Skip to main content

Avatar MSO 2022 Update 11

  1. Last updated
  2. Save as PDF

Product Requirements / Recommendations

Avatar MSO required
RADplus required

Product Update Form Description

The following modifications are made: 1) The 'Performing Provider Association' form is added to Avatar MSO. This form will allow the user to assign Performing Providers to Contracting Provider Registrations without using the 'Contracting Provider Registration' form. 2) The following fields are added to the 'Contracting Provider Registration', 'Performing Provider Association' and 'Performing Provider Registration' forms: 'Performing Provider's Office Telephone (1)','Performing Provider's Office Telephone (2)','Performing Provider's Cellular Telephone', 'Performing Provider's Fax', 'Secondary Provider Identification Number'. 3) The 'Date Claims Received' field in the 'Fast Service Entry Submission' form is updated to default in the current date and will now remain disabled. 4) An issue is resolved where the 'Claim Status' field would become enabled when selecting an authorization from the 'Display Valid Authorizations' menu.

Included Updates

8

Required Updates

None

Details
NEW2 CHANGED0 FIXED1
New (2)
Avatar MSO 'Performing Provider Association' form
The 'Performing Provider Association' form is added to Avatar MSO.
The 'Performing Provider Association' form is added, and will allow users to assign Performing Providers to Contracting Provider Registrations without using the 'Contracting Provider Registration' form. In addition, the following fields are added to the 'Contracting Provider Registration' and 'Performing Provider Registration' forms:
- 'Performing Provider's Office Telephone (1)'
- 'Performing Provider's Office Telephone (2)'
- 'Performing Provider's Cellular Telephone'
- 'Performing Provider's Fax'
- 'Secondary Provider Identification Number'
Value Added: Adds 'Performing Provider Association' form to Avatar MSO.
Topics
• Contracting Provider Registration • NX • Performing Provider
 
Avatar MSO 'Fast Service Entry Submission' Form
The 'Date Claims Submitted' field in the 'Fast Service Entry Submission' form is updated to default in the current date and remain disabled.
Value Added: Updates 'Fast Service Entry Submission' form field behavior.
Topics
• Claims Processing
 
Fixed (1)
Avatar MSO 'Fast Service Entry Submission' Form
An issue is resolved in the 'Fast Service Entry Submission' form to ensure that the 'Claim Status' field is not enabled for edit when selecting an authorization from the 'Display Valid Authorizations' menu.
Topics
• Claims Processing
 
