Skip to main content

Avatar PM 2022 Monthly Release 2022.02.02 Acceptance Tests

  1. Last updated
  2. Save as PDF
Update 13 Summary | Details
Client Account Services Report
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Dynamic Form - Add To Problem List
  • Service Codes
  • Front Desk Information
  • Dynamic Form - Deposit Entry
  • Client Account Services Report
Scenario 1: Client Account Services Report - Validating payment amount
Specific Setup:
  • Guarantors/Payor:
  • A self pay guarantor is identified. Note the guarantor's code/value.
  • Client:
  • An existing client, with the above guarantor in Financial Eligibility, is selected, or a new client is admitted and assigned the above guarantor in Financial Eligibility. Note the client's id, admission date and admission program.
  • A diagnosis record is created for the client.
  • Service Code:
  • Select a service code that has a Service Fee/Cross Reference Maintenance record, noting the 'Fee’.
  • Recurring Client Charge Input:
  • Services are rendered to the client that will create charges that total more than $10,000.00. Note the service date range.
  • Client Ledger:
  • The service distributed to the self pay guarantor.
Steps
  1. Open desired form and post a payment greater than $10,000.00 to the client. Note the payment date.
  2. Validate that the generated receipt displays the full payment amount.
  3. Close the receipt.
  4. Close the form.
  5. Open the 'Client Ledger' for the client / payment date and validate that the full payment amount displays.
  6. Close the report.
  7. Close the form.
  8. Open 'Client Account Services Report'.
  9. Select the client and the payment date.
  10. Click [Process].
  11. Validate that the report displays the full payment amount.
  12. Close the report.
  13. Close the form.
  14. Repeat steps 1 -13 with a payment amount of less than $1,000.00.
Avatar AM - Front Desk Service Information - Deposit Entry
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Registry Settings (PM)
  • Dynamic Form - Add To Problem List
  • Service Codes
  • Receipt Definition
  • Dispense Locking Maintenance
  • Dynamic Form - Clear Locks
  • Medication Order
  • Fast Dose Dispensing
  • Front Desk Information
  • Dynamic Form - Deposit Entry
  • Posting/Adjustment Codes Definition
Scenario 1: Avatar AM Front Desk Information - Receipt Verification
Specific Setup:
  • Avatar AM module is installed.
  • Guarantors/Payors:
  • The guarantor is a contract guarantor with a value of ‘Contractual Allowance By Liability Distribution’ in ‘Does This Guarantor Use Contractual Allowance By Batch Or Through Liability Distribution?’.
  • Service Codes:
  • Select a minimum of two services codes that have a ‘Service Fee/ Cross Reference Maintenance’, ‘Guarantor Definition’ that contains values in ‘Maximum Amount To Distribute Per Service’, and ‘Contract Rate’. ‘Write-off Remaining Balance (Contract Guarantors Only)’ = Yes. ‘Ignore Specified Amounts When Distributing Liability’ = No.
  • Client:
  • Select a client who is assigned the above guarantor, plus a self-pay guarantor in Financial Eligibility’ or create a new client. Note the client’s id, program, and date of admission.
  • Posting/Adjustment Coded Definition:
  • Identify codes that will allow a receipt to be generated and codes that will not allow a receipt to be generated. At least one code should be a payment and one code should be an adjustment.
  • Desired method for creating services is used to create services on the same date, using both service codes. Create services on two or more different dates. Note the service dates.
Steps
  1. Open ‘Front Desk Information’.
  2. Select the desired ‘Client Id’.
  3. Select ‘Deposit Entry’.
  4. Enter the service date in ‘Date Of Receipt Or Adjustment’.
  5. Select the ‘Service Code’ if not defaulted.
  6. Select the self-pay ‘Guarantor’.
  7. Enter the ‘Amount To Post’.
  8. Select desired ‘Posting Code’ that is for a payment.
  9. Enter optional data as desired.
  10. Click [File].
  11. Validate that if the ‘Posting Code’ did not allow the receipt to be generated that the receipt did not generate.
  12. Validate that if the ‘Posting Code’ did allow the receipt to be generated that the receipt did generate.
  13. Validate that the receipt contains the current information as entered in ‘Deposit Entry’.
  14. If desired, use ‘Client Ledger’ to verify the deposit.
  15. Repeat steps 1 - 15 for a Posting Code’ that is for an adjustment.
Topics
• Billing • Front Desk • NX
Update 36 Summary | Details
'Create Interim Billing Batch' Quick Billing Batch Deletion
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Quick Billing
  • Create Interim Billing Batch File
Scenario 1: 'Create Interim Billing Batch' - Verification of Interim Billing Batch Deletion
Specific Setup:
  • Avatar PM 'Quick Billing Rule Definition' where 'Create Interim Billing Batch' is set to 'Yes'
  • One or more Interim Billing Batch(es) created via Avatar PM 'Quick Billing' form/functionality
Steps
  1. Open Avatar PM 'Create Interim Billing Batch' form.
  2. Select 'Delete Batch' in 'Create, View Or Delete Batch' field.
  3. Select Interim Billing Batch created via Avatar PM 'Quick Billing' in 'Interim Batch Number' field for deletion (or select associated Quick Billing Batch in 'Quick Billing Batch Number' field).
