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Avatar MSO 2022 Update 15

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Product Requirements / Recommendations

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Product Update Form Description

The 'Through Date' field is added to the 'Provider Activity Invoice' (Provider Activity Invoice Details) and 'Provider Activity Invoice with Override' (Provider Activity Invoice Details) forms. The InvoiceEntry web service is updated to include 'Activity Through Date'.

Included Updates

None

Required Updates

None

Details
NEW1 CHANGED0 FIXED0
New (1)
'Provider Activity Invoice' Forms
The 'Activity Through Date' field is added to the 'Provider Activity Invoice' forms.
The 'Activity Through Date' field is added to the Avatar MSO 'Provider Activity Invoice' and 'Provider Activity Invoice with Override' forms. In addition, the 'Activity Date' field is updated to 'Activity From Date' in the 'Provider Activity Invoice' and 'Provider Activity Invoice with Override' forms.
Value Added: Adds 'Activity Through Date' field to Avatar MSO 'Provider Activity Invoice' forms
Topics
• NX • Provider Activity
 
Acceptance Tests
AV-68086 Summary | Details
'Provider Activity Invoice' Forms
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Provider Activity Invoice
  • Provider Activity Invoice with Override
Scenario 1: 'Provider Activity Invoice' - Form Verification
Specific Setup:
  • Avatar MSO Contracting Provider(s) with Provider Activity Authorization record(s) valid for Provider Activity Invoice entry
  • Crystal Reports or other SQL reporting tool
Steps
  1. Open the Avatar MSO 'Provider Activity Invoice' form.
  2. Select Contracting Provider for Provider Activity Invoice entry/review.
  3. Select existing Provider Activity Invoice for review/edit, or click 'Add' button for new Provider Activity Invoice entry.
  4. Enter/select values for 'Invoice/Name Description', 'Invoice Date' and 'Provider Invoice Identifier' fields.
  5. Navigate to 'Provider Activity Invoice Details' section of form.
  6. Click 'Add New Item' button for new Provider Activity entry, or select existing Provider Activity entry/row and click 'Edit Selected Item' button.
  7. Select value in 'Funding Source' field.
  8. Ensure 'From Date' and 'Through Date' fields are present in 'Provider Activity Invoice' form.
  9. 'From Date' field replaces previously existing 'Activity Date' field
  10. 'Through Date' field is not required for Provider Activity row/entry
  11. Enter/select value for 'From Date' field (and 'Through Date' field if desired).
  12. Ensure that on entry of 'From Date' and/or 'Through Date' value which is later than 'Invoice Date' for Provider Activity Invoice, user is presented with error dialog noting 'Activity From Date cannot be past the Invoice Date' or 'Activity Through Date cannot be past the Invoice Date' and the entry/edit is disallowed.
  13. Ensure that on entry of 'Through Date' value which is earlier than 'From Date' value for Provider Activity entry/row, user is presented with error dialog noting 'Activity To Date cannot be before Activity From Date' and the entry/edit is disallowed.
  14. Enter/select values for 'Activity Type', 'Activity Unit' and 'Activity Amount' fields (as well as 'Performing Provider' and 'Contracting Provider Program' and fields if desired).
  15. Click 'Display Valid Authorizations' button to display/select associated Provider Activity Authorization.
  16. Ensure Provider Activity Authorization(s) valid for Provider Activity association are displayed for selection (based on 'From Date' and 'Through Date' values entered for Provider Activity compared to 'Start Date'/'End Date' values for Provider Activity Authorization records).
  17. If no applicable Provider Activity Authorization exists, ensure user is presented with dialog noting 'No authorizations are on file which match the entered criteria.'
  18. Select Provider Activity Authorization record/row and click 'OK' button.
  19. Ensure 'Activity Status' field value is determined by Avatar MSO on entry/selection of Provider Activity detail field values (and 'Explanation Of Coverage' field is populated with reason/information for 'Pended' or 'Denied' status services).
  20. 'Explanation Of Coverage' examples:
  21. 'Invalid authorization'
  22. 'Activity From Date is before the authorization start date'
  23. 'Activity Through Date is after the authorization end date'
  24. Select 'Activity Status Reason' field value if desired.
  25. Repeat Provider Activity entry/update steps as desired.
  26. Click 'Submit' button to file 'Provider Activity Invoice' form with Provider Activity entries.
  27. Re-open the Avatar MSO 'Provider Activity Invoice' form (selecting same Contracting Provider/Provider Activity Invoice for review).
  28. Navigate to 'Provider Activity Invoice Details' section of form.