Acceptance Tests
AV-66729 Summary | Details
Avatar MSO 'Performing Provider Association' form
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Contracting Provider Registration
  • Performing Provider Registration
  • Performing Provider Association
Scenario 1: 'Performing Provider Association' - Form Verification
Specific Setup:
  • One or more Avatar MSO Contracting Provider Registration entries eligible for Performing Provider association entry
  • One or more Avatar MSO Performing Provider Registration entries eligible for Contracting Provider assignment
Steps
  1. Open Avatar MSO 'Performing Provider Association' form.
  2. Enter/select Contracting Provider for Performing Provider Association entry.
  3. In 'Performing Provider Association' form, ensure the following fields exist:
  4. 'Contracting Provider Registration'
  5. Dropdown selection field containing all Contracting Provider Registration entries for selected Contracting Provider
  6. 'Performing Provider'
  7. Lookup/selection field for selection of Performing Provider to be associated/assigned to selected Contracting Provider Registration
  8. 'Performing Provider Registration'
  9. Dropdown selection field for selection of Performing Provider Registration record to be associated/assigned to selected Contracting Provider Registration (if more than one Performing Provider Registration record exists for selected Performing Provider)
  10. 'Effective Start Date' / 'Effective End Date'
  11. Used to enter begin/end date for Performing Provider association/assignment; Value defaulted from row selected in 'Performing Provider Registration' field
  12. 'Registration Start Date' / 'Registration End Date'
  13. Populated from row selected in 'Performing Provider Registration' field
  14. 'Primary License Type Effective Dates'
  15. Dropdown selection field for Primary License Type rows/entries, including 'Create New' selection; populated with all Primary License Type rows/entries defined via 'Performing Provider Registration' form for row selected in 'Performing Provider Registration' field
  16. 'Primary License Type For Claims' / 'Effective Start Date' / 'Effective End Date'
  17. Used to enter/edit selected Primary License Type row/entry if desired; 'File Primary License Type Effective Date', 'Delete...' and 'Display...' buttons also present in form for Primary License Type row/entry functions
  18. Performing Provider Demographic information fields (all fields from Avatar MSO 'Performing Provider Registration' form / Avatar MSO 'Contracting Provider Registration' form 'Performing Provider's Information' section), including but not limited to the following fields:
  19. 'Performing Provider's Name'
  20. 'Performing Provider's Birthdate'
  21. 'Performing Provider's Social Security Number'
  22. 'Performing Provider's E-mail Address'
  23. 'Performing Provider's Address Street 1', '...Street 2', '...City', '...State'
  24. 'Medicaid Provider #'
  25. 'Provider ID' / 'Provider ID Qualifier'
  26. 'Performing Provider's Office Telephone (1)'
  27. 'Performing Provider's Office Telephone (2)'
  28. 'Performing Provider's Cellular Telephone'
  29. 'Performing Provider's Fax'
  30. 'Secondary Provider Identification Number'
  31. Select Contracting Provider Registration for Performing Provider association/assignment in the 'Contracting Provider Registration' field.
  32. Enter/select Performing Provider for association/assignment in the 'Performing Provider' field (and select row/entry in 'Performing Provider Registration' field if more than one entry exists/different row is desired).
  33. On selection of 'Performing Provider' and 'Performing Provider Registration' values, ensure that Performing Provider Demographic information fields are populated with values defined via Avatar MSO 'Performing Provider Registration' form for selected record ('Performing Provider's Name', 'Performing Provider's Social Security Number', 'Provider ID', 'Secondary Provider Identification Number', etc.).
  34. Enter/edit Performing Provider Demographic information field values (if desired).
  35. On selection of 'Performing Provider' and 'Performing Provider Registration' values, ensure that 'Primary License Type Effective Dates' selection field is populated with all Primary License Type rows/entries defined via 'Performing Provider Registration' form for selected Performing Provider Registration.
  36. Enter/edit Performing Provider Primary License Type row/entry information (if desired; Selection of existing Primary License Type row or 'Create New', entry/edit of 'Primary License Type For Claims' / 'Effective Start Date' / 'Effective End Date' fields and use of 'File Primary License Type Effective Date' / 'Delete Primary License Type Effective Date' buttons).
