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Avatar Cal-PM 2024 Update 8

Product Requirements and Recommendations

Avatar Cal-PM required
RADplus required

Product Update Description

An issue is resolved where closing services that originated in MSO would reset the units to 1.

Required Updates

None

Included Updates

None

Details

NEW0 CHANGED0 FIXED1
Fixed (1)
Avatar MSO to Parent System Service Filing
An issue is resolved to ensure that 'Service Units' values for services originating in Avatar MSO and filed to Avatar Cal-PM are not reset to 1.
Topics
• Close Charges • Electronic Billing
 
Acceptance Tests

AV-94613 Summary | Details
Avatar MSO to Parent System Service Filing
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Client Ledger
  • Close Batch
  • Electronic Billing
Scenario 1: 'Close Batch' - Avatar MSO to Cal-PM Parent System Service Filing, Verification of Service Unit Values
Specific Setup:
  • Avatar MSO Registry Setting 'Send Units to Avatar PM' must 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 services originating in Avatar MSO and 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 claim/services eligible for filing to parent Avatar Cal-PM system (including Avatar MSO 837 'Replacement' claims/services).
  3. Set 'Close Batch' field to 'Yes' (and click 'OK' button to close warning message dialog).
  4. Click 'Submit' button to close batch/file services to parent Avatar Cal-PM system.
  5. Open 'Client Ledger' form in parent Avatar Cal-PM system.
  6. Select 'Client ID' value for client where services are present in Avatar MSO closed status Claims Processing batch.
  7. Select 'Claim/Episode/All Episodes' value.
  8. Select 'Ledger Type' value.
  9. 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).
  10. In Client Ledger data - ensure that services originating in Avatar MSO are present in Avatar Cal-PM parent system with correct/original 'Service Units' ('UNT') value filed from Avatar MSO (including Avatar MSO 837 'Replacement' claims/services and case where charges are closed in Avatar Cal-PM automatically on service receipt from Avatar MSO, according to Avatar MSO Registry Setting 'Send Units to Avatar PM' ).
Topics
• Close Charges • Electronic Billing