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Avatar HL7 2022 Update 12

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Product Update Form Description

Inbound HL7 charge processing is enhanced to support using the service program sent in the charge message. This is accomplished by adding new configuration setting 'Service Program Determination Method' to form 'Default Settings For Processing An Inbound HL7 Charge Batch'

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Details
NEW1 CHANGED0 FIXED0
New (1)
Inbound HL7 charge processing
Inbound HL7 charge processing is enhanced to support using the service program sent in the charge message.
Updated inbound HL7 charge process to allow for service program to be determined in a variety of ways. This is accomplished by adding a new configuration setting 'Service Program Determination Method' to form 'Default Settings For Processing An Inbound HL7 Charge Batch' with the following choices:
1 - Program client was active in as of the date of service.
2 - Program sent in HL7 field 'Department Code' (FT1-13). If program not sent then program client was active in as of the date of service.
3 - Program sent in HL7 field 'Department Code' (FT1-13).
Value Added: Support to use service program sent in charge message
Topics
• HL7 charge processing
 
Acceptance Tests
AV-85004 Summary | Details
Inbound HL7 charge processing
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Default Settings For Processing An Inbound HL7 Charge Batch
  • Client Ledger
  • Compile Inbound HL7 Charge Batch File
  • HL7 Connection Monitor
  • Post Inbound HL7 Charge Batch File
Scenario 1: Validate 'Default Settings For Processing An Inbound HL7 Charge Batch '
Steps
  1. Open the 'Default Settings For Processing An Inbound HL7 Charge Batch' form.
  2. Validate a new radio button field 'Service Program Determination Method' is displayed.
  3. Validate the help message for the field indicates "Use this field to indicate how the service program should be determined. If the service program is to be taken from the charge message then it needs to match a program code defined in the system else it will error. If this field is not valued then the determination method used will be the program the client was active in as of the date of service.
  4. Validate the 3 available choices are :
  5. Program client was active in as of the date of service.
  6. Program sent in HL7 field 'Department Code' (FT1-13). If program not sent then program client was active in as of the date of service.
  7. Program sent in HL7 field 'Department Code' (FT1-13).
Scenario 2: Validate Inbound HL7 Lab charge processing support using the service program sent in the charge message
Specific Setup:
  • There must be an Inbound Billing Lab connection.
  • Test Client A must exist.
Steps
  1. Open the 'Default Settings For Processing An Inbound HL7 Charge Batch' form.
  2. Click the 'Lab' - Charge Type radio button.
  3. Click the 'Program sent in HL7 field 'Department Code' (FT1-13)' radio button.
  4. File the form.
  5. Send a Charge (P03) HL7 message with FT1:13 segment with a different Program then what Patient is currently in.
  6. Compile and post the charge data and verify that it is processed without any errors.
  7. Open Client ledger and view the charges for the test client A in 'Ledger Type' as "Crystal".
  8. On the client ledger report click on the date link.
  9. Validate that the 'Providing Program' on the report is equal to the Program sent in FT1:13 segment of the Charge message.
  10. Send a Charge (P03) HL7 message with FT1:13 segment with an Invalid Program Code.
  11. Compile the charge file and validate that there is an error "Service program sent is not valid:"
  12. Void the file.
  13. Send a Charge (P03) HL7 message with FT1:13 segment as empty
  14. Compile the charge file and validate that there is an error "Service program missing."
  15. Void the file.
  16. Open the 'Default Settings For Processing An Inbound HL7 Charge Batch' form.
  17. Click the 'Lab' - Charge Type radio button.
  18. Click the 'Program client was active in as of the date of service.' radio button.
  19. File the form.
  20. Send a Charge (P03) HL7 message with FT1:13 segment with a different Program then what Patient is currently in.
  21. Compile and post the charge data and verify that it is processed without any errors.
  22. Open Client ledger and view the charges for the test client A in 'Ledger Type' as "Crystal".
  23. On the client ledger report click on the date link.
  24. Validate that the 'Providing Program' on the report is equal to the Program client was active in as of the date of service.
  25. Send a Charge (P03) HL7 message with FT1:13 segment with an Invalid Program Code.
  26. Compile and post the charge data and verify that it is processed without any errors.
  27. Open Client ledger and view the charges for the test client A in 'Ledger Type' as "Crystal".
  28. On the client ledger report click on the date link.
  29. Validate that the 'Providing Program' on the report is equal to the Program client was active in as of the date of service.
  30. Send a Charge (P03) HL7 message with FT1:13 segment as empty
  31. Compile and post the charge data and verify that it is processed without any errors.
  32. Open Client ledger and view the charges for the test client A in 'Ledger Type' as "Crystal".
  33. On the client ledger report click on the date link.
  34. Validate that the 'Providing Program' on the report is equal to the Program client was active in as of the date of service.
  35. Open the 'Default Settings For Processing An Inbound HL7 Charge Batch' form.
  36. Click the 'Lab' - Charge Type radio button.
  37. Click the 'Program sent in HL7 field 'Department Code' (FT1-13). If program not sent then program client was active in as of the date of service' radio button.