  37. Click 'Submit' button to file 'Performing Provider Association' form and create or update Contracting Provider/Performing Provider association/assignment.
  38. Ensure user is presented with a confirmation dialog noting 'Performing Provider Association Successfully Filed'; Click 'OK' button and ensure 'Performing Provider Association' form is closed.
  39. Open Avatar MSO 'Contracting Provider Registration' form
  40. Enter/select Contracting Provider/Contracting Provider Registration record for review (selecting same Contracting Provider Registration record as updated via 'Performing Provider Association' form).
  41. Navigate to 'Performing Provider's Information' section of form.
  42. Confirm Performing Provider association/assignment row created/updated via 'Performing Provider Association' form is present in multi-row selection grid.
  43. Select Performing Provider association/assignment row created/updated via 'Performing Provider Association' form and click 'Edit Selected Item' button.
  44. On selection/view of Performing Provider association/assignment row, ensure that all field values filed via 'Performing Provider Association' form are present (including Primary License Type Effective Date rows/entries).
  45. Ensure that subsequent filing of 'Performing Provider Association' form for same Contracting Provider Registration/Performing Provider combination results in updating of existing Performing Provider association/assignment row in 'Contracting Provider Registration' form/record.
Scenario 2: 'Performing Provider Registration' - Form Verification
Specific Setup:
  • Crystal Reports or other SQL reporting tool
Steps
  1. Open Avatar MSO 'Performing Provider Registration' form.
  2. Click 'New Performing Provider' button to create new Performing Provider Registration (or search/select existing Performing Provider Registration record for edit).
  3. Enter/select values in 'Name' and 'Registration Start Date' fields.
  4. Ensure that the following fields are present in the 'Performing Provider Registration' form:
  5. 'Performing Provider's Office Telephone (1)'
  6. 'Performing Provider's Office Telephone (2)'
  7. 'Performing Provider's Cellular Telephone'
  8. 'Performing Provider's Fax'
  9. 'Secondary Provider Identification Number'
  10. Enter value(s) in 'Performing Provider's Office Telephone (1)', 'Performing Provider's Office Telephone (2)', 'Performing Provider's Cellular Telephone', 'Performing Provider's Fax' and/or 'Secondary Provider Identification Number' fields (and any other Provider data fields as required/desired).
  11. Select one or more values in 'Primary License Type for Claims' field.
  12. Select 'Create New' from the 'Primary License Type Effective Dates' field.
  13. Enter/select values for 'Effective Start Date', 'Primary License Type for Claims' fields.
  14. Click 'File Primary License Type Effective Date' button.
  15. Click 'Submit' button to file 'Performing Provider Registration' form.
  16. Open Avatar MSO 'Performing Provider Registration' form.
  17. Enter/select previously filed Performing Provider Registration record.
  18. Ensure that previously entered/filed values are present in 'Performing Provider's Office Telephone (1)', 'Performing Provider's Office Telephone (2)', 'Performing Provider's Cellular Telephone', 'Performing Provider's Fax' and/or 'Secondary Provider Identification Number' fields.
  19. Open Crystal Reports or other SQL reporting tool.
  20. In Avatar MSO SQL table 'SYSTEM.performing_provider_data', ensure that the following fields are present and reflect values entered/filed via 'Performing Provider Registration' form for fields noted above (respectively):
  21. 'perf_prov_office_phone_1'
  22. 'perf_prov_office_phone_2'
  23. 'perf_prov_cellular_telephone'
  24. 'perf_prov_fax'
  25. 'sec_prov_ident_num'
Scenario 3: 'Contracting Provider Registration' - Form Verification
Specific Setup:
  • One or more Avatar MSO Contracting Provider entries eligible for Contracting Provider Registration entry/edit
  • One or more Avatar MSO Performing Provider Registration entries eligible for Contracting Provider assignment
  • Crystal Reports or other SQL reporting tool
Steps
  1. Open Avatar MSO 'Contracting Provider Registration' form.
  2. Enter/select Contracting Provider for Contracting Provider Registration entry/edit.
  3. Click 'Add' button to create new Contracting Provider Registration (or select existing Contracting Provider Registration record for edit).
  4. Enter/select values for all required/desired fields in main/first section of 'Contracting Provider Registration' form.
