Avatar MSO 2024 Monthly Release 2024.02.00 Summary

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NEW7 CHANGED0 FIXED1

New (7)

Update 14 Details \| User Acceptance Tests Guardiant - metric processing The system is prepared for future functionality Value Added: Prepares Avatar MSO for improvements made to internal Guardiant metric processing	Topics • 837 Professional

Update 21 Details \| User Acceptance Tests Avatar MSO 'Replacement Claim Assignment (CMS-1500)' Form The 'Replacement Claim Assignment (CMS-1500)' form is added to Avatar MSO. Value Added: Adds 'Replacement Claim Assignment (CMS-1500)' form and functionality to Avatar MSO. Avatar MSO 'Replacement Claim Assignment (UB-04)' Form The 'Replacement Claim Assignment (UB-04)' form is added to Avatar MSO. Value Added: Adds 'Replacement Claim Assignment (UB-04)' form and functionality to Avatar MSO. Avatar MSO 'Provider EOB Report' The Avatar MSO 'Provider EOB Report' is updated to denote claims/services filed as 'Replacement' claims with '(R)'. Value Added: Updates 'Provider EOB Report' results to reflect 'Replacement' claims/services Avatar MSO 'Void Claim Assignment' Form 'Performing Provider' is added as a service selection criteria field in the 'Void Claim Assignment' Form. Value Added: Adds 'Performing Provider' as a service selection criteria field in the 'Void Claim Assignment' Form 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. Value Added: Updates Avatar MSO to parent service push process for future functionality	Topics • Retro Claim Adjudication • Claims Processing • Replacement Claim Assignment • Reports • MSO To Parent System Integration Mapping

Update 22 Details \| User Acceptance Tests MSO - Members by Authorized Procedure Code The menu launched report has been converted to a report definition for "Members by Authorized Procedure Code". Value Added: This new feature enhances the efficiency and ease of generating reports for "Members by Authorized Procedure Code".	Topics • Contracting Provider Service Authorization • Service Authorizations

Update 23 Details \| User Acceptance Tests MSO - Active Member Enrollment A new feature has been introduced to convert the menu launched report to a report definition for "Active Member Enrollment". Value Added: Enhances the efficiency and accessibility of the "Active Member Enrollment" report. MSO - Batch Display A new feature has been introduced to convert the menu launched report to a report definition for "Batch Display". Value Added: Enhances the efficiency and accessibility of the "Batch Display" report. 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". Value Added: Enhances the efficiency and accessibility of the "Care Manager's Denied Authorizations" report. 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". Value Added: Enhances the efficiency and accessibility of the "Denied Services By Procedure Code" report.	Topics • Member Enrollment • Database Management • Claims Processing • Service Authorizations

Update 26 Details \| User Acceptance Tests 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. Value Added: Enhance data accuracy and integrity for billing processes with new field validations, directly benefiting client’s operational efficiency. This new feature is relevant as it improves the overall user experience and ensures the precision of billing data.	Topics • Database Management • 837 Health Care Claim Professional • 837 Professional

Update 28 Details \| User Acceptance Tests MSO - Services paid within 30 days The menu launched report is converted to a report definition for "Services paid within 30 days". Value Added: This enhancement streamlines report processing.	Topics • Create EOB • Reports • Create Voucher • Service Authorizations

Update 29 Details \| User Acceptance Tests MSO - Member by Authorized Provider The menu launched report is converted to a report definition for "Member by Authorized Provider". Value Added: This enhancement streamlines report processing. MSO - Paid Services by Procedure Code The menu launched report is converted to a report definition "Paid Services by Procedure Code". Value Added: This enhancement streamlines report processing.	Topics • Contracting Provider Service Authorization • Member Enrollment • Service Authorizations • Create EOB • Create Voucher

Fixed (1)

Update 21 Details | User Acceptance Tests

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.

Topics

• Close Batch • Claims Processing • MSO To Parent System Integration Mapping • CPT Code Definition • 837 Professional

Avatar_MSO_2024_Monthly_Release_2024.02.00_Details.csv