput'.
  2. Enter the System Code in 'System Code' Field.
  3. Enter the user name in the 'User Name' field.
  4. Enter the password in the 'Password' field.
  5. Enter any 'Client 1' in 'ClientID'.
  6. Enter any value in 'Date of Service'.
  7. Enter value in 'Duration' less than Minimum Duration for Unit Calculation in Service Codes form.
  8. Enter any value in 'Episode Number'.
  9. Enter any value in 'Location'.
  10. Enter any value in 'Practitioner'.
  11. Enter any value in 'Program'.
  12. Enter 'Service Code 1' in 'Service Code'.
  13. Click [Run].
  14. Verify Response - 'Duration (Minutes): The service [Service Code 1] does not meet the minimum duration requirements for unit calculation and cannot be filed. A unit will only be calculated once the duration is at least 'xx' minutes.
  15. Enter value in 'Duration' greater than 'Minimum Duration for Unit Calculation' in Service Codes form.
  16. Click [Run].
  17. Verify Response - 'Client Charge Input web service has been filed successfully'.
  18. Open "Client Ledger" form.
  19. Enter 'Client 1' in 'Client ID'.
  20. Click [All Episodes] in 'Claim/Episode/All Episodes'.
  21. Click [Simple] in 'Ledger Type'.
  22. Click [Yes] in 'Include Zero Charges'.
  23. Click [Process].
  24. Validate the report data to validate that the charges and units were created correctly.
  25. Click [X].
  26. Click [Yes].
  27. Click [Discard].
  28. Open the "Registry Settings" form.
  29. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  30. Set the 'Registry Setting Value' to 'Y'.
  31. Repeat Steps 7- 27 to file a service and validate 'Client Ledger' report data.
  32. Open the "Registry Settings" form.
  33. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  34. Set the 'Registry Setting Value' to 'YW'.
  35. Repeat Steps 7- 27 to file a service and validate 'Client Ledger' report data.
Topics
• Registry Settings • Service Codes • Client Charge Input • File Import • Edit Service Information • Web Services
Update 35 Summary | Details
274 Provider Directory
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • 274 - Provider Directory Defaults
  • 274 - Provider Directory Definition
  • 274 - Provider Directory Submission
Scenario 1: Cal-PM - 274 Provider Directory Workflow - MHP & DMCODS
Specific Setup:
  • 274 Provider Directory Defaults has been submitted.
  • 274 Provider Directory Definition:
  • Group Definitions exist for a minimum of one 'Mental Health Plan' and one 'Drug Medi-Cal Organized Delivery System'.
  • Site Definitions exist for a minimum of one 'Mental Health Plan' and one 'Drug Medi-Cal Organized Delivery System'.
  • Provider Definitions exist for a minimum of one 'Mental Health Plan' and one 'Drug Medi-Cal Organized Delivery System'.
  • 'Drug Medi-Cal Organized Delivery System'.
  • The 'Modality Type (2100EA-N2-02)' field contains a minimum of one value.
  • The 'Provider Email Address (2100EA-N2-01)' field does not contain a value.
Steps
  1. Open '274 Health Care Directory Submission'.
  2. Click [Mental Health Plan] in 'Plan Type'
  3. Click [Compile File] in 'Options'.
  4. Enter desired value in 'Reporting Period (MM/YY).
  5. Enter desired value in 'File Description'.
  6. Click [Process File].
  7. Validate the 'Mental Health Plan' data in the report.
  8. Close the report.
  9. Click [Mental Health Plan] in 'Plan Type'
  10. Click [Dump File] in 'Options'.
  11. Select the file compiled above in 'Select File'.
  12. Click [Process File].
  13. Review the dump file report to ensure it contains the correct values.
  14. Close the report.
  15. Repeat step 2 - 14, clicking 'Drug Medi-Cal Organized Delivery System' in step two.
  16. If desired:
  17. Edit the 'Provider Definition' for 'Drug Medi-Cal Organized Delivery System' to contain a value in 'Provider Email Address (2100EA-N2-01)'.
  18. Create a new '274 Health Care Directory Submission' and validate the data.
Topics
• 274 - Provider Directory
Update 40 Summary | Details
SQL Table validations
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Program Maintenance
  • Admission (Outpatient)
  • CSI Admission
  • Crystal Reports or other SQL Reporting tool (SDK_AVCALPM Namespace)
  • CSI Submission
Scenario 1: SYSTEM.edi_ca_csi_records - field validation
Specific Setup:
  • Program Maintenance:
  • Identify an existing CSI program or create a new CSI program where the field 'Mental Health Program (CSI)' is set to "Yes". Note the program code / description.
  • Admission:
  • Admit a new client to the CSI program identified above. Note the client's id/ name, admission date.
  • CSI Admission:
  • CSI admission is filed for the client admitted above. Note the data entry date when the CSI admission is filed.
  • CSI Submission:
  • The CSI submission is filed for the client with the 'Through Date' that covers the 'CSI Admission' filed above.
Steps
  1. Open the 'Crystal Report' or any other SQL data viewer.
  2. Query the 'SYSTEM.edi_ca_csi_records' table specific to the 'index_counter' containing data.
  3. Verify the table column 'index_counter' is displayed correctly with decimal data.
  4. Close the report.
Topics
• Database Management
Update 41 Summary | Details
SQL Table Validation - Data Retrieval
Scenario 1: SYSTEM.mhsa_compile_error - Validating Data Retrieval
Specific Setup:
  • Tester has access to the 'Crystal Report' or any other SQL data viewer for the system.
Steps
  1. Open the 'Crystal Report' or any other SQL data viewer.
  2. Run the SQL query to retrieve data from the 'SYSTEM.mhsa_compile_error' table.
  3. Verify that the data was successfully retrieved from the table.
  4. Close the report.
Scenario 2: SYSTEM.billing_medical_rev_assign - Validating Data Retrieval
Specific Setup:
  • Tester has access to the 'Crystal Report' or any other SQL data viewer for the system.
