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Avatar MSO 2024 Monthly Release 2024.02.00 Details

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Product Requirements and Recommendations

Avatar MSO required
RADplus required

  • Guardiant - metric processing
    The system is prepared for future functionality
Included Updates
None
Product Update Description
The system is prepared for future functionality.
Topics
• 837 Professional
  • Avatar MSO 'Replacement Claim Assignment (CMS-1500)' Form
    The 'Replacement Claim Assignment (CMS-1500)' form is added to Avatar MSO.
    The 'Replacement Claim Assignment (CMS-1500)' form allows for Replacement claim/service entry for existing 'Closed' status Avatar MSO CMS-1500/Professional services. On selection/filing of Replacement Claim/Service Assignment details, Retro Claim Adjudication 'Void' (full takeback) entries will be created for original claim/service(s) and new claim/service(s) will be created for subsequent Claim Processing adjudication.
  • Avatar MSO 'Replacement Claim Assignment (UB-04)' Form
    The 'Replacement Claim Assignment (UB-04)' form is added to Avatar MSO.
    The 'Replacement Claim Assignment (UB-04)' form allows for Replacement claim/service entry for existing 'Closed' status Avatar MSO UB-04/Institutional services. On selection/filing of Replacement Claim/Service Assignment details, Retro Claim Adjudication 'Void' (full takeback) entries will be created for original claim/service(s) and new claim/service(s) will be created for subsequent Claim Processing adjudication.
  • Avatar MSO 'Provider EOB Report'
    The Avatar MSO 'Provider EOB Report' is updated to denote claims/services filed as 'Replacement' claims with '(R)'.
  • Avatar MSO 'Void Claim Assignment' Form
    'Performing Provider' is added as a service selection criteria field in the 'Void Claim Assignment' Form.
    The Avatar MSO 'Void Claim Assignment' Form will allow service selection for Void entry based on the following service selection criteria fields: - 'From Date Of Service' - 'Through Date Of Service' - 'Client ID' - 'Contracting Provider' - 'Contracting Provider Program' - 'Performing Provider'
  • Avatar MSO to Parent System Service Filing
    The Avatar MSO to Avatar PM/Cal-PM parent service push process has been updated for future functionality.
  • Pended claims/services in Avatar MSO 'Close Batch' form
    An issue is resolved to ensure that the pop-up message 'This client is not eligible for this service. Avatar Financial Eligibility check failed' is not produced in the Avatar MSO 'Close Batch' form for each claim that contains pended service(s).
  • Avatar MSO to Avatar PM/Cal-PM Service Filing
    An issue is resolved to ensure correct linking of primary and add-on services in Avatar PM/Cal-PM when originating via Avatar MSO.
Included Updates
2, 7, 9, 10, 11, 15, 20
Product Update Description
The following changes are made: 1) The 'Replacement Claim Assignment (CMS-1500)' and 'Replacement Claim Assignment (UB-04)' forms are added to Avatar MSO. 2) The MSO to parent service push process has been updated for future functionality. 3) An issue is resolved where upon closing of a batch, the pop-up message "This client is not eligible for this service. Avatar Financial Eligibility check failed." is produced for each claim that contains a pended service. 4) An issue is resolved to ensure correct linking of primary and add-on services in Avatar PM when originating via Avatar MSO.
Topics
• Retro Claim Adjudication • Claims Processing • Replacement Claim Assignment • Reports • MSO To Parent System Integration Mapping • Close Batch • CPT Code Definition • 837 Professional
  • MSO - Members by Authorized Procedure Code
    The menu launched report has been converted to a report definition for "Members by Authorized Procedure Code".
    This change involves the conversion of the previously menu launched report to a report definition. This report definition is specifically for "Members by Authorized Procedure Code". This allows for a more streamlined and efficient way of generating reports.
Included Updates
None
Product Update Description
Updated the 'Members By Authorized Procedure Code' form from a menu launched report to a report definition.
Topics
• Contracting Provider Service Authorization • Service Authorizations
  • MSO - Active Member Enrollment
    A new feature has been introduced to convert the menu launched report to a report definition for "Active Member Enrollment".
    The feature allows the conversion of the previously menu launched report into a more accessible and efficient report definition specifically for "Active Member Enrollment". This streamlines the process of accessing and utilizing the "Active Member Enrollment" report, making it more user-friendly and efficient.
  • MSO - Batch Display
    A new feature has been introduced to convert the menu launched report to a report definition for "Batch Display".
    The feature allows the conversion of the previously menu launched report into a more accessible and efficient report definition specifically for "Batch Display". This streamlines the process of accessing and utilizing the "Batch Display" report, making it more user-friendly and efficient.
  • MSO - Care Manager's Denied Authorizations
    A new feature has been introduced to convert the menu launched report to a report definition for "Care Manager's Denied Authorizations".
    The feature allows the conversion of the previously menu-launched report into a more accessible and efficient report definition specifically for "Care Manager's Denied Authorizations". This streamlines the process of accessing and utilizing the "Care Manager's Denied Authorizations" report, making it more user-friendly and efficient.
  • MSO - Denied Services By Procedure Code
    A new feature has been introduced to convert the Menu launched report to a report definition for "Denied Services By Procedure Code".
    The feature allows the conversion of the previously menu-launched report into a more accessible and efficient report definition specifically for "Denied Services By Procedure Code". This streamlines the process of accessing and utilizing the "Denied Services By Procedure Code" report, making it more user-friendly and efficient.
Included Updates
None
Product Update Description
The following reports have been re-installed as report definitions to support Avatar NX: 'Active Member Enrollment', 'Denied Services By Procedure Code', 'Batch Display', 'Care Manager's Denied Authorizations'.
Topics
• Member Enrollment • Database Management • Claims Processing • Service Authorizations
  • SYSTEM.billing_837p_claim_data and SYSTEM.billing_837p_service_data - Field validation
    SQL tables SYSTEM.billing_837p_claim_data and SYSTEM.billing_837p_service_data are enhanced to add new fields to store information from the 2310D/2420D NM1 element from the 837 Health Claim Professional file.
    Users can find additional fields within the SYSTEM.billing_837p_claim_data and SYSTEM.billing_837p_service_data SQL tables. These fields are specifically designed to capture and store data from the 2310D/2420D NM1 If an inbound MSO claim has supervising practitioner information included in the 2310D and/or 2420D segment of the 837 Health Claim Professional file.
Included Updates
None
Product Update Description
Avatar MSO is updated to support the '2310D' and '2420D' segments on 837 Professional files.
Topics
• Database Management • 837 Health Care Claim Professional • 837 Professional
  • MSO - Services paid within 30 days
    The menu launched report is converted to a report definition for "Services paid within 30 days".
Included Updates
None
Product Update Description
Updated the 'Services Paid Within 30 Days' form from a menu launched report to a report definition.
Topics
• Create EOB • Reports • Create Voucher • Service Authorizations
  • MSO - Member by Authorized Provider
    The menu launched report is converted to a report definition for "Member by Authorized Provider".
  • MSO - Paid Services by Procedure Code
    The menu launched report is converted to a report definition "Paid Services by Procedure Code".
Included Updates
None
Product Update Description
Updated the 'Members By Authorized Provider' and 'Paid Services by Procedure Code' forms from menu launched reports to report definitions.
Topics
• Contracting Provider Service Authorization • Member Enrollment • Service Authorizations • Create EOB • Create Voucher
 

Avatar_MSO_2024_Monthly_Release_2024.02.00_Details.csv