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Site Specific Section Modeling - Fast Service Entry Submission
Site Specific Section Modeling is updated to resolve an error when '
MSOBAT185SUBMISSION (Fast Service Entry Submission) Fast Service Detail' is selected.
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Claim Processing - Third Party Adjudication Data
The 'Third Party Adjudication Data' functionality has been updated to retain the data for pended claims and to copy it to the service when a new pended batch is created.
Included Updates
None
Product Update Form Description
The following issues are resolved: 1) The error "[UNDEFINED]Predisplay1+68^GUISSTabModeling" produced when selecting 'Fast Service Entry Submission' in the 'Site Specific Section Modeling' form. 2) When a batch is closed via the 'Close Batch' form, COB/Third Party Liability grid data for pended services are not being copied to the pended batch. 3) User definitions are being copied when a new system code is created.
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Topics
• Claims Processing
• Service Authorizations
• Site Specific Section Modeling
• NX
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Avatar MSO 'Claim Processing Automation' form.
An issue is resolved to ensure files are correctly loaded/compiled/posted via Avatar MSO Claim Processing Automation functions.
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'837 Health Care Claim Professional' Form / '837 Health Care Claim Institutional' Form
An issue is resolved to ensure that user-friendly error messaged are produced on attempted loading of an invalid format 837 Professional or Institutional file.
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Avatar MSO 'Other EOB Information' form
An issue is resolved to ensure that Avatar MSO SQL table 'SYSTEM.table_eob_core' data is updated when an existing check date, check number, or check amount is removed via the 'Other EOB Information' form.
Included Updates
None
Product Update Form Description
The following issues are resolved: 1) The error "[UNDEFINED]FileClaimForm+5^MSOCLAIMFORMFile" produced on 837 automated posting. 2) The error "[UNDEFINED]Save997toClass+60^MSOEACK997Compile" produced on load of an 837 Professional or Institutional file and the error "[MAXNUMBER]Save997toClass+38^MSOEACK997Compile" produced on compile of an 837 Professional or Institutional file. 3) The 'SYSTEM.table_eob_core' table is not updated when an existing check date, check number, or check amount is removed via the 'Other EOB Information' form.
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Topics
• 837 Health Care Claim Professional
• Claims Processing
• 837 Health Care Claim Institutional
• NX
• Create EOB
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Avatar MSO to Avatar PM Service Filing
An issue is resolved to ensure that using the 'File' or 'Delete' fields in the 'Service Filling' section of the 'MSO to Parent System Integration Mapping' form while claims are being filed from MSO to PM correctly validates for EOB/EOB check numbers before filing.
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'Claim Entry' Web Service
An issue is resolved to ensure that the Avatar MSO 'Claim Entry' Web Service correctly files data where Batch ID to be created exceeds 6 digits in length.
Included Updates
None
Product Update Form Description
The following updates are included: 1) An issue is resolved where the Avatar MSO 'Claim Entry' web service may not correctly file claim/service data. 2) An issue is resolved where using the 'File' or 'Delete' fields in the 'Service Filling' section of the 'MSO to Parent System Integration Mapping' form while claims are being filed from MSO to PM may result in claims incorrectly validating for EOB and EOB check numbers before filing.
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Topics
• MSO To Parent System Integration Mapping
• NX
• Web Services
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Avatar MSO 'Performing Provider Registration' Form.
An issue is resolved to ensure that Performing Provider Registration can be terminated after the existing registration date is modified to an earlier date.
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'837 Health Care Claim Professional' Form / '837 Health Care Claim Institutional' Form
An issue is resolved to ensure successful loading of either a 837 5010 Professional file (via the '837 Health Care Claim Professional' form) or an 837 5010 Institutional file (via the '837 Health Care Claim Institutional' form) where the '2430-CAS-02' value is blank.
Included Updates
None
Product Update Form Description
The following issues are resolved: 1) Performing provider registration cannot be terminated after the existing registration date is modified to an earlier date. 2) The error "[SUBSCRIPT]DOSEGMENT+25^EB837pLoad" produced when loading an 837 5010 Professional file via the '837 Health Care Claim Professional' form, and the error "[SUBSCRIPT]DOSEGMENT+36^EB837iLoad" produced when loading an 837 5010 Institutional file via the '837 Health Care Claim Institutional' form.