Steps
  1. Open the 'Crystal Report' or any other SQL data viewer.
  2. Run the SQL query to retrieve data from the 'SYSTEM.billing_medical_rev_assign' table.
  3. Verify that the data was successfully retrieved from the table.
  4. Close the report.
Topics
• Database Management
Update 46 Summary | Details
Enhanced Character Escaping for ‘File Definition’ Help Message
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Quick Billing Rule Definition
Scenario 1: Quick Billing Rule Definition - Help Message on File Description
Steps
  1. Open the "Quick Billing Rule Definition" form.
  2. Click the [File Description] help button.
  3. Validate in the field description that the special characters '<' and '>' display correctly.
  4. Click the [Return To Form] link.
  5. Click the [Discard] button.
Topics
• Quick Billing
Update 53 Summary | Details
The 'Age Display Format' registry setting
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Registry Settings (PM)
  • Admission (Outpatient)
  • Call Intake
  • Pre Admit
  • Family Registration
  • Client Medical Conditions
  • Avatar NX Report Viewer
Scenario 1: Admission - Validate the 'Age Display Format' registry setting
Steps
  1. Access the 'Registry Settings' Form.
  2. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field.
  3. Click [View Registry Settings].
  4. Validate the 'Registry Setting Details' field contains: This registry setting accepts the values "1", "2", or "3", to customize the format of age across various forms and widgets, including 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit', 'Call Intake', 'Client Header', and the 'Client Information' widget. Selecting "1" enables a simplified age display, presenting only the clients' age in years across all specified forms and widgets. Selecting "2", a more detailed age field is made visible and the display of age only in years is hidden on the 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit' and 'Call Intake' forms. For clients older than three years, age is shown in months and years, while for those under three, age is shown in days, months, and years. Selecting "3" allows for clients under 3 years old to display their age in months, and those under 2 years to display their age in months and days. All clients aged 3 and above will display age in years only.
  5. Enter "1" in the 'Registry Setting Value' field.
  6. Submit the form.
  7. Access the 'Admission' form.
  8. Populate all required fields to admit a new client. This will be referred to as "Client A".
  9. Enter the desired value in the 'Date Of Birth' field.
  10. Validate the 'Age' field contains the client's age in years.
  11. Submit the form.
  12. Access the 'Registry Settings' Form.
  13. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field.
  14. Click [View Registry Settings].
  15. Enter "2" in the 'Registry Setting Value' field.
  16. Submit the form.
  17. Select "Client A" and access the 'Admission' form.
  18. Click [Edit].
  19. Enter a date making the client older than 3 years old in the 'Date Of Birth' field.
  20. Validate the 'Age' field contains the client's age in years and months.
  21. Enter a date making the client less than 3 years old in the 'Date Of Birth' field.
  22. Validate the 'Age' field contains the client's age in years, months, and days.
  23. Close the form.
  24. Access the 'Registry Settings' Form.
  25. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field.
  26. Click [View Registry Settings].
  27. Enter "3" in the 'Registry Setting Value' field.
  28. Submit the form.
  29. Select "Client A" and access the 'Admission' form.
  30. Click [Edit].
  31. Enter a date making the client older than 3 years old in the 'Date Of Birth' field.
  32. Validate the 'Age' field contains the client's age in years.
  33. Enter a date making the client between 2-3 years old in the 'Date Of Birth' field.
  34. Validate the 'Age' field contains the client's age in months.
  35. Enter a date making the client less than 2 years old in the 'Date Of Birth' field.
  36. Validate the 'Age' field contains the client's age in months and days.
  37. Close the form.
Scenario 2: Admission (Outpatient) - Validate the 'Age Display Format' registry setting
Steps
  1. Access the 'Registry Settings' Form.
  2. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field.
  3. Click [View Registry Settings].
  4. Validate the 'Registry Setting Details' field contains: This registry setting accepts the values "1", "2", or "3", to customize the format of age across various forms and widgets, including 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit', 'Call Intake', 'Client Header', and the 'Client Information' widget. Selecting "1" enables a simplified age display, presenting only the clients' age in years across all specified forms and widgets. Selecting "2", a more detailed age field is made visible and the display of age only in years is hidden on the 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit' and 'Call Intake' forms. For clients older than three years, age is shown in months and years, while for those under three, age is shown in days, months, and years. Selecting "3" allows for clients under 3 years old to display their age in months, and those under 2 years to display their age in months and days. All clients aged 3 and above will display age in years only.
  5. Enter "1" in the 'Registry Setting Value' field.
  6. Submit the form.
  7. Access the 'Admission (Outpatient)' form.
  8. Populate all required fields to admit a new client. This will be referred to as "Client A".
  9. Enter the desired value in the 'Date Of Birth' field.
  10. Validate the 'Age' field contains the client's age in years.
  11. Submit the form.
  12. Access the 'Registry Settings' Form.
  13. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field.
  14. Click [View Registry Settings].
  15. Enter "2" in the 'Registry Setting Value' field.
  16. Submit the form.
  17. Select "Client A" and access the 'Admission (Outpatient)' form.
  18. Click [Edit].
  19. Enter a date making the client older than 3 years old in the 'Date Of Birth' field.
  20. Validate the 'Age' field contains the client's age in years and months.
  21. Enter a date making the client less than 3 years old in the 'Date Of Birth' field.
  22. Validate the 'Age' field contains the client's age in years, months, and days.
  23. Close the form.
  24. Access the 'Registry Settings' Form.
  25. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field.
  26. Click [View Registry Settings].
  27. Enter "3" in the 'Registry Setting Value' field.
  28. Submit the form.
  29. Select "Client A" and access the 'Admission (Outpatient)' form.
  30. Click [Edit].
  31. Enter a date making the client older than 3 years old in the 'Date Of Birth' field.
  32. Validate the 'Age' field contains the client's age in years.
  33. Enter a date making the client between 2-3 years old in the 'Date Of Birth' field.
  34. Validate the 'Age' field contains the client's age in months.
  35. Enter a date making the client less than 2 years old in the 'Date Of Birth' field.
  36. Validate the 'Age' field contains the client's age in months and days.
  37. Close the form.
Scenario 3: Call Intake - Validate the 'Age Display Format' registry setting
Specific Setup:
  • The 'Add Demographics To Call Intake' registry setting must be set to "Y" in Cal-PM systems.
Steps
  1. Access the 'Registry Settings' Form.
  2. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field.
  3. Click [View Registry Settings].
  4. Validate the 'Registry Setting Details' field contains: This registry setting accepts the values "1", "2", or "3", to customize the format of age across various forms and widgets, including 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit', 'Call Intake', 'Client Header', and the 'Client Information' widget. Selecting "1" enables a simplified age display, presenting only the clients' age in years across all specified forms and widgets. Selecting "2", a more detailed age field is made visible and the display of age only in years is hidden on the 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit' and 'Call Intake' forms. For clients older than three years, age is shown in months and years, while for those under three, age is shown in days, months, and years. Selecting "3" allows for clients under 3 years old to display their age in months, and those under 2 years to display their age in months and days. All clients aged 3 and above will display age in years only.
