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Avatar Cal-PM 2024 Update 17

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Product Requirements and Recommendations

Avatar Cal-PM required
RADplus required

Recommended Update Level

Avatar Cal-PM 2024 Monthly Release 2024.00.00
RADplus 2024 Monthly Release 2024.00.00

Product Update Description

The following provider directory (274) issues are resolved: 1) Field 'Healthcare Plan Code' shows duplicate entries in form '274 - Provider Directory Defaults'. This can occur when entering the form and prior to selecting a 'Plan Type'. 2) The value for fields 'Percentage of FTE Serving Children' (2100EA-N2-01) and 'Percentage of FTE Serving Adults' (2100EA-N2-01) is padded out to 3 zeros for DMC submissions instead of being left null. The zero padding should only be done for MHP submissions. Said fields are a part of the 'Provider Definition' tab of the '274 - Provider Directory Definition' form.

Required Updates

None

Included Updates

None

Details
NEW0 CHANGED0 FIXED1
Fixed (1)
274 Provider Directory Submission
Functionality for the 274 Provider Directory Submission has been updated.
The field 'Healthcare Plan Code' can no longer be selected prior to selecting a value in the 'Plan Type' field. In addition, the value for fields 'Percentage of FTE Serving Children' (2100EA-N2-01) and 'Percentage of FTE Serving Adults' (2100EA-N2-01) is
In addition, the value for fields 'Percentage of FTE Serving Children' (2100EA-N2-01) and 'Percentage of FTE Serving Adults' (2100EA-N2-01) is no longer padded the three zeros form for DMC submissions.
Topics
• 274 - Provider Directory • NX
 
Acceptance Tests
AV-95305 Summary | Details
274 Provider Directory Submission
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • 274 - Provider Directory Defaults
  • 274 - Provider Directory Definition
  • 274 - Provider Directory Submission
  • Crystal Report Viewer
  • User Definition
Scenario 1: 274 - worklflow (274 - Provider Directory Defaults, 274 - Provider Directory Definition, 274 - Provider Directory Submission)
Specific Setup:
  • Tester has been given access to the following forms in 'User Definition' under ‘Avatar PM / System Maintenance / System Definition / Health Care Provider Directory (274)’:
  • 274 - Provider Directory Defaults.
  • 274 - Provider Directory Definition.
  • 274 - Provider Directory Submission.
Steps
  1. Open '274 - Provider Directory Defaults'.
  2. Validate that the 'Plan Type' field is required.
  3. Select desired value in 'Plan Type' and validate that the 'Healthcare Plan Code' field becomes required.
  4. Enter desired data for each field.
  5. Submit the form.
  6. Open '274 - Provider Directory Defaults'.
  7. Validate that the submitted data was retained.
  8. Open ‘274 - Provider Directory Definition’.
  9. Validate that the form opened to the ‘Group Definition’ section.
  10. Validate that the 'Plan Type' field is required.
  11. Select desired value in 'Plan Type' and validate that the 'Add or Edit Group' field is required.
  12. Select 'Add' in 'Add or Edit Group'.
  13. Validate that the 'Active' and 'Provider Group Name (2100CA-NM1-03)' fields are required.
  14. Enter desired data for each field.
  15. Click [File Group Details].
  16. Select 'Edit' in 'Add or Edit Group'.
  17. Select the group added above and validate that the submitted data was retained.
  18. Select the 'Site Definition' section.
  19. Validate that the 'Plan Type' field is required.
  20. Select desired value in 'Plan Type' and validate that the 'Add or Edit Site' field is required.
  21. Select 'Add' in 'Add or Edit Site'.
  22. Validate that 'Site or Location of Service Name (2100DA-NM1-03)', 'Provider Group', and 'Active' fields are required.
  23. Validate that the field label 'Site or Location Address (2100DA-N3-01)' has been replaced with 'Site or Location Address (2110DA-N3-01)'.
  24. Validate that the field label 'Site or Location Address 2 (2100DA-N3-02)' has been replaced with 'Site or Location Address 2 (2110DA-N3-02)'.
  25. Enter desired data for each field, which would include nine digit zip codes with a hyphen.
  26. Click [Site Work Schedule (2100DA-WS)].
  27. Enter desired data.
  28. Click [Save].
  29. Click [Yes].
  30. Click [Foreign Languages Spoken At This Site (2100DA-LUI)].
  31. Enter desired data.
  32. Click [Save].
  33. Click [Yes].
  34. Click [Affiliated Entities (2100DB)].
  35. Enter desired data.
  36. Click [Save].
  37. Click [Yes].
  38. Click [File Site Details].
  39. Click [OK].
  40. Select 'Edit' in 'Add or Edit Site'.
  41. Select the 'Provider Site' that was added above and validate that the submitted data was retained.
  42. Select the 'Provider Definition' section.
  43. Validate that the 'Plan Type' field is required.
  44. Select desired value in 'Plan Type' and validate that the 'Provider' field is required.
  45. Select a 'Provider'.
  46. Validate that 'Associated Site' and 'Active' became required.
  47. Enter desired data for each field. Note:
  48. To meet California regulations, when there is data in these fields, 'Additional Provider Name (2100EA-N2-01)' and 'Provider Doing Business As or Trade Name (2100EA-N2-02)', that data is output in the submission file.
  49. If those fields are left blank, the data from the 'Percentage of FTE Serving Children (2100EA-N2-01)' and 'Percentage of FTE Serving Adults (2100EA-N2-01)' fields will be output in the submission file.
  50. When the 'Plan Type' equals 'Mental Health Plan', the value of the field will contain three characters and be zero filled for values less than three digits. A value of '27' is output as '027'.
  51. When the 'Plan Type' equals 'Drug Medi-Cal Organized Delivery System, can contain three characters and be null filled for values less than three digits. A value of '40' is output as '40'.
  52. Click [File Provider Details].
  53. Click [OK].
  54. Select the same 'Provider'.
  55. Select the 'Associated Site' selected above.
  56. Validate that the submitted data was retained.
  57. Close the form.
  58. Open '274 - Provider Directory Submission'.
  59. Validate that the 'Plan Type' field is required.
  60. Select desired value in 'Plan Type' and validate that the
  61. Select 'Compile File' in 'Options'.
  62. Enter the desired value in 'Reporting Period (MM/YY)'.
  63. Enter desired 'File Description'.
  64. Click [Process File].
  65. Validate that the report display and that the zip code fields do not contain a hyphen.
  66. Validate the report data.
  67. Close the report.
  68. Close the form.
Topics
• 274 - Provider Directory • NX