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.
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.
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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.
'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.
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.
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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.
'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.
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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.
'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.
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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.
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Topics
• Retro Claim Adjudication
• File Import
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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.
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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'.
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Topics
• 837 Health Care Claim Professional
• Claims Processing
• 837 Health Care Claim Institutional
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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.
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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.
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Topics
• Electronic Billing
• Claims Processing
• NX
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