  5. Enter "1" in the 'Registry Setting Value' field.
  6. Submit the form.
  7. Access the 'Call Intake' form.
  8. Populate all required fields to admit a client into a 'Call Intake' program. This will be referred to as "Client A".
  9. Enter the desired value in the 'Date Of Birth' field.
  10. Validate the 'Age' field contains the client's age in years.
  11. Submit the form.
  12. Access the 'Registry Settings' Form.
  13. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field.
  14. Click [View Registry Settings].
  15. Enter "2" in the 'Registry Setting Value' field.
  16. Submit the form.
  17. Select "Client A" and access the 'Call Intake' form.
  18. Click [Edit].
  19. Enter a date making the client older than 3 years old in the 'Date Of Birth' field.
  20. Validate the 'Age' field contains the client's age in years and months.
  21. Enter a date making the client less than 3 years old in the 'Date Of Birth' field.
  22. Validate the 'Age' field contains the client's age in years, months, and days.
  23. Close the form.
  24. Access the 'Registry Settings' Form.
  25. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field.
  26. Click [View Registry Settings].
  27. Enter "3" in the 'Registry Setting Value' field.
  28. Submit the form.
  29. Select "Client A" and access the 'Call Intake' form.
  30. Click [Edit].
  31. Enter a date making the client older than 3 years old in the 'Date Of Birth' field.
  32. Validate the 'Age' field contains the client's age in years.
  33. Enter a date making the client between 2-3 years old in the 'Date Of Birth' field.
  34. Validate the 'Age' field contains the client's age in months.
  35. Enter a date making the client less than 2 years old in the 'Date Of Birth' field.
  36. Validate the 'Age' field contains the client's age in months and days.
  37. Close the form.
Scenario 4: Pre Admit - Validate the 'Age Display Format' registry setting
Steps
  1. Access the 'Registry Settings' Form.
  2. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field.
  3. Click [View Registry Settings].
  4. Validate the 'Registry Setting Details' field contains: This registry setting accepts the values "1", "2", or "3", to customize the format of age across various forms and widgets, including 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit', 'Call Intake', 'Client Header', and the 'Client Information' widget. Selecting "1" enables a simplified age display, presenting only the clients' age in years across all specified forms and widgets. Selecting "2", a more detailed age field is made visible and the display of age only in years is hidden on the 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit' and 'Call Intake' forms. For clients older than three years, age is shown in months and years, while for those under three, age is shown in days, months, and years. Selecting "3" allows for clients under 3 years old to display their age in months, and those under 2 years to display their age in months and days. All clients aged 3 and above will display age in years only.
  5. Enter "1" in the 'Registry Setting Value' field.
  6. Submit the form.
  7. Access the 'Pre Admit' form.
  8. Populate all required fields to admit a new client into a Pre Admit program. This will be referred to as "Client A".
  9. Enter the desired value in the 'Date Of Birth' field.
  10. Validate the 'Age' field contains the client's age in years.
  11. Submit the form.
  12. Access the 'Registry Settings' Form.
  13. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field.
  14. Click [View Registry Settings].
  15. Enter "2" in the 'Registry Setting Value' field.
  16. Submit the form.
  17. Select "Client A" and access the 'Pre Admit' form.
  18. Click [Edit].
  19. Enter a date making the client older than 3 years old in the 'Date Of Birth' field.
  20. Validate the 'Age' field contains the client's age in years and months.
  21. Enter a date making the client less than 3 years old in the 'Date Of Birth' field.
  22. Validate the 'Age' field contains the client's age in years, months, and days.
  23. Close the form.
  24. Access the 'Registry Settings' Form.
  25. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field.
  26. Click [View Registry Settings].
  27. Enter "3" in the 'Registry Setting Value' field.
  28. Submit the form.
  29. Select "Client A" and access the 'Pre Admit' form.
  30. Click [Edit].
  31. Enter a date making the client older than 3 years old in the 'Date Of Birth' field.
  32. Validate the 'Age' field contains the client's age in years.
  33. Enter a date making the client between 2-3 years old in the 'Date Of Birth' field.
  34. Validate the 'Age' field contains the client's age in months.
  35. Enter a date making the client less than 2 years old in the 'Date Of Birth' field.
  36. Validate the 'Age' field contains the client's age in months and days.
  37. Close the form.
Scenario 5: Family Registration - Validate the 'Age Display Format' registry setting
Specific Setup:
  • A client is enrolled in an existing episode (Client A).
Steps
  1. Access the 'Registry Settings' Form.
  2. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field.
  3. Click [View Registry Settings].
  4. Validate the 'Registry Setting Details' field contains: This registry setting accepts the values "1", "2", or "3", to customize the format of age across various forms and widgets, including 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit', 'Call Intake', 'Client Header', and the 'Client Information' widget. Selecting "1" enables a simplified age display, presenting only the clients' age in years across all specified forms and widgets. Selecting "2", a more detailed age field is made visible and the display of age only in years is hidden on the 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit' and 'Call Intake' forms. For clients older than three years, age is shown in months and years, while for those under three, age is shown in days, months, and years. Selecting "3" allows for clients under 3 years old to display their age in months, and those under 2 years to display their age in months and days. All clients aged 3 and above will display age in years only.
  5. Enter "1" in the 'Registry Setting Value' field.
  6. Submit the form.
  7. Access the 'Family Registration' form.
  8. Enter the desired value in the 'Select Family' dialog and click [New Family]. This will be referred to as "Family A".
  9. Enter the desired value in the 'Family Name' field.
  10. Enter the desired date in the 'Family Activation Date' field.
  11. Select the "Family Members" section.
  12. Click [Add New Item].
  13. Select "Client A" in the 'Client ID#' field.
  14. Enter the desired date in the 'Start Date Of Family Membership' field.
  15. Enter the desired value in the 'Date Of Birth' field.
  16. Validate the 'Age at Time of Data Entry' field contains the client's age in years.
  17. Submit the form.
  18. Access the 'Registry Settings' Form.
  19. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field.
  20. Click [View Registry Settings].
  21. Enter "2" in the 'Registry Setting Value' field.
  22. Submit the form.
  23. Access the 'Family Registration' form.
  24. Search for and select "Family A" in the 'Select Family' dialog.
  25. Select the "Family Members" section.
  26. Select "Client A" in the 'Family Membership Information' grid and click [Edit Selected Item].
  27. Enter a date making the client older than 3 years old in the 'Date Of Birth' field.
  28. Validate the 'Age at Time of Data Entry' field contains the client's age in years and months.
  29. Enter a date making the client less than 3 years old in the 'Date Of Birth' field.
  30. Validate the 'Age at Time of Data Entry' field contains the client's age in years, months, and days.
  31. Close the form.
  32. Access the 'Registry Settings' Form.
  33. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field.