  4. Click 'Submit' button to file 'Create Interim Billing Batch' form/batch deletion.
  5. Verify user dialog noting 'Batch Deleted' is presented on filing; click 'OK' button to close dialog.
  6. Select 'View Batch', 'Edit Batch' or 'Delete Batch' in 'Create, View Or Delete Batch' field.
  7. Click 'Interim Batch Number' field to expand; ensure that deleted Interim Billing Batch is not present/does not exist in system following deletion.
  8. Click 'Quick Billing Batch Number' field to expand; ensure that Quick Billing Batch associated to deleted Interim Billing Batch is not present/does not exist in system following deletion.
'Quick Billing' File Name
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Quick Billing
Scenario 1: 'Quick Billing' - Verification of File Naming Convention
Specific Setup:
  • Avatar PM 'Quick Billing Rule Definition' where 'Send Generated Bill To' field is set to 'File' and 'File Description' is defined for output file naming convention
  • Example: 'Medicaid_<YYYY>_<MM>_<DD>_<CT100>'
  • One or more unclaimed service(s) meeting 'Quick Billing Rule Definition' criteria and eligible for Quick Bill file inclusion
Steps
  1. Open Avatar PM 'Quick Billing' form.
  2. Select 'Add' in 'Add New Or Edit Existing Quick Billing Batch' field.
  3. Enter value for 'First Date Of Service To Include' and 'Last Date Of Service To Include' fields.
  4. Select value in 'Billing Rule To Execute' field (or 'Billing Rule Group To Execute' field).
  5. Select 'Create Batch', 'Close Charges' and 'Generate Bills' in 'Quick Billing Tasks to Execute' field (and 'Create Claims' if desired).
  6. Enter value for 'Date of Claim' field.
  7. Click 'Submit' button to execute selected Quick Billing Rule (or Quick Billing Rule Group).
  8. Verify user dialog noting 'Compile Complete' is presented on Quick Billing execution/completion; click 'OK' button to close dialog.
  9. Navigate to file creation location/directory (as defined in Quick Billing Rule Definition 'File Location' field).
  10. Review billing file(s) created in specified location/directory to ensure that all file names are in format specified in Quick Billing Rule Definition 'File Description' field (including case where multiple 'Guarantor/Program Billing Defaults' templates are applicable to guarantors/programs included in single Quick Billing execution).
  11. Example: 'Medicaid_2022_08_05_100', 'Medicaid_2022_08_05_101'
Topics
• Interim Billing Batch • NX • Quick Billing
Update 38 Summary | Details
Client Merge - Current Census
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Current Unit Census
Scenario 1: Client Merge - Existing episode - Validate Census after merge
Specific Setup:
  • Add hospital beds to the unit using "Maintain Hospital Bed File" form.
  • Admit source client to an outpatient episode.
  • Admit target client a day after the source client into first a different outpatient episode than the source client and then into an inpatient episode.
Steps
  1. Open the "Client Merge" form.
  2. Enter the Source client from setup,
  3. Click "Yes" on "Merge All Client Data Through Single Filing".
  4. Enter the Target client from setup.
  5. Click "No" on "Create New Episode on Merge".
  6. Complete merge.
  7. Open "Current Unit Census" form and verify the target client is still listed n the hospital bed they were admitted to.
Scenario 2: Client Merge - Create new episode - Validate Census after merge
Specific Setup:
  • Add hospital beds to the unit using "Maintain Hospital Bed File" form.
  • Admit source client to an outpatient episode.
  • Admit target client a day after the source client into first a different outpatient episode than the source client and then into an inpatient episode.
Steps
  1. Open the "Client Merge" form.
  2. Enter the Source client from setup,
  3. Click "Yes" on "Merge All Client Data Through Single Filing".
  4. Enter the Target client from setup.
  5. Click "Yes" on "Create New Episode on Merge".
  6. Complete merge.
  7. Open "Current Unit Census" form and verify the target client is still listed n the hospital bed they were admitted to.
Compile and Post Residential/Inpatient services - Medical diagnosis
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Program Maintenance
  • Compile And Post Residential/Inpatient Charges
  • Post Residential/Inpatient Worklist
Scenario 1: Compile and Post Residential/Inpatient Charges - Validate Worklist Diagnosis
Specific Setup:
  • Using "Program Maintenance", select or enter an inpatient service code that has the "Primary Medical Program" selected.
  • Admit a client into an inpatient episode.
  • Add insurance information into "Financial Eligibility" form.
  • Enter a diagnosis for the client using the "Diagnosis" form.
Steps
  1. Using the "Verify Unit Census", verify the census for the test client for the date of admission only.
  2. Using the "Compile and Post Residential/Inpatient Charges" form, compile and post the inpatient services.
  3. Using the preferred method to validate SQL tables, validate the column "jointodiagnosisobject1" is populated with the diagnosis code
Scenario 2: Post Resident/Inpatient Charges - Validate worklist diagnosis
Specific Setup:
  • Using "Program Maintenance", select or enter an inpatient service code that has the "Primary Medical Program" selected.
