Avatar MSO 2024 Update 20

1. Open 'Registry Settings' form.
2. Enter search value 'MSO Location Field' and click 'View Registry Settings' button.
3. Ensure Registry Setting 'MSO Location Field' is returned (under 'Avatar MSO-> Claims Processing -> Service Detail' path).
4. Ensure 'Registry Setting Details' field contains the following explanation text:

"The following are valid values for the behavior of the 'Location' field on the claims processing options.

0: Hide 'Location' - Default

1: Display 'Location'

2: Display and push 'Location' to Parent System.

3: Display and require 'Location'

4: Display, require and push 'Location' to Parent System.

5: Display 'Location' in all forms and require 'Location' in 'Fast Service Entry', 'Claim Processing (CMS 1500)' and 'Claim Processing with Override (CMS 1500)'.

6: Display and push 'Location' to Parent System in all forms and require 'Location' in 'Fast Service Entry', 'Claim Processing (CMS 1500)' and 'Claim Processing with Override (CMS 1500)'."

• Avatar MSO Registry Setting 'MSO Location Field' may optionally be enabled/configured (Registry Setting values '0' through '6')
• Client record(s) valid for Service Entry/Claim Processing

1. Open Avatar MSO 'Claim Processing (CMS 1500)' form (and/or 'Claim Processing With Override (CMS 1500)' form).
2. Select claims processing batch for service entry/edit.
3. Open existing claim for adjudication or create new claim for service entry/edit.
4. Set value for 'Member Name or ID' and 'Provider' in claim level section (if adding new claim/services).
5. Navigate to 'Service Detail' section of form.
6. Click 'Add New Item' button (or select existing service and click 'Edit Selected Item' button).
7. Ensure that the 'Location' field is present in 'Claim Processing (CMS 1500)' form (and required/optional for entry) according to the 'MSO Location Field' Registry Setting as follows:
8. Where 'MSO Location Field' Registry Setting value is '0' - ensure that 'Location' field is not present in form
9. Where 'MSO Location Field' Registry Setting value is '1' - ensure that 'Location' field is present in form as a non-required/optional entry field
10. Where 'MSO Location Field' Registry Setting value is '2' - ensure that 'Location' field is present in form as a non-required/optional entry field
11. Where 'MSO Location Field' Registry Setting value is '3' - ensure that 'Location' field is present in form as a required entry field
12. Where 'MSO Location Field' Registry Setting value is '4' - ensure that 'Location' field is present in form as a required entry field
13. Where 'MSO Location Field' Registry Setting value is '5' - ensure that 'Location' field is present in form as a required entry field
14. Where 'MSO Location Field' Registry Setting value is '6' - ensure that 'Location' field is present in form as a required entry field
15. Enter/select values in all other service detail fields as required/desired.
16. Click 'Add New Item' button to enter additional service(s) (or select additional existing service and click 'Edit Selected Item' button to update/adjudicate additional service(s)).
17. Click 'Submit' button to file 'Claim Processing (CMS 1500)' form (or 'Claim Processing With Override (CMS 1500)' form) and claim/service(s).

• Avatar MSO Registry Setting 'MSO Location Field' may optionally be enabled/configured (Registry Setting values '0' through '6')
• Client record(s) valid for Service Entry/Claim Processing

1. Open Avatar MSO 'Claim Processing (UB-04)' form (and/or 'Claim Processing With Override (UB-04)' form).
2. Select claims processing batch for service entry/edit.
3. Open existing claim for adjudication or create new claim for service entry/edit.
4. Set value for 'Member Name or ID' and 'Provider' in claim level section (if adding new claim/services).
5. Navigate to 'Service Detail' section of form.
6. Click 'Add New Item' button (or select existing service and click 'Edit Selected Item' button).
7. Ensure that the 'Location' field is present in 'Claim Processing (UB-04)' form (and required/optional for entry) according to the 'MSO Location Field' Registry Setting as follows:
8. Where 'MSO Location Field' Registry Setting value is '0' - ensure that 'Location' field is not present in form
9. Where 'MSO Location Field' Registry Setting value is '1' - ensure that 'Location' field is present in form as a non-required/optional entry field
10. Where 'MSO Location Field' Registry Setting value is '2' - ensure that 'Location' field is present in form as a non-required/optional entry field
11. Where 'MSO Location Field' Registry Setting value is '3' - ensure that 'Location' field is present in form as a required entry field
12. Where 'MSO Location Field' Registry Setting value is '4' - ensure that 'Location' field is present in form as a required entry field
13. Where 'MSO Location Field' Registry Setting value is '5' - ensure that 'Location' field is present in form as a non-required/optional entry field
14. Where 'MSO Location Field' Registry Setting value is '6' - ensure that 'Location' field is present in form as a non-required/optional entry field
15. Enter/select values in all other service detail fields as required/desired.
16. Click 'Add New Item' button to enter additional service(s) (or select additional existing service and click 'Edit Selected Item' button to update/adjudicate additional service(s)).
17. Click 'Submit' button to file 'Claim Processing (UB-04)' form (or 'Claim Processing With Override (UB-04)' form) and claim/service(s).