  34. Click [View Registry Settings].
  35. Enter "3" in the 'Registry Setting Value' field.
  36. Submit the form.
  37. Access the 'Family Registration' form.
  38. Search for and select "Family A" in the 'Select Family' dialog.
  39. Select the "Family Members" section.
  40. Select "Client A" in the 'Family Membership Information' grid and click [Edit Selected Item].
  41. Enter a date making the client older than 3 years old in the 'Date Of Birth' field.
  42. Validate the 'Age at Time of Data Entry' field contains the client's age in years.
  43. Enter a date making the client between 2-3 years old in the 'Date Of Birth' field.
  44. Validate the 'Age at Time of Data Entry' field contains the client's age in months.
  45. Enter a date making the client less than 2 years old in the 'Date Of Birth' field.
  46. Validate the 'Age at Time of Data Entry' field contains the client's age in months and days.
  47. Close the form.
Scenario 6: Validate the 'Age Display Format' registry setting in the 'Client Header' and 'Client Information' widget
Specific Setup:
  • A client is enrolled in an existing episode (Client A).
  • The 'Client Information' widget must be accessible on the HomeView.
Steps
  1. Access the 'Registry Settings' Form.
  2. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field.
  3. Click [View Registry Settings].
  4. Validate the 'Registry Setting Details' field contains: This registry setting accepts the values "1", "2", or "3", to customize the format of age across various forms and widgets, including 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit', 'Call Intake', 'Client Header', and the 'Client Information' widget. Selecting "1" enables a simplified age display, presenting only the clients' age in years across all specified forms and widgets. Selecting "2", a more detailed age field is made visible and the display of age only in years is hidden on the 'Admission', 'Admission (OutPatient)', 'Family Registration', 'Pre Admit' and 'Call Intake' forms. For clients older than three years, age is shown in months and years, while for those under three, age is shown in days, months, and years. Selecting "3" allows for clients under 3 years old to display their age in months, and those under 2 years to display their age in months and days. All clients aged 3 and above will display age in years only.
  5. Enter "1" in the 'Registry Setting Value' field.
  6. Submit the form.
  7. Select "Client A" and access the 'Admission' form.
  8. Click [Edit].
  9. Enter the desired value in the 'Date Of Birth' field.
  10. Submit the form.
  11. Select "Client A" and access the 'Client Information' widget.
  12. Validate the 'Age' field contains the client's age in years.
  13. Select "Client A" and access the 'Admission' form.
  14. Click [Edit].
  15. Validate the 'Client Header' displays the client's age in years.
  16. Close the form.
  17. Access the 'Registry Settings' Form.
  18. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field.
  19. Click [View Registry Settings].
  20. Enter "2" in the 'Registry Setting Value' field.
  21. Submit the form.
  22. Select "Client A" and access the 'Client Information' widget.
  23. Validate the 'Age' field displays the client's age in:
  24. Months and years if the client is older than 3 years old.
  25. Months, years, and days if the client is under 3 years old.
  26. Select "Client A" and access the 'Admission' form.
  27. Click [Edit].
  28. Validate the 'Client Header' displays the client's age in:
  29. Months and years if the client is older than 3 years old.
  30. Months, years, and days if the client is under 3 years old.
  31. Close the form.
  32. Access the 'Registry Settings' Form.
  33. Enter the 'Age Display Format' in the 'Limit Registry Settings to the Following Search Criteria' field.
  34. Click [View Registry Settings].
  35. Enter "3" in the 'Registry Setting Value' field.
  36. Submit the form.
  37. Select "Client A" and access the 'Client Information' widget.
  38. Validate the 'Age' field displays the client's age in:
  39. Years if the client is older than 3 years old.
  40. Months if the client is between 2 and 3 years old.
  41. Months and days if the client is under 2 years old.
  42. Select "Client A" and access the 'Admission' form.
  43. Click [Edit].
  44. Validate the 'Client Header' displays the client's age in:
  45. Years if the client is older than 3 years old.
  46. Months if the client is between 2 and 3 years old.
  47. Months and days if the client is under 2 years old.
  48. Close the form.
Topics
• Registry Settings • Admission • NX • Admission (Outpatient) • Call Intake • Pre Admit • Family Registration • Widgets • Client Header
Update 60 Summary | Details
Service Codes - 'Always Allow Overbooking' field
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Service Codes
  • Service Code Upload Process
Scenario 1: 'Service Codes' - Add a Provider Only Service Code
Specific Setup:
  • Must have access to Crystal Reports or other SQL Reporting Tool.
Steps
  1. Access the 'Service Codes' form.
  2. Select "Add" in the 'Add New Or Edit Existing' field.
  3. Validate the 'Clinic Hours' field is displayed and disabled.
  4. Validate the 'Always Allow Overbooking' field is displayed and disabled.
  5. Populate the required and desired fields.
  6. Select "Provider" in the 'Service Required By' field.
  7. Validate the 'Clinic Hours' and 'Always Allow Overbooking' fields are now enabled. Note: These fields will only be enabled when "Provider" is selected in the 'Service Required By' field.
  8. Select "No" in the 'Clinic Hours' field.
  9. Select "Yes" in the 'Always Allow Overbooking' field.
  10. Click [Submit].
  11. Access Crystal Reports or other SQL reporting tool.
  12. Create a report using the 'SYSTEM.billing_tx_master_table' SQL table.
  13. Validate a row is displayed for the service code filed in the previous steps.
  14. Validate the 'clinic_hours_code' field contains "N".
  15. Validate the 'clinic_hours_value' field contains "No".
  16. Validate the 'alwoverbook_code' field contains "Y".
  17. Validate the 'alwoverbook_value' field contains "Yes".
  18. Access the 'Service Codes' form.
  19. Select "Edit" in the 'Add New Or Edit Existing' field.
  20. Select the service code filed in the previous steps.
  21. Validate "No" is selected in the 'Clinic Hours' field.
  22. Select "No" in the 'Always Allow Overbooking' field.
  23. Click [Submit].
  24. Access Crystal Reports or other SQL reporting tool.
  25. Refresh the report using the 'SYSTEM.billing_tx_master_table' SQL table.
  26. Validate the 'alwoverbook_code' field contains "N".
  27. Validate the 'alwoverbook_value' field contains "No".
  28. Close the report.
Scenario 2: Cal-PM - 'Service Code Upload Process' - Upload Provider Only Service Code
Specific Setup:
  • Must have a Cal-PM Service Code Upload file containing a valid row with "Provider" as the value for the 'Service Provided By' field, "No" as the value for the 'Clinic Hours' field and "Yes" as the value for 'Always Allow Overbooking' field (File A).
