Avatar LA Provider Integration 2022 Update 5

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Product Requirements / Recommendations

Avatar Cal-PM required
Avatar LA Provider Integration required
RADplus required

Product Update Form Description

The issue is resolved where transferred LA Community Outreach services (COS) are not producing 2440-FRM segments on the 837 5010 Professional file created via the 'Electronic Billing' form.

Included Updates

2, 3, 4

Required Updates

Avatar LA Provider Integration 2022 Update 2

Details

NEW0 CHANGED0 FIXED1

Fixed (1)

AV-82669 Details \| User Acceptance Tests Validate transferred LA Community Outreach services (COS) generate 2440-FRM segments on the 837 5010 Professional files created via the 'Electronic Billing' form The issue is resolved where transferred LA Community Outreach services (COS) are not producing 2440-FRM segments on the 837 5010 Professional files created via the 'Electronic Billing' form.	Topics • 837 Professional

Acceptance Tests

AV-82669 Summary | Details

Validate transferred LA Community Outreach services (COS) generate 2440-FRM segments on the 837 5010 Professional files created via the 'Electronic Billing' form

Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:

Electronic Billing
Individual Cash Posting (PM)

Scenario 1: Validate transferred LA Community Outreach services (COS) generate 2440-FRM segments on the 837 5010 Professional files created via the 'Electronic Billing' form

Specific Setup:

Guarantors/Payors: 2 guarantors that contain a value in ‘LA County Guarantor’.
Program Maintenance: Note the 'Location' of a program that has a value in ‘LA County Program’.
Guarantor/Program Billing Defaults: A template exists for the above Guarantors/Payors/Program.
Service Code is selected for use.
Practitioner is selected for use. Note the 'Practitioner Categories For Coverage'.
Test Patient (Client A): Client is enrolled in the above program and is assigned the above 2 Guarantors/Payors in Financial Eligibility. Client has an active Diagnosis record and a Managed Care Authorization record for the Service Code and Practitioner Categories For Coverage.
LA Community Outreach Service Entry is used to create services.
Close Charges has been used to close charges.

Steps

Open 'Electronic Billing'.
Create an 837 Professional bill for the client, 1st guarantor, and service dates with 'Create Claim' = "No".
Validate that the 'Compile Complete' message is received.
Validate that the dump file's 2440 loop contains 'LQ' and 'FRM' segment.
Close the report.
Close the form.
Open 'Electronic Billing'.
Create an 837 Professional bill for the client, 1st guarantor, and service dates with 'Create Claim' = "Yes".
Validate that the 'Compile Complete' message is received.
Validate that the dump file's 2440 loop contains 'LQ' and 'FRM' segments.
Close the report.
Close the form.
Open 'Individual Cash Posting'.
Transfer the service to the 2nd guarantor.
Open 'Electronic Billing'.
Create an 837 Professional bill for the client, 2nd guarantor, and service dates with 'Create Claim' = "No".
Validate that the 'Compile Complete' message is received.
Validate that the dump file's 2440 loop contains 'LQ' and 'FRM' segments.
Close the report.
Close the form.

Topics

• 837 Professional