  29. Select previously entered/updated Provider Activity entry/row and click 'Edit Selected Item' button.
  30. Ensure 'From Date' and 'Through Date' field values for selected Provider Activity entry/row (as well as all other field values for selected row).
  31. Open Crystal Reports or other SQL reporting tool.
  32. In Avatar MSO SQL table 'SYSTEM.prov_act_inv_detail', ensure that 'From Date' and 'Through Date' values filed via 'Provider Activity Invoice' form are present in fields 'activity_date' and 'activity_to_date' (respectively).
Scenario 2: 'Provider Activity Invoice With Override' - Form Verification
Specific Setup:
  • Avatar MSO Contracting Provider(s) with Provider Activity Authorization record(s) valid for Provider Activity Invoice entry
  • Crystal Reports or other SQL reporting tool
Steps
  1. Open the Avatar MSO 'Provider Activity Invoice With Override' form.
  2. Select Contracting Provider for Provider Activity Invoice entry/review.
  3. Select existing Provider Activity Invoice for review/edit, or click 'Add' button for new Provider Activity Invoice entry.
  4. Enter/select values for 'Invoice/Name Description', 'Invoice Date' and 'Provider Invoice Identifier' fields.
  5. Navigate to 'Provider Activity Invoice Details' section of form.
  6. Click 'Add New Item' button for new Provider Activity entry, or select existing Provider Activity entry/row and click 'Edit Selected Item' button.
  7. Select value in 'Funding Source' field.
  8. Ensure 'From Date' and 'Through Date' fields are present in 'Provider Activity Invoice With Override' form.
  9. 'From Date' field replaces previously existing 'Activity Date' field.
  10. 'Through Date' field is not required for Provider Activity row/entry.
  11. Enter/select value for 'From Date' field (and 'Through Date' field if desired).
  12. Ensure that on entry of 'From Date' and/or 'Through Date' value which is later than 'Invoice Date' for Provider Activity Invoice, user is presented with error dialog noting 'Activity From Date cannot be past the Invoice Date' or 'Activity Through Date cannot be past the Invoice Date' and the entry/edit is disallowed.
  13. Ensure that on entry of 'Through Date' value which is earlier than 'From Date' value for Provider Activity entry/row, user is presented with error dialog noting 'Activity To Date cannot be before Activity From Date' and the entry/edit is disallowed.
  14. Enter/select values for 'Activity Type', 'Activity Unit' and 'Activity Amount' fields (as well as 'Performing Provider' and 'Contracting Provider Program' and fields if desired).
  15. Click 'Display Valid Authorizations' button to display/select associated Provider Activity Authorization.
  16. Ensure Provider Activity Authorization(s) valid for Provider Activity association are displayed for selection (based on 'From Date' and 'Through Date' values entered for Provider Activity compared to 'Start Date'/'End Date' values for Provider Activity Authorization records).
  17. If no applicable Provider Activity Authorization exists, ensure user is presented with dialog noting 'No authorizations are on file which match the entered criteria.'
  18. Select Provider Activity Authorization record/row and click 'OK' button.
  19. Ensure 'Activity Status' field value is determined by Avatar MSO on entry/selection of Provider Activity detail field values (and 'Explanation Of Coverage' field is populated with reason/information for 'Pended' or 'Denied' status services).
  20. 'Explanation Of Coverage' examples:
  21. 'Invalid authorization'
  22. 'Activity From Date is before the authorization start date'
  23. 'Activity Through Date is after the authorization end date'
  24. 'Activity Status' field value may be manually selected/set in the 'Provider Activity Invoice With Override' form.
  25. Select 'Activity Status Reason' field value if desired.
  26. Repeat Provider Activity entry/update steps as desired.
  27. Click 'Submit' button to file 'Provider Activity Invoice With Override' form with Provider Activity entries.
  28. Re-open the Avatar MSO 'Provider Activity Invoice With Override' form (selecting same Contracting Provider/Provider Activity Invoice for review).
  29. Navigate to 'Provider Activity Invoice Details' section of form.
  30. Select previously entered/updated Provider Activity entry/row and click 'Edit Selected Item' button.
  31. Ensure 'From Date' and 'Through Date' field values for selected Provider Activity entry/row (as well as all other field values for selected row).
  32. Open Crystal Reports or other SQL reporting tool.
  33. In Avatar MSO SQL table 'SYSTEM.prov_act_inv_detail', ensure that 'From Date' and 'Through Date' values filed via 'Provider Activity Invoice With Override' form are present in fields 'activity_date' and 'activity_to_date' (respectively).
Topics
• NX • Provider Activity

 

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