Steps
  1. Access the 'Service Code Upload Process' form.
  2. Enter "File A" in the 'Filename' field.
  3. Select "Compile" in the 'Compile Or Post' field.
  4. Select "No" in the 'Override Existing Service Codes' field.
  5. Click [Submit].
  6. Validate a message is displayed stating: Compile Completed. To view results review accepted and rejected reports.
  7. Click [OK] and leave the form opened.
  8. Select "Post" in the 'Compile Or Post' field.
  9. Click [Submit].
  10. Validate a message is displayed stating: Posting completed.
  11. Click [OK] and close the form.
  12. Access the 'Service Code Upload Accepted Codes' form.
  13. Select "File A" in the 'Select Desired Service Code Import File Name' field.
  14. Click [Process].
  15. Validate "File A" contents are displayed in the report.
  16. Validate the 'Clinic Hours' field contains "No".
  17. Validate the 'Always Allow Overbooking' field contains "Yes".
  18. Close the report and the form.
  19. Access the 'Service Codes' form.
  20. Select "Edit" in the 'Add New Or Edit Existing' field.
  21. Select the service code uploaded in the previous steps in the 'Service Code' field.
  22. Validate the 'Clinic Hours' field contains "No".
  23. Validate the 'Always Allow Overbooking' field contains "Yes".
  24. Validate all other information displays as expected.
  25. Close the form
  26. Access Crystal Reports or other SQL reporting tool.
  27. Create a report using the 'SYSTEM.batchload_tx_accepted' SQL table.
  28. Validate a row is displayed for the service code uploaded in the previous steps.
  29. Validate the 'clinic_hours_code' field contains "N".
  30. Validate the 'clinic_hours_value' field contains "No".
  31. Validate the 'alwoverbook_code' field contains "Y".
  32. Validate the 'alwoverbook_value' field contains "Yes".
  33. Close the report.
Topics
• Service Codes
Update 62 Summary | Details
'Consent For Access' web services
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • SoapUI - ConsentForAccess.Update42CFR - GetDictionaryItems
  • SoapUI - ConsentForAccess.Update42CFR - Update42CFR
  • Consent For Access
  • SoapUI - ConsentForAccess.UpdateHIE - UpdateClientConsent
  • SoapUI - ConsentForAccess.UpdateReferrals - UpdateClientConsent
Scenario 1: Validate the 'ConsentForAccess.Update42CFR' - 'GetDictionaryItems' web service
Steps
  1. Access SoapUI for the 'ConsentForAccess.Update42CFR' - 'GetDictionaryItems' 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. Click [Run].
  6. Validate the 'GetDictionaryItemsResponse' field is populated with the defined dictionary values for the 'Consent For Access' form.
Scenario 2: Validate the 'ConsentForAccess.Update42CFR' - 'Update42CFR' web service
Specific Setup:
  • A client is enrolled in an existing episode (Client A).
Steps
  1. Access SoapUI for the 'ConsentForAccess.Update42CFR' - 'Update42CFR' 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 value in the 'PatientEnrolled42CFR' field.
  6. Enter "Client A" in the 'ClientID' field.
  7. Click [Run].
  8. Validate the 'Update42CFRResponse' field contains "Consent For Access web service has been filed successfully".
  9. Select "Client A" and access the 'Consent For Access' form.
  10. Validate the 'Is this patient enrolled in a program that must meet 42 CFR Part 2 Regulations' field contains the value filed via web service.
  11. Close the form.
Scenario 3: Validate the 'ConsentForAccess.UpdateHIE' - 'UpdateClientConsent' web service (Network)
Specific Setup:
  • A client is enrolled in an existing episode (Client A).
  • The 'CareConnect HIE Configuration' form is configured for a Network.
  • The 'Enable Agencies Specified for Consent For Access' registry setting is set to "Y".
  • One or more dictionary codes must be defined for the 'Client' file, '(36021) Agencies Specified' dictionary.
Steps
  1. Access SoapUI for the 'ConsentForAccess.UpdateHIE' - 'UpdateClientConsent' 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 network in the 'HIEToAccess' field.
  6. Enter the desired value in the 'AgenciesSpecified' field.
  7. Enter "1" in the 'ConsentForCode' field.
  8. Enter the desired value in either the 'ConsentToQuery' field.
  9. Enter the desired value in the 'ConsentToSend' field.
  10. Enter the desired value in the 'StartDate' field.
  11. Enter the desired value in the 'EndDate' field. Please note: 'EndDate' is not applicable for "Revoke" or "Void" consent.
  12. Enter the desired user in the 'RecordedBy' field.
  13. Enter "Client A" in the 'ClientID' field.
  14. Click [Run].
  15. Validate the 'UpdateClientConsentResponse' field contains "Consent For Access web service has been filed successfully."
  16. Select "Client A" and access the 'Consent For Access' form.
  17. Select the "External Network" section.
  18. Select the record filed via web service and click [Edit Selected Item].
  19. Validate the 'Consent For' field contains "Network".
  20. Validate the 'Network' field contains the network filed via web service.
  21. Validate the 'Consent To Query' or the 'Consent To Opt In/Opt Out' field contains the value filed via web service (Depending on the configuration in the 'CareConnect HIE Configuration' form).
  22. Validate the 'Start Date' field contains the value filed via web service.
  23. Validate the 'End Date' field contains the value filed via web service, if applicable.
  24. Validate the 'Recorded By' field contains the value filed via web service.
  25. Validate the 'Agencies Specified' field contains the value filed via web service.
  26. Close the form.
Scenario 4: Validate the 'ConsentForAccess.UpdateReferrals' - 'UpdateClientConsent' web service
Specific Setup:
  • A client is enrolled in an existing episode (Client A).
Steps
  1. Access SoapUI for the 'ConsentForAccess.UpdateReferrals' - 'UpdateClientConsent' 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 provider in the 'Providers' field. Please note: the 'GUID' value from the 'SYSTEM.referral_providers' SQL table will be used.
  6. Enter the desired value in the 'ConsentToSend' field.
  7. Enter the desired value in the 'StartDate' field.
  8. Enter the desired value in the 'EndDate' field. Please note: 'EndDate' is not applicable for "Revoke" or "Void" consent.