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Topics
• Performing Provider
• NX
• 837 Health Care Claim Professional
• Claims Processing
• 837 Health Care Claim Institutional
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Avatar MSO Retro Claim Adjudication File Import
An issue is resolved to ensure that Retro Claim Adjudication entries for multiple services are correctly compiled/posted in the 'File Import' form for processing of '[Avatar MSO] Retro Claim Adjudication' import files.
Included Updates
None
Product Update Form Description
The error "A retro for this service will be created with information from Line #1. This line will be skipped." is resolved in the 'Retro Claim Adjudication' selection of the 'File Import' form.
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Topics
• Retro Claim Adjudication
• File Import
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'Provider File Attach' Form
A new form 'Provider File Attach' is added to Avatar MSO.
The Avatar MSO 'Provider File Attach' form allows for upload and storage of files in conjunction with Avatar Document Management functionality/configuration.
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Avatar MSO 'Provider File Attach' Widget
A new 'Provider File Attach' Widget is added to Avatar MSO.
The Avatar MSO 'Provider File Attach' Widget is added to support Home View/Dashboard display of Provider File Attach records/files for selected/active client (and viewing via 'Console Widget Viewer').
Included Updates
None
Additional Requirements
Avatar NX Release 2022.05.00 is required for .PDF/,TIF support in Avatar NX 'Console Widget Viewer'
Product Update Form Description
A new form 'Provider File Attach' is added to Avatar MSO.
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Topics
• NX
• Provider File Attach
• Widgets
• Console Widget
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837 Health Care Claim Adjustment Posting
An issue is resolved to ensure that after an 837 5010 Professional or Institutional inbound file is posted and automatically re-adjudicated, OHC claim adjustment data in the SYSTEM.mso_claim_adjustments table is retained, to ensure that claim adjustment segments are produced in the 837 generated in the parent PM system.
Included Updates
None
Product Update Form Description
The issue is resolved where after an 837 5010 Professional or Institutional inbound file is posted and automatically re-adjudicated, OHC claim adjustment data in the SYSTEM.mso_claim_adjustments table is not retained, causing claim adjustment segments to not produce in the 837 generated in the parent PM system.
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Topics
• 837 Health Care Claim Professional
• Claims Processing
• NX
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Avatar MSO 'Claim Acknowledgement (277CA) File' Form/Function
An issue is resolved to ensure that 277CA files generated via the 'Claim Acknowledgement (277CA) File' form correctly report valid/posted claims with 'Pended' status services as 'Accepted'.
Included Updates
None
Product Update Form Description
The issue is resolved where 277 files generated via the 'Claim Acknowledgement (277CA) File' form is incorrectly rejecting claims with pended services.
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Topics
• 837 Health Care Claim Professional
• Claims Processing
• 837 Health Care Claim Institutional
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Avatar MSO 'Void Claim Assignment' form
The 'Void Claim Assignment' form is added to Avatar MSO.
The Avatar MSO 'Void Claim Assignment' form allows for user entry of 'Void' (full takeback) Retro Claim Adjudication entries for claims/service(s) in 'Closed' status Claim Processing batches (where no previous Retro Claim Adjudication/Void entry has been filed for service).
Included Updates
None
Product Update Form Description
The 'Void Claim Assignment' form is added to Avatar MSO.
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Topics
• Retro Claim Adjudication
• NX
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Avatar MSO Budget Tracking
The 'Budget Tracking Account Setup' form and Avatar MSO Budget Tracking functionality are updated to ensure that Retro Claim Adjudication 'Take Back Amount' values (as well as any deleted services) are correctly reflected/added back to Budget Tracking Account/Account Level 'Remaining Amount' calculations.
Included Updates
None
Product Update Form Description
The issue is resolved where retro take back amounts are not added back to the remaining amount in the budget account.
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Topics
• Retro Claim Adjudication
• NX
• Budget Tracking
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'Electronic Billing' Support for Services Originating in Avatar MSO
An issue is resolved to ensure that 837 5010 Professional and Institutional files are produced without system error via the Avatar Cal-PM 'Electronic Billing' form for services originating in Avatar MSO when the Avatar Cal-PM 'Support MSO Other Healthcare Coverage' Registry Setting is enabled.
Included Updates
12
Required Updates
Avatar MSO 2022 Update 12
Product Update Form Description
The issue is resolved where the error "[SUBSCRIPT]zGetOHCData+44^SYSTEM.msoservicecob.1" is produced when compiling an 837 5010 Professional or Institutional file via the 'Electronic Billing' form that includes MSO OHC services.
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Topics
• Electronic Billing
• Claims Processing
• NX
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