  5. Navigate to 'Performing Provider's Information' section of form.
  6. Click 'Add New Item' button to create new Performing Provider association entry (or select existing Performing Provider association record for edit).
  7. Ensure that the following fields are present in the 'Contracting Provider Registration' form, 'Performing Provider's Information' section:
  8. 'Performing Provider's Office Telephone (1)'
  9. 'Performing Provider's Office Telephone (2)'
  10. 'Performing Provider's Cellular Telephone'
  11. 'Performing Provider's Fax'
  12. 'Secondary Provider Identification Number'
  13. On addition of new Performing Provider association entry in 'Contracting Provider Registration' form, ensure that values for 'Performing Provider's Office Telephone (1)', 'Performing Provider's Office Telephone (2)', 'Performing Provider's Cellular Telephone', 'Performing Provider's Fax' and/or 'Secondary Provider Identification Number' fields are defaulted from 'Performing Provider Registration' information for selected Performing Provider record where defined.
  14. Enter/edit value(s) in 'Performing Provider's Office Telephone (1)', 'Performing Provider's Office Telephone (2)', 'Performing Provider's Cellular Telephone', 'Performing Provider's Fax' and/or 'Secondary Provider Identification Number' fields (and any other Performing Provider's Information data fields as required/desired).
  15. Click 'Submit' button to file 'Contracting Provider Registration' form.
  16. Open Avatar MSO 'Contracting Provider Registration' form.
  17. Enter/select previously filed Contracting Provider Registration record.
  18. Navigate to 'Performing Provider's Information' section of form.
  19. Select previously entered Performing Provider association record for edit.
  20. Ensure that previously entered/filed values are present in 'Performing Provider's Office Telephone (1)', 'Performing Provider's Office Telephone (2)', 'Performing Provider's Cellular Telephone', 'Performing Provider's Fax' and/or 'Secondary Provider Identification Number' fields.
  21. Open Crystal Reports or other SQL reporting tool.
  22. In Avatar MSO SQL table 'SYSTEM.provider_performing_data', ensure that the following fields are present and reflect values entered/filed via 'Contracting Provider Registration' form for fields noted above (respectively):
  23. 'perf_prov_office_phone_1'
  24. 'perf_prov_office_phone_2'
  25. 'perf_prov_cellular_telephone'
  26. 'perf_prov_fax'
  27. 'sec_prov_ident_num'
Topics
• Contracting Provider Registration • NX • Performing Provider
AV-68563 Summary | Details
Avatar MSO 'Fast Service Entry Submission' Form
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Fast Service Entry Submission
Scenario 1: 'Fast Service Entry Submission' - Verification of form filing
Specific Setup:
  • One or more client records eligible for Fast Service Entry
Steps
  1. Open Avatar MSO 'Fast Service Entry Submission' form (under 'Avatar MSO / Claims Processing' menu).
  2. In 'Fast Service Entry Submission' form, ensure that 'Close Batches' field is set to 'No' and is read-only/disabled for any system user which does not also have access to Avatar MSO 'Close Batch form (via 'User Definition' and/or 'User Role Definition' forms).
  3. Ensure that 'Close Batches' field is set to 'No' by default but value may be changed to 'Yes' for any system user which also has access to Avatar MSO 'Close Batch form (via 'User Definition' and/or 'User Role Definition' forms).
  4. Ensure that 'Date Claims Received' field is set to current date by default; ensure that 'Date Claims Received' field is disabled/read-only and date value may not be edited.
  5. Navigate to 'Fast Service Detail' section of form.
  6. Click 'Add New Item' button to enter new service.
  7. Enter/select client for service entry in 'Member Name or ID' field.
  8. Ensure that 'Funding Source' field contains only selections applicable to Contracting Provider Registration; enter/select value in 'Funding Source' field.
  9. Enter/select value in 'Provider' field.
  10. Ensure that 'Performing Provider' field contains only selections applicable to Contracting Provider Registration; select value in 'Performing Provider' field if desired.
  11. Enter value in 'Begin Date Of Authorization' and 'End Date Of Authorization' field.
  12. Select value in 'Date Of Service' field.
  13. Enter/select value in 'Procedure Code' field.
  14. Enter value in 'Total Charge' and 'Service Units' field.
  15. Enter value in 'Authorization Number' field, or click 'Display Valid Authorizations' button and select Service Authorization applicable to service entry.