  9. Enter "Client A" in the 'ClientID' field.
  10. Click [Run].
  11. Validate the 'UpdateClientConsentResponse' field contains "Consent For Access web service has been filed successfully."
  12. Select "Client A" and access the 'Consent For Access' form.
  13. Select the "Referral" section.
  14. Select the record filed via web service and click [Edit Selected Item].
  15. Validate the 'Providers' field contains the provider filed via web service.
  16. Validate the 'Consent to Opt In/Opt Out' field contains the value filed via web service.
  17. Validate the 'Start Date' field contains the value filed via web service.
  18. Validate the 'End Date' field contains the value filed via web service, if applicable.
  19. Close the form.
Scenario 5: Validate the 'ConsentForAccess.UpdateHIE' - 'UpdateClientConsent' web service (Organization)
Specific Setup:
  • A client is enrolled in an existing episode (Client A).
  • The 'CareConnect HIE Configuration' form is configured.
  • The 'Enable Agencies Specified for Consent For Access' registry setting is set to "Y".
  • One or more dictionary codes must be defined for the 'Client' file, '(36021) Agencies Specified' dictionary.
Steps
  1. Access SoapUI for the 'ConsentForAccess.UpdateHIE' - 'UpdateClientConsent' 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 organization in the 'OrgToAccess' field. Please note: the 'ORGID' value from the 'SYSTEM.consent_organizations' SQL table will be used.
  6. Enter the desired value in the 'AgenciesSpecified' field.
  7. Enter "2" in the 'ConsentForCode' field.
  8. Enter the desired value in the 'ConsentToQuery' field.
  9. Enter the desired value in the 'ConsentToSend' field.
  10. Enter the desired value in the 'StartDate' field.
  11. Enter the desired value in the 'EndDate' field. Please note: 'EndDate' is not applicable for "Revoke" or "Void" consent.
  12. Enter the desired user in the 'RecordedBy' field.
  13. Enter "Client A" in the 'ClientID' field.
  14. Click [Run].
  15. Validate the 'UpdateClientConsentResponse' field contains "Consent For Access web service has been filed successfully."
  16. Select "Client A" and access the 'Consent For Access' form.
  17. Select the "External Network" section.
  18. Select the record filed via web service and click [Edit Selected Item].
  19. Validate the 'Consent For' field contains "Organization".
  20. Validate the 'Organization' field contains the organization filed via web service.
  21. Validate the 'Consent To Query' field contains the value filed via web service.
  22. Validate the 'Consent to Opt In/Opt Out' field contains the value filed via web service.
  23. Validate the 'Start Date' field contains the value filed via web service.
  24. Validate the 'End Date' field contains the value filed via web service, if applicable.
  25. Validate the 'Recorded By' field contains the value filed via web service.
  26. Validate the 'Agencies Specified' field contains the value filed via web service.
  27. Close the form.
Topics
• Web Services • Consent for Access
Update 64 Summary | Details
Dictionary Update - 'Exception type' dictionary
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Staff Members Hours And Exceptions
  • Site Registration
  • Dictionary Update (PM)
Scenario 1: Dictionary Update - Validate the 'Exception Type' dictionary
Steps
  1. Access the 'Dictionary Update' form.
  2. Select "Staff File" in the 'File' field.
  3. Select "(20042) Exception Type" in the 'Data Element' field.
  4. Enter desired value in the 'Dictionary Code' field.
  5. Enter desired value in the 'Dictionary value' field.
  6. Click [Apply Changes].
  7. Validate a message is displayed stating: Filed!
  8. Click [OK].
  9. Select the "Print Dictionary" section.
  10. Select "Staff File" in the 'File' field.
  11. Select "(20042) Exception Type" in the 'Data Element' field.
  12. Click [Print Dictionary].
  13. Validate the newly added code/value display as expected.
  14. Close the form.
Topics
• Dictionary
Update 65 Summary | Details
Support for CareFabric actions
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • SoapUI - ClientServices - ClientServicesService - GetClientServicesByDate
  • SoapUI - ClientServices - ClientServicesService - GetClientServicesByDate - GetClientServicesByDateResult
Scenario 1: Validate the 'GetClientServiceHistory' SDK action
Steps
  • Internal testing only.
Topics
• CareFabric • Web Services
Update 70 Summary | Details
Avatar MSO to Cal-PM Parent System Service Filing
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Registry Settings (PM)
  • 837 Health Care Claim Professional
  • Close Batch
  • 837 Health Care Claim Institutional
Scenario 1: 'Close Batch' - Avatar MSO to Cal-PM Parent System Service Filing, Verification of Void/Replacement Claim and Service Filing
Specific Setup:
  • Avatar Cal-PM Registry Setting 'Support Additional Claim Follow-Up Functionality' may optionally be enabled
  • 'File Services On Closing Of Batch Or Creation of EOB?' must be set to 'Yes' (via Avatar MSO 'MSO to Parent System Integration Mapping' form 'Service Filing' section)
  • One or more 'Approved' status 'Void' and/or 'Replacement' claim for single or multiple service claims eligible for filing to parent Avatar Cal-PM system
Steps
  1. Open Avatar MSO 'Close Batch' form.
  2. Select Avatar MSO Claims Processing batch containing one or more 'Approved' status 'Replacement' claim/services eligible for filing to parent Avatar Cal-PM system.
  3. Note - Retro Claim Adjudication entries from Avatar MSO 'Void' 837 Professional/837 Institutional claims are pushed/filed to Avatar Cal-PM parent system on posting in MSO, as no Avatar MSO Claims Processing Batch is created; Retro Claim Adjudication entries from Avatar MSO 'Replacement' 837 Professional/837 Institutional claims are pushed/filed to Avatar Cal-PM parent system on closing of Claims Processing Batch for Replacement Claims/Services in MSO
  4. Set 'Close Batch' field to 'Yes' (and click 'OK' button to close warning message dialog).
  5. Click 'Submit' button to close batch/file services to parent Avatar Cal-PM system.
  6. Open 'Client Ledger' form in parent Avatar Cal-PM system.
  7. Select 'Client ID' value for client where services are present in Avatar MSO closed status Claims Processing batch.
  8. Select 'Claim/Episode/All Episodes' value.
  9. Select 'Ledger Type' value.
  10. In Client Ledger data - ensure that 'Approved' status original claim services originating in Avatar MSO are present in Avatar Cal-PM system following 'Close Batch' filing (where services are valid for filing to parent system).
