Avatar MSO 2022 Update 8

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Product Requirements / Recommendations

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Product Update Form Description

The following issues are resolved: 1) Performing provider registration cannot be terminated after the existing registration date is modified to an earlier date. 2) The error "[SUBSCRIPT]DOSEGMENT+25^EB837pLoad" produced when loading an 837 5010 Professional file via the '837 Health Care Claim Professional' form, and the error "[SUBSCRIPT]DOSEGMENT+36^EB837iLoad" produced when loading an 837 5010 Institutional file via the '837 Health Care Claim Institutional' form.

Included Updates

None

Required Updates

None

Details

NEW0 CHANGED0 FIXED2

Fixed (2)

AV-78357 Details \| User Acceptance Tests 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.	Topics • NX • Performing Provider

AV-78416 Details \| User Acceptance Tests '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.	Topics • 837 Health Care Claim Institutional • 837 Health Care Claim Professional • Claims Processing • NX

Acceptance Tests

AV-78357 Summary | Details

Avatar MSO 'Performing Provider Registration' Form.

Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:

Performing Provider Registration

Scenario 1: 'Performing Provider Registration' - Form Verification

Specific Setup:

A 'Performing Provider Registration' exists that has data filed for all required fields and includes a date that was overlapping from a deleted registration date.

Steps

Open Avatar MSO 'Performing Provider Registration' form.
Click 'New Performing Provider' button to create new Performing Provider Registration (or search/select existing Performing Provider Registration record for edit).
Enter/select values for 'Name', 'Registration Start Date' and any other Provider data fields as required/desired.
Ensure 'Registration End State' is not specified.
Select one or more values in 'Primary License Type for Claims' field.
Select 'Create New' from the 'Primary License Type Effective Dates' field.
Enter/select values for 'Effective Start Date', 'Primary License Type for Claims' fields.
Click 'File Primary License Type Effective Date' button.
Click 'Submit' button to file 'Performing Provider Registration' form.
Open Avatar MSO 'Performing Provider Registration' form.
Enter/select previously filed Performing Provider Registration record.
Change 'Registration Start Date' to an earlier date.
Click 'Primary License Type Effective Date' drop down. Select previously created row.
Click 'Delete Primary License Type Effective Dates' button.
Click 'Primary License Type Effective Date' drop down and Select 'Create New'.
Enter same value as 'Registration Start Date' field into the 'Effective Start Date' field.
Select 'Primary License Type for Claims' value.
Click 'File Primary License Type Effective Date' button.
Click 'Submit' button to file 'Performing Provider Registration' form.
Open Avatar MSO 'Performing Provider Registration' form
Enter/select previously filed Performing Provider Registration record.
Enter date that overlaps with the previous Registration period in 'Registration End Date' field.
Ensure “Already Active For This Date…Invalid Movement” error message is not displayed, and 'Registration End Date' is allowed.

Topics

• NX • Performing Provider

AV-78416 Summary | Details

'837 Health Care Claim Professional' Form / '837 Health Care Claim Institutional' Form

Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:

837 Health Care Claim Professional
837 Health Care Claim Institutional

Scenario 1: '837 Health Care Claim Professional' - Verification of Claim/Service Adjustment Filing

Specific Setup:

837 Professional format inbound file for compilation and posting including one or more claims/services where '2430-CAS-02' value is blank.

Steps

Open '837 Health Care Claim Professional' form.
Select 'Load File' in the 'Options' field.
Enter file path for invalid inbound 837 Professional format file where '2430-CAS-02 value' is blank.
Click 'Process' button
Ensure error dialog is displayed with message: "Missing Required Field. Unable To Determine Loop Information. 1 - 2430 - CAS"

Scenario 2: '837 Health Care Claim Institutional' - Verification of Claim/Service Adjustment Filing

Specific Setup:

837 Institutional format inbound file for compilation and posting including one or more claims/services where '2430-CAS-02' value is blank

Steps

Open '837 Health Care Claim Institutional' form.
Select 'Load File' in the 'Options' field.
Enter file path for invalid inbound 837 Institutional format file where '2430-CAS-02' value is blank.
Click 'Process' button
Ensure error dialog is displayed with message: "Missing Required Field. Unable To Determine Loop Information. 1 - 2430 - CAS"

Topics

• 837 Health Care Claim Institutional • 837 Health Care Claim Professional • Claims Processing • NX