  16. Ensure that 'Claim Status' field (Approved/Denied/Pending) is populated with value determined by Avatar MSO claim/service adjudication rules and requirements.
  17. Ensure that 'Claim Status' field is disabled/read-only, and that 'Claim Status' value/status may not be manually edited following entry of service detail values and/or selection of Service Authorization.
  18. Ensure that 'Expected Disbursement' and 'Approved Units' fields are populated with value determined by Avatar MSO claim/service adjudication rules and requirements in conjunction with 'Claim Status'.
  19. Enter/select values in any other fields as required/desired.
  20. Click 'Add New Item' button to enter additional service(s) as desired; when all desired services have been entered in 'Fast Service Detail' section of form, navigate to 'Fast Service Entry Summary' section of form.
  21. Click 'Submit Fast Service Entry' form to file service(s) and create Avatar MSO claims processing batch(es). Claims processing batch(es) created via the 'Fast Service Entry Submission' form where 'Close Batches' field is set to 'No' must be further adjudicated/finalized/closed via Avatar MSO 'Close Batch' form (or 'Close Multiple Batches' form).
Topics
• Claims Processing
AV-79174 Summary | Details
Avatar MSO 'Fast Service Entry Submission' Form
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Fast Service Entry Submission
Scenario 1: 'Fast Service Entry Submission' - Verification of form filing
Specific Setup:
  • One or more client records eligible for Fast Service Entry
Steps
  1. Open Avatar MSO 'Fast Service Entry Submission' form (under 'Avatar MSO / Claims Processing' menu).
  2. In 'Fast Service Entry Submission' form, ensure that 'Close Batches' field is set to 'No' and is read-only/disabled for any system user which does not also have access to Avatar MSO 'Close Batch form (via 'User Definition' and/or 'User Role Definition' forms).
  3. Ensure that 'Close Batches' field is set to 'No' by default but value may be changed to 'Yes' for any system user which also has access to Avatar MSO 'Close Batch form (via 'User Definition' and/or 'User Role Definition' forms).
  4. Ensure that 'Date Claims Received' field is set to current date by default; ensure that 'Date Claims Received' field is disabled/read-only and date value may not be edited.
  5. Navigate to 'Fast Service Detail' section of form.
  6. Click 'Add New Item' button to enter new service.
  7. Enter/select client for service entry in 'Member Name or ID' field.
  8. Ensure that 'Funding Source' field contains only selections applicable to Contracting Provider Registration; enter/select value in 'Funding Source' field.
  9. Enter/select value in 'Provider' field.
  10. Ensure that 'Performing Provider' field contains only selections applicable to Contracting Provider Registration; select value in 'Performing Provider' field if desired.
  11. Enter value in 'Begin Date Of Authorization' and 'End Date Of Authorization' field.
  12. Select value in 'Date Of Service' field.
  13. Enter/select value in 'Procedure Code' field.
  14. Enter value in 'Total Charge' and 'Service Units' field.
  15. Enter value in 'Authorization Number' field, or click 'Display Valid Authorizations' button and select Service Authorization applicable to service entry.
  16. Ensure that 'Claim Status' field (Approved/Denied/Pending) is populated with value determined by Avatar MSO claim/service adjudication rules and requirements.
  17. Ensure that 'Claim Status' field is disabled/read-only, and that 'Claim Status' value/status may not be manually edited following entry of service detail values and/or selection of Service Authorization.
  18. Ensure that 'Expected Disbursement' and 'Approved Units' fields are populated with value determined by Avatar MSO claim/service adjudication rules and requirements in conjunction with 'Claim Status'.
  19. Enter/select values in any other fields as required/desired.
  20. Click 'Add New Item' button to enter additional service(s) as desired; when all desired services have been entered in 'Fast Service Detail' section of form, navigate to 'Fast Service Entry Summary' section of form.
  21. Click 'Submit Fast Service Entry' form to file service(s) and create Avatar MSO claims processing batch(es). Claims processing batch(es) created via the 'Fast Service Entry Submission' form where 'Close Batches' field is set to 'No' must be further adjudicated/finalized/closed via Avatar MSO 'Close Batch' form (or 'Close Multiple Batches' form).
Topics
• Claims Processing

 

  1. Back to top
  • Was this article helpful?

Recommended articles

  1. Page type
    Reference
  2. Tags
    1. content:release
    2. llm-no-index
    3. role:sysadmin
    4. search:ready