• Avatar MSO Registry Setting 'MSO Location Field' may optionally be enabled/configured (Registry Setting values '0' through '6')
• Client record(s) valid for Service Entry/Claim Processing

1. Open Avatar MSO 'Fast Service Entry' form (and/or 'Fast Service Entry Submission' form).
2. Enter/select value in 'Date Claims Received' and 'Close Batches' fields (if applicable).
3. Navigate to 'Fast Service Detail' section of form.
4. Click 'Add New Item' button to enter new service.
5. Enter/select client for service entry in 'Member Name or ID', field.
6. Enter/select value in 'Funding Source', 'Provider', 'Date of Service' and 'Procedure Code' fields.
7. Ensure that the 'Location' field is present in 'Fast Service Entry' form (and required/optional for entry) according to the 'MSO Location Field' Registry Setting as follows:
8. Where 'MSO Location Field' Registry Setting value is '0' - ensure that 'Location' field is not present in form
9. Where 'MSO Location Field' Registry Setting value is '1' - ensure that 'Location' field is present in form as a non-required/optional entry field
10. Where 'MSO Location Field' Registry Setting value is '2' - ensure that 'Location' field is present in form as a non-required/optional entry field
11. Where 'MSO Location Field' Registry Setting value is '3' - ensure that 'Location' field is present in form as a required entry field
12. Where 'MSO Location Field' Registry Setting value is '4' - ensure that 'Location' field is present in form as a required entry field
13. Where 'MSO Location Field' Registry Setting value is '5' - ensure that 'Location' field is present in form as a required entry field
14. Where 'MSO Location Field' Registry Setting value is '6' - ensure that 'Location' field is present in form as a required entry field
15. Enter/select values in all other service detail fields as required/desired; repeat service entry process if desired for additional clients/services.
16. Navigate to 'Fast Service Entry Summary' main/first form section.
17. Click 'Submit Fast Service Entry' button to file services/create Avatar MSO claim processing batch(es).

• Avatar MSO Registry Setting 'Send Units to Avatar PM' must be enabled
• Avatar MSO Registry Setting 'MSO Location Field' may optionally be enabled/configured (Registry Setting values '0' through '6')
• 'File Services On Closing Of Batch Or Creation of EOB?' must be set to 'Yes' (via Avatar MSO 'MSO to Parent System Integration Mapping' form 'Service Filing' section)
• One or more 'Approved' status services originating in Avatar MSO and eligible for filing to parent Avatar PM/Cal-PM system

1. Open Avatar MSO 'Close Batch' form.
2. Note - Acceptance Testing may also be confirmed on service filing to parent Avatar PM/Cal-PM system via Avatar MSO 'Create EOB' or 'Other EOB Information' entry/filing where 'Inhibit Service Filing' restrictions are defined via 'MSO to Parent System Integration Mapping' form 'Service Filing' section
3. Select Avatar MSO Claims Processing batch containing one or more 'Approved' status services eligible for filing to parent Avatar PM/Cal-PM system.
4. Set 'Close Batch' field to 'Yes' (and click 'OK' button to close warning message dialog).
5. Click 'Submit' button to close batch/file services to parent Avatar PM/Cal-PM system.
6. In Avatar PM/Cal-PM parent system, review service information for services filed from/originating in Avatar MSO (service information may be reviewed via Avatar PM/Cal-PM 'Edit Service Information' form and/or directly via Avatar PM/Cal-PM SQL table 'SYSTEM.billing_tx_history').
7. Ensure that the 'Location' value is present in Avatar PM/Cal-PM service information for services originating in Avatar MSO according to the 'MSO Location Field' Registry Setting as follows:
8. Where 'MSO Location Field' Registry Setting value is '0' - ensure that Avatar MSO 'Location' field value is not present in Avatar PM/Cal-PM service information 'Location' field
9. Where 'MSO Location Field' Registry Setting value is '1' - ensure that Avatar MSO 'Location' field value is not present in Avatar PM/Cal-PM service information 'Location' field
10. Where 'MSO Location Field' Registry Setting value is '2' - ensure that Avatar MSO 'Location' field value is present/filed in Avatar PM/Cal-PM service information 'Location' field
11. Where 'MSO Location Field' Registry Setting value is '3' - ensure that Avatar MSO 'Location' field value is not present in Avatar PM/Cal-PM service information 'Location' field
12. Where 'MSO Location Field' Registry Setting value is '4' - ensure that Avatar MSO 'Location' field value is present/filed in Avatar PM/Cal-PM service information 'Location' field
13. Where 'MSO Location Field' Registry Setting value is '5' - ensure that Avatar MSO 'Location' field value is not present in Avatar PM/Cal-PM service information 'Location' field
14. Where 'MSO Location Field' Registry Setting value is '6' - ensure that Avatar MSO 'Location' field value is present/filed in Avatar PM/Cal-PM service information 'Location' field
15. Note - 'Location' value for Avatar PM/Cal-PM services originating in Avatar MSO may be determined/assigned by Avatar PM/Cal-PM where Avatar MSO 'Location' value is not filed under 'MSO Location Field' Registry Setting value