Product Requirements / Recommendations
Avatar MSO
required
RADplus
required
-
Avatar MSO 'Claim Acknowledgement (277CA) File' Service Line Information
The 'Claim Acknowledgement (277CA) File' process is updated to add support for Service Line Information segments.
The Avatar MSO 'Claim Acknowledgement (277CA) File' process is updated to add support for the following Service Line Information segments in 277CA response files for rejected and 'split claims' (claims where both accepted and rejected services are included in inbound 837 Health Care Claim file):
* '2220D-SVC' Service Line Information
* '2220D-STC' Service Line Level Status Information
* '2220D-REF' Service Line Item Identification
* '2220D-DTP' Service Line Date
-
Avatar MSO 'Claim Acknowledgement (277CA) File' Report
The 'Claim Acknowledgement (277CA) File' Report is updated to add support for Service Line Information including 'split claims'.
The Avatar MSO 'Claim Acknowledgement (277CA) File' Report is updated to add support for 277CA response Service Line Information including 'split claims' (claims where both accepted and rejected services are included in inbound 837 Health Care Claim file).
Included Updates
13
Product Update Form Description
The 'Claim Acknowledgement (277CA) File' process is updated to add support for Service Line Information segments.
|
Topics
• 837 Health Care Claim Professional
• Claims Processing
• 837 Health Care Claim Institutional
• Claim Acknowledgement (277CA)
• Reports
|
-
Avatar MSO 'Functional Acknowledgement File' Deletion
An issue is resolved to ensure that deletion of an Avatar MSO 837 inbound file also deletes the corresponding Functional Acknowledgement (999) file entry.
Included Updates
None
Product Update Form Description
The issue is resolved where deleting a MSO 837 file does not delete the corresponding Functional Acknowledgement file.
|
Topics
• 837 Health Care Claim Professional
• Functional Acknowledgement (999) File
• 837 Health Care Claim Institutional
|
-
Avatar MSO 'Enable Service Times' Registry Setting
The 'Enable Service Times' Registry Setting is updated to require the 'Service Start Time' and 'Service End Time' fields in Claim Processing forms.
The Avatar MSO 'Enable Service Times' Registry Setting is updated to require the 'Service Start Time' and 'Service End Time' fields in the following Avatar MSO Claim Processing forms if the 'Require Service Time' field in the 'CPT Code Definition'/'Revenue Code Definition' forms is set to 'Yes':
* 'Claim Processing (CMS 1500)'
* 'Claim Processing with Override (CMS 1500)'
* 'Claim Processing (UB-04)'
* 'Claim Processing with Override (UB-04)'
* 'Fast Service Entry'
* 'Fast Service Entry Submission'
Included Updates
8, 11, 20
Product Update Form Description
The 'Enable Service Times' registry setting is updated to require 'Service Start Time' and 'Service End Time' fields in the Claim Processing forms if the 'Require Service Time' field in the CPT/Revenue Code Definition forms is set to 'Yes'.
|
Topics
• Registry Settings
• CPT Code Definition
• Claims Processing
• NX
• Revenue Code Definition
|
-
Approve/Pend/Deny Rules Definition
The 'Approve/Pend/Deny' functionality is updated for the 'Claim Submitter ID Already Successfully Processed' rule to ensure that the claim is not denied when the 'Service Authorization' is changed from pended to approved and the existing pended batch is manually adjudicated.
-
Performing Provider Registration
The functionality for ‘Performing Provider Registration’ is updated to ensure that an error is not received when the form is submitted.
Included Updates
None
Product Update Form Description
The following issues are resolved: 1) APD rule 'Claim Submitter ID Already Successfully Processed' is incorrectly applied when a claim has been pended and placed in a new batch. 2) The error "[NOROUTINE]HADF1+19^HADF1" produced upon submission of the 'Performing Provider Registration' form.
|
Topics
• Claims Processing
• Performing Provider
|
-
Avatar MSO 'Create EOB' Form/Function
Performance improvements have been made in the Avatar MSO 'Create EOB' form/function for inclusion of information from the 'SYSTEM.retro_claim_adjudications' SQL table.
Included Updates
4
Product Update Form Description
Performance improvements have been made to the query process for 'SYSTEM.retro_claim_adjudications' table.
|
Topics
• Create EOB
|
| |
