Avatar MSO 'Void Claim Assignment' form
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- Retro Claim Adjudication
- Void Claim Assignment
Scenario 1: 'Void Claim Assignment' - Form Verification
Specific Setup:
- Client with claim(s)/services eligible for Retro Claim Adjudication entry in Avatar MSO (where no previous 'Void' Retro Claim Adjudication entry has been filed)
Steps
- Open Avatar MSO 'Void Claim Assignment' form (under 'Avatar MSO / Claims Processing' menu).
- Ensure that the following fields are present in 'Void Claim Assignment' form:
- 'From Date Of Service'
- Begin date of service to include for Void service selection; Required
- 'Through Date Of Service'
- Begin date of service to include for Void service selection; Required
- 'Client ID'
- Client ID for Void service selection; Required
- 'Contracting Provider'
- Contracting Provider for Void service selection filtering; Optional
- 'Contracting Provider Program'
- Contracting Provider Program for Void service selection filtering (available selections populated based on 'Contracting Provider' selection); Optional
- 'Select Services To Void' button
- 'File' button
- Enter value for 'From Date Of Service' and 'Through Date of Service' criteria fields.
- Ensure that if date span for 'From Date Of Service'/'Through Date of Service' is greater than 365 days, user is presented with an error dialog noting 'Selected Time Period cannot exceed a 365 day period' and the criteria entry is disallowed.
- Enter/select value for 'Client ID' criteria field.
- Enter/select value for 'Contracting Provider' criteria field if desired.
- Select value for 'Contracting Provider Program' criteria field if desired.
- Click 'Select Services To Void' button to display Void service selection dialog for service selection criteria entered.
- Ensure that 'Select Service(s) To Void' service selection dialog displays all service(s) in 'Closed' status Avatar MSO Claim Processing batch(es) for the selected client/service dates (and 'Contracting Provider'/'Contracting Provider Program' if specified) where no previous 'Void' Retro Claim Adjudication entry has been filed for service.
- If no eligible services are found for selected client/service dates (and 'Contracting Provider'/'Contracting Provider Program' if specified), ensure that user is presented with error dialog noting 'No Services Found' on clicking 'Select Services To Void' button.
- In the 'Select Service(s) To Void' dialog, ensure that all service(s) meeting service selection criteria are displayed for selection with the following information for each service:
- 'Batch'
- 'Contracting Provider'
- 'Date Of Service'
- 'Claim #'
- 'Procedure Code'
- 'Charges'
- 'Total Disbursement'
- Select one or more service(s) for 'Void' Retro Claim Adjudication entry (using checkbox selection field for each desired service).
- Click 'OK' button in the 'Select Service(s) To Void' to complete Void service selection.
- Click 'File' button in 'Void Claim Assignment' form to file 'Void' (full takeback) Retro Claim Adjudication entry for each/all selected service(s).
- Ensure user is presented with a 'Void Services' confirmation dialog noting 'Selected services will be voided. Continue?'; Click 'Yes' button to proceed with Void Claim Assignment service filing.
- On Void Claim Assignment filing, ensure user is presented with a confirmation dialog noting 'Filed'; click 'OK' button to close confirmation dialog.
- Re-enter/re-select values for 'From Date Of Service'/'Through Date of Service' and 'Client ID' Void service selection criteria fields (along with 'Contracting Provider'/'Contracting Provider Program' if desired); Click 'Select Services To Void' button for Void service selection dialog display.
- Ensure that 'Select Service(s) To Void' service selection dialog excludes any service(s) where previous 'Void' Retro Claim Adjudication entry has been filed for service.
Scenario 2: 'Void Claim Assignment' - Verification of Retro Claim Adjudication Entries for Voided Services
Specific Setup:
- Client with claim(s)/services eligible for Retro Claim Adjudication entry in Avatar MSO (where no previous 'Void' Retro Claim Adjudication entry has been filed)
Steps
- Open Avatar MSO 'Void Claim Assignment' form.
- Enter value for 'From Date Of Service' and 'Through Date of Service' fields.
- Enter/select value for 'Client ID' field.
- Enter/select value for 'Contracting Provider' (and 'Contracting Provider Program') criteria field if desired.
- Click 'Select Services To Void' button to display Void service selection dialog for service selection criteria entered.
- Select one or more service(s) for 'Void' Retro Claim Adjudication entry (using checkbox selection field for each desired service).
- Click 'OK' button in the 'Select Service(s) To Void' to complete Void service selection.
- Click 'File' button in 'Void Claim Assignment' form to file 'Void' (full takeback) Retro Claim Adjudication entry for each/all selected service(s).
- Ensure user is presented with a 'Void Services' confirmation dialog noting 'Selected services will be voided. Continue?'; Click 'Yes' button to proceed with Void Claim Assignment service filing.
- On Void Claim Assignment filing, ensure user is presented with a confirmation dialog noting 'Filed'; click 'OK' button to close confirmation dialog.
- Open Avatar MSO 'Retro Claim Adjudication' form.
- Note, Retro Claim Adjudication entries filed via the 'Void Claim Assignment' form may also be confirmed directly via Avatar MSO SQL table 'SYSTEM.retro_claim_adjudications'
- Select 'Edit' in 'Add/Edit/Delete Claim Adjudication' field.
- In 'Claim' field, select claim including service(s) where Void entry was filed via 'Void Claim Assignment' form.
- In 'Date Of Service/Procedure' field, select service where Void entry was filed via 'Void Claim Assignment' form.
- In 'Retro Claim Adjudication' form, ensure that 'Void' (full takeback) Retro Claim Adjudication information exists for selected Claim/Service where 'Void' entry was filed via 'Void Claim Assignment' form, with information/values as follows:
- 'Updated Disbursement Amount' = 0
- 'Updated Approved Units' = 0
- 'Take Back Amount' = 'Original Disbursement Amount'
- 'Take Back Units' = 'Original Approved Units'
- 'Adjustment Code' contains code/value defined as system default Adjustment Code for Void
- Default Adjustment Code defined via Avatar MSO 'Set System Defaults' form, 'Default Retro Claim Adjudication Adjustment Code For 837 Professional Voids' / 'Default Retro Claim Adjudication Adjustment Code For 837 Institutional Voids' fields
- 'Comments' field for 'Void' Retro Claim Adjudication entry filed via 'Void Claim Assignment' form contains comment entry 'Retro rate adjustment created because of a void generated by the 'Void Claim Assignment' form'
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Topics
• NX
• Retro Claim Adjudication
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