  38. File the form.
  39. Send a Charge (P03) HL7 message with FT1:13 segment with a different Program then what Patient is currently in.
  40. Compile and post the charge data and verify that it is processed without any errors.
  41. Open Client ledger and view the charges for the test client A in 'Ledger Type' as "Crystal".
  42. On the client ledger report click on the date link.
  43. Validate that the 'Providing Program' on the report is equal to the Program sent in FT1:13 segment of the Charge message.
  44. Send a Charge (P03) HL7 message with FT1:13 segment with an Invalid Program Code.
  45. Compile the charge file and validate that there is an error "Service program sent is not valid:"
  46. Void the file.
  47. Send a Charge (P03) HL7 message with FT1:13 segment as empty
  48. Compile and post the charge data and verify that it is processed without any errors.
  49. Open Client ledger and view the charges for the test client A in 'Ledger Type' as "Crystal".
  50. On the client ledger report click on the date link.
  51. Validate that the 'Providing Program' on the report is equal to the Program client was active in as of the date of service.
Scenario 3: Validate Inbound HL7 Pharmacy charge processing support using the service program sent in the charge message
Specific Setup:
  • There must be an Inbound Billing Pharmacy connection.
  • Test Client A must exist.
Steps
  1. Open the 'Default Settings For Processing An Inbound HL7 Charge Batch' form.
  2. Click the 'Pharmacy' - Charge Type radio button.
  3. Click the 'Program sent in HL7 field 'Department Code' (FT1-13)' radio button.
  4. File the form.
  5. Send a Charge (P03) HL7 message with FT1:13 segment with a different Program then what Patient is currently in.
  6. Compile and post the charge data and verify that it is processed without any errors.
  7. Open Client ledger and view the charges for the test client A in 'Ledger Type' as "Crystal".
  8. On the client ledger report click on the date link.
  9. Validate that the 'Providing Program' on the report is equal to the Program sent in FT1:13 segment of the Charge message.
  10. Send a Charge (P03) HL7 message with FT1:13 segment with an Invalid Program Code.
  11. Compile the charge file and validate that there is an error "Service program sent is not valid:"
  12. Void the file.
  13. Send a Charge (P03) HL7 message with FT1:13 segment as empty
  14. Compile the charge file and validate that there is an error "Service program missing."
  15. Void the file.
  16. Open the 'Default Settings For Processing An Inbound HL7 Charge Batch' form.
  17. Click the 'Pharmacy' - Charge Type radio button.
  18. Click the 'Program client was active in as of the date of service.' radio button.
  19. File the form.
  20. Send a Charge (P03) HL7 message with FT1:13 segment with a different Program then what Patient is currently in.
  21. Compile and post the charge data and verify that it is processed without any errors.
  22. Open Client ledger and view the charges for the test client A in 'Ledger Type' as "Crystal".
  23. On the client ledger report click on the date link.
  24. Validate that the 'Providing Program' on the report is equal to the Program client was active in as of the date of service.
  25. Send a Charge (P03) HL7 message with FT1:13 segment with an Invalid Program Code.
  26. Compile and post the charge data and verify that it is processed without any errors.
  27. Open Client ledger and view the charges for the test client A in 'Ledger Type' as "Crystal".
  28. On the client ledger report click on the date link.
  29. Validate that the 'Providing Program' on the report is equal to the Program client was active in as of the date of service.
  30. Send a Charge (P03) HL7 message with FT1:13 segment as empty
  31. Compile and post the charge data and verify that it is processed without any errors.
  32. Open Client ledger and view the charges for the test client A in 'Ledger Type' as "Crystal".
  33. On the client ledger report click on the date link.
  34. Validate that the 'Providing Program' on the report is equal to the Program client was active in as of the date of service.
  35. Open the 'Default Settings For Processing An Inbound HL7 Charge Batch' form.
  36. Click the 'Pharmacy' - Charge Type radio button.
  37. Click the 'Program sent in HL7 field 'Department Code' (FT1-13). If program not sent then program client was active in as of the date of service' radio button.
  38. File the form.
  39. Send a Charge (P03) HL7 message with FT1:13 segment with a different Program then what Patient is currently in.
  40. Compile and post the charge data and verify that it is processed without any errors.
  41. Open Client ledger and view the charges for the test client A in 'Ledger Type' as "Crystal".
  42. On the client ledger report click on the date link.
  43. Validate that the 'Providing Program' on the report is equal to the Program sent in FT1:13 segment of the Charge message.
  44. Send a Charge (P03) HL7 message with FT1:13 segment with an Invalid Program Code.
  45. Compile the charge file and validate that there is an error "Service program sent is not valid:"
  46. Void the file.
  47. Send a Charge (P03) HL7 message with FT1:13 segment as empty
  48. Compile and post the charge data and verify that it is processed without any errors.
  49. Open Client ledger and view the charges for the test client A in 'Ledger Type' as "Crystal".
  50. On the client ledger report click on the date link.
  51. Validate that the 'Providing Program' on the report is equal to the Program client was active in as of the date of service.
Topics
• HL7 charge processing

 

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