  11. In Client Ledger data - ensure that services originating in Avatar MSO where 'Void' claim has subsequently been processed in Avatar MSO (resulting in Retro Claim Adjudication service takeback entries) are updated in Avatar Cal-PM parent system as follows:
  12. Original services in 'Open' charge status will be deleted in Avatar Cal-PM parent system
  13. Original services in 'Closed' and 'Unbilled' charge status (not claimed) will have service deletion reversal code ('DELETE') filed in Avatar Cal-PM parent system
  14. Original services which have been included in 837 Electronic Billing outbound claim in Avatar Cal-PM parent system (claimed) will remain in Client Ledger as originally filed, and 'Electronic Re-Billing Service Assignment' entries will be created in Avatar Cal-PM for original claims/services where enabled (with 'Void/Cancel of Prior Claim' Claim Submission Reason Code)
  15. In Avatar Cal-PM parent systems where Avatar Cal-PM Registry Setting 'Support Additional Claim Follow-Up Functionality' is enabled:
  16. 'Claim Follow-Up' entries will be created for original Avatar Cal-PM claims/services on filing of 'Void' claim in Avatar MSO
  17. 'Electronic Re-Billing Service Assignment' entries will only be created in Avatar Cal-PM for original claims and services where/when 835 Remittance Advice with 'Approval' status has been received/posted for original Avatar Cal-PM claim
  18. In Client Ledger data - ensure that services originating in Avatar MSO where 'Replacement' claim has subsequently been processed in Avatar MSO (resulting in Retro Claim Adjudication service takeback entries and new services) are updated in Avatar Cal-PM parent system as follows:
  19. Original services in 'Open' charge status will be deleted in Avatar Cal-PM parent system, and new/replacement services will be filed/present in Avatar Cal-PM system following 'Close Batch' filing (if 'Approved' status and where replacement services are valid for filing to parent system)
  20. Original services in 'Closed' and 'Unbilled' charge status (not claimed) will have service deletion reversal code ('DELETE') filed in Avatar Cal-PM parent system, and new/replacement services will be filed/present in Avatar Cal-PM system following 'Close Batch' filing (if 'Approved' status and where replacement services are valid for filing to parent system)
  21. Original services which have been included in 837 Electronic Billing outbound claim in Avatar Cal-PM parent system (claimed)will remain in Client Ledger as originally filed, and 'Electronic Re-Billing Service Assignment' entries will be created in Avatar Cal-PM for original claims/services where enabled (with 'Replacement of Prior Claim' Claim Submission Reason Code)
  22. In Avatar Cal-PM parent systems where Avatar Cal-PM Registry Setting 'Support Additional Claim Follow-Up Functionality' is enabled:
  23. 'Claim Follow-Up' entries will be created for original Avatar Cal-PM claims/services on filing of 'Replacement' claim in Avatar MSO
  24. 'Electronic Re-Billing Service Assignment' entries will only be created in Avatar Cal-PM for original claims and services where/when 835 Remittance Advice has been received/posted for original Avatar Cal-PM claim
Topics
• Electronic Billing • Claims Processing
Update 72 Summary | Details
Service/Fee Cross Reference Maintenance - Guarantor Definition
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Service Fee/Cross Reference Maintenance
  • Admission (Outpatient)
  • Financial Eligibility
  • Client Charge Input
Scenario 1: Service Fee/Cross Reference Maintenance - Service Fee/Guarantor Definition Report
Specific Setup:
  • Guarantors/Payors:
  • An existing guarantor is identified to be used. Note the guarantor's code/name.
  • 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' = 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 = Evaluation Management
  • 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 = Evaluation Management
  • 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.
  • Service Fee/Cross Reference Maintenance:
  • A fee definition is created for the primary and Add-On service codes.
  • There is no HCPCS code defined for the primary and add-on service in the 'Service Fee Maintenance' section.
  • The only applicable HCPCS code is defined in the 'Guarantor Definitions' section for the guarantor that is assigned to the client. Note the fee for each service code.
  • An active practitioner is identified. Note the practitioner's ID.
  • Admission:
  • An active client is identified, or a new client is created. Note the client's 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.
  • Client Charge Input:
  • A primary service is rendered to the client and the Add-On service code is attached to the primary while rendering the service. Note service date, service code.
  • Client Ledger:
  • The primary and Add-On services are distributed correctly to the assigned guarantor.
  • Close Charges:
  • The charges are closed.
  • Create Interim Billing Batch:
  • An interim billing batch is created to cover client, services rendered to the client and the guarantor. Note the batch number.
Steps
  1. Open the 'Electronic Billing' form.
  2. Select “837-Professional” in 'Billing Form' and “Blue Cross” in 'Type Of Bill'.
  3. Select desired guarantor in 'Guarantor'.
  4. Click [Outpatient] in 'Billing Type'.
  5. Click [Sort File] in 'Billing Options' and [Interim Batch] in 'All Clients Or Interim Billing Batch'.
  6. Select desired interim billing batch in 'Interim Batch Number'.
  7. Click [No] in 'Create Claims'.
  8. Set both 'First Date Of Service To Include' and 'Last Date Of Service To Include' to desired dates.
  9. Click [Version 5010] in "HIPAA Transaction Version",
  10. Verify the bill compiles successfully.
  11. Click [Run Report] in 'Billing Options'.
  12. Click [Print] in 'Print Or Delete Report'.
  13. Select the most recent compiled file in 'File'.
  14. Click [Print 837 Report].
  15. Verify that the report does not contain an error regarding 'Missing HCPCS code' and displays primary and add-on services correctly.
  16. Click [X].
  17. Click [Discard].
Topics
• Service Fee/Cross Reference Maintenance
Update 75 Summary | Details
Client Charge Input - Rendering a service to the client
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Client Charge Input
  • Progress Notes (Group and Individual)
  • ProgressNote Approval
  • Client Charge Input (Charge Fee Access)
Scenario 1: Client Charge Input - Registry Setting 'Additional Service Fee Configuration Fields = "2"
Specific Setup:
  • Registry Setting:
  • Avatar PM->System Maintenance->Service Code Maintenance->Additional Service Fee Configuration Fields = "2".
  • Service codes:
  • An existing service code is identified to be used or a new service code is created. Note the service code/description.
  • Service Fee/ Cross Reference Maintenance:
  • A fee definition is created for the service code identified in the 'Service Codes' form and the 'Fee Type' ="M".
  • Admission:
  • An existing client is identified, or a new client is admitted. Note client id, admission program, admission date.
Steps
  1. Open the ‘Client Charge Input’ form.
  2. Enter desired 'Date Of Service'.
  3. Enter desired 'Client ID'.
  4. Validate that the 'Episode Number' and 'Program' are defaulted if there is only one active episode for the service date.
  5. Select an episode if more than one episode is active. Validate that the 'Program' defaults.
  6. Enter the desired 'Service Code'.
  7. Enter desired data for all required fields.
  8. Enter desired data for optional fields.
  9. Validate the value of the ‘Cost of Service’. Note the amount.
  10. Click [Submit].
  11. Close the form.
  12. Open the ‘Client Ledger’ form.
  13. Select the desired ‘Client ID’.
  14. Select ‘All Episodes’ in the ‘Claim/Episode/All Episodes’.
  15. Select "Simple" in ‘Ledger Type' field.
  16. Select the service date in ‘From Date’ field.
  17. Click [Process].
  18. Validate that the service is equal to the amount entered in ‘Cost of Service’.
  19. Close the form.
  20. Open the ‘Progress Note (Group and Individual)’ form.
  21. Enter desired 'Date Of Service'.
  22. Enter desired 'Client ID'.
  23. Validate that the 'Episode Number' and 'Program' are defaulted if there is only one active episode for the service date.
  24. Select an episode if more than one episode is active. Validate that the 'Program' defaults.
  25. Enter the desired 'Service Code'.
  26. Enter desired data for all required fields.
  27. Select "Final" in the 'Draft/Final' field.
  28. Enter desired data for the optional fields as needed.
  29. Validate the value of the ‘Cost of Service’. Note the amount.
  30. Click [Submit].
  31. Close the form.
  32. Open the ‘Client Ledger’ form.
  33. Select the desired ‘Client ID’.
  34. Select ‘All Episodes’ in the ‘Claim/Episode/All Episodes’.
  35. Select "Simple" in ‘Ledger Type' field.
  36. Select the service date in ‘From Date’ field.
  37. Click [Process].
  38. Validate that the service rendered through the 'Progress Note (Group And Individual)' form is displayed correctly.
  39. Close the form.
  40. Open the ‘Client Charge Input (Charge Fee Access)’ form.
  41. Enter desired 'Date Of Service'.
  42. Enter desired 'Client ID'.
  43. Validate that the 'Episode Number' and 'Program' are defaulted if there is only one active episode for the service date.
  44. Select an episode if more than one episode is active. Validate that the 'Program' defaults.
  45. Enter the desired 'Service Code'.
  46. Enter desired data for all required fields.
  47. Enter desired data for optional fields.
  48. Validate the value of the ‘Cost of Service’. Note the amount.
  49. Click [Submit].
  50. Close the form.
  51. Open the ‘Client Ledger’ form.
  52. Select the desired ‘Client ID’.
  53. Select ‘All Episodes’ in the ‘Claim/Episode/All Episodes’.
  54. Select "Simple" in ‘Ledger Type' field.
  55. Select the service date in ‘From Date’ field.
  56. Click [Process].
  57. Validate that the ‘CHG’ is equal to the amount entered in ‘Cost of Service’.
  58. Close the form.
Topics
• Client Charge Input
Update 97 Summary | Details
Registry Settings
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Registry Settings (PM)
  • Client Charge Input
  • Service Fee/Cross Reference Maintenance
Scenario 1: Registry Settings = 'Unit Calculation with Minimum Durations' - Cal-PM
Specific Setup:
  • Registry Settings:
  • ‘Unit Calculation with Minimum Duration'='Y'.
  • Client:
  • Identify an existing client or create a new client. Note the client’s admission date.
  • Service Codes:
  • Service codes are identified or created with different combinations of 'Maximum Duration (Minutes)' and 'Minimum Duration for Unit Calculation' in 'Service Codes' form.
  • Service codes are identified or created with no rounding and with rounding.
Steps
  1. Open "Client Charge Input" form.
  2. Enter any value in 'Date Of Service'.
  3. Enter 'Client 1' in 'Client ID'.
  4. Enter desired 'Service Code'.
  5. Enter any value in 'Practitioner'.
  6. Enter any value in 'Duration (Minutes)' that is less than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  7. Click [Submit].
  8. Validate form return.
  9. Click [Yes].
  10. Repeat Steps 2-8, with value in 'Duration (Minutes)' greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  11. Click [Yes].
  12. Repeat Steps 2-10, to input service to client through different service codes.
  13. Open "Client Ledger" form.
  14. Enter 'Client 1' created in setup in 'Client ID'.
  15. Click [All Episodes] in 'Claim/Episode/All Episodes'.
  16. Click [Simple] in 'Ledger Type'.
  17. Click [Yes] in 'Include Zero Charges'.
  18. Click [Process].
  19. Validate the ledger report to check charges and units assigned.
  20. Click [X].
  21. Click [No].
  22. Open the "Registry Settings" form.
  23. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  24. Set the 'Registry Setting Value' to 'YE'.
  25. Repeat Steps 2-10, to input service to client through different service codes.
  26. Validate the error message displayed: 'The service [Service Code] does not meet the minimum duration requirements for unit calculation and cannot be filed. A unit will only be calculated once the duration is at least X minutes.
  27. Click [OK].
  28. Enter any value in 'Duration (Minutes)' that is greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  29. Click [Submit].
  30. Open "Client Ledger" form.
  31. Enter 'Client 1' created in setup in 'Client ID'.
  32. Click [All Episodes] in 'Claim/Episode/All Episodes'.
  33. Click [Simple] in 'Ledger Type'.
  34. Click [Yes] in 'Include Zero Charges'.
  35. Click [Process].
  36. Validate the ledger report to check charges and units assigned.
  37. Click [X].
  38. Click [No].
  39. Open the "Registry Settings" form.
  40. Set the 'Limit Registry Settings' to ‘Unit Calculation with Minimum Duration'.
  41. Set the 'Registry Setting Value' to 'YW'.
  42. Repeat Steps 2-10, to input service to client through different service codes.
  43. Validate the error message displayed: 'The service [Service Code] does not meet the minimum duration requirements for unit calculation. A unit will only be calculated once the duration is at least X minutes.
  44. Click [OK].
  45. Enter any value in 'Duration (Minutes)' that is greater than the 'Minimum Duration for Unit Calculation' set in the 'Service Codes' form.
  46. Click [Submit].
  47. Repeat Steps 30-38 to validate the ledger report to check charges and units assigned.
Topics
• Registry Settings • Client Charge Input
 

Avatar_Cal-PM_2024_Monthly_Release_2024.01.02_Details.csv