  • Admit a client into an inpatient episode.
  • Add insurance information into "Financial Eligibility" form.
  • Enter a diagnosis for the client using the "Diagnosis" form.
Steps
  1. Using the "Verify Unit Census", verify the census for the test client for the date of admission only.
  2. Using the "Compile Residential/Inpatient Charges" form, compile the inpatient services.
  3. Using the "Post Residential/Inpatient Charges" form, post the compiled worklist.
  4. Using the preferred method to validate SQL table "SYSTEM.billing_tx_history column "jointodiagnosisobject1" is populated with the diagnosis code
Chart Review - Attached forms from child namespaces
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Attach Other Application Form to Menu (CWS)
  • Chart Review
  • Leaves
Scenario 1: Chart Review - Validate Diagnosis form attached to a child namespace menu
Specific Setup:
  • Admit or select a test client using the "Admission" form.
  • Enter or verify the client has diagnosis data using the "Diagnosis" form.
  • Add the "Diagnosis" form that was attached to the child namespace menu to the chart using "Chart Review".
Steps
  1. Open the "Attach Other Application Form to Menu" form from a child namespace such as CWS.
  2. Select "Avatar PM" from the "Application" dropdown list.
  3. Select the form to be attached to a CWS menu.
  4. Add the form to a child namespace menu.
  5. Open the "Chart Review" form.
  6. Open the "Diagnosis" form that was attached to the child namespace menu from the chart.
  7. Validate the Diagnosis data appears on the chart.
  8. Click the "Edit" button.
  9. The "Diagnosis" form launches.
  10. Add another diagnosis and file the data.
  11. After returning to the chart, click "Refresh" button.
  12. Validate the diagnosis data that was just added appears on the chart.
  13. Click "Report".
  14. Validate all diagnosis data for the client appears on the report.
Scenario 2: Chart Review - Validate Leaves form attached to a child namespace menu
Specific Setup:
  • Admit or select a test client in an inpatient episode using the "Admission" form.
  • Enter or verify the client has leave data using the "Leaves" form.
  • Add the "Leaves" form that was attached to the child namespace menu to the chart using "Chart Review".
Steps
  1. Open the "Attach Other Application Form to Menu" form from a child namespace such as CWS.
  2. Select "Avatar PM" from the "Application" dropdown list.
  3. Select the "Leaves" form to be attached to a CWS menu.
  4. Add the form to a child namespace menu.
  5. Open the "Chart Review" form.
  6. Open the "Leaves" form that was attached to the child namespace menu from the chart.
  7. Validate the Leave data appears on the chart.
  8. Click "Report".
  9. Validate all leave data for the client appears on the report.
Topics
• Client Merge • NX • Inpatient Worklist • Leaves • RADplus Utilities
Update 40 Summary | Details
Quick Billing/Electronic Billing - Natural Disaster added to the Delay Reason Code data dictionary
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Quick Billing
  • Electronic Billing
Scenario 1: Quick Billing - Field Validations with Delay Reason Code
Specific Setup:
  • Admit a client.
  • Enter a diagnosis for the new client.
  • Using the "Financial Eligibility" form, enter a guarantor being sure to provide a Subscriber Policy #.
  • Create or choose a "Quick Billing Rule Definition" to be used.
  • Create a charge that is dated prior to the # of days from the claim date for a Guarantor/Payor who has a value in the "Number of Days From The Date of Service to the Posting Date For Which A Service Requires A Delay Reason Code".
Steps
  1. Open the "Quick Billing" form.
  2. Add a new Quick Billing batch.
  3. Edit the quick billing batch just created, adding a delay reason.
  4. Click "Launch Workscreen".
  5. Select "Natural Disaster" in the "Delay Reason Code" to a row in the table.
  6. Click "Save".
  7. Click "Submit".
  8. Using the preferred method, check the SQL table "SYSTEM.billing_qb_delay_reason.
  9. Validate a row is added to the table for every service processed with a delay reason code.
Scenario 2: Electronic Billing - Field Validations - Delay Reason Code
Specific Setup:
  • Admit a new client.
  • Add Financial Eligibility for the new client.
  • Add a Diagnosis to the client.
  • Add charges for the client using "Client Charge Input". Date the services 5 days prior to the current date.
  • Close the charges using "Close Charges".
Steps
  1. Open the "Client Ledger" form and validate the charges are set to UNBILL.
  2. Open "Close Charges" and close the charge.
  3. Open the "Electronic Billing" form.
  4. Generate a professional 837 bill. Don't create claims.
  5. Validate the file using the "Dump File" "Billing Option".
  6. Generate a professional 837 bill. This time create claims.
  7. The "Clam Date" must be the current date.
  8. Set the field "Number of days from Date of Service to Date of Claim in which the service requires a Day Reason Code Assignment in 2300-CLM-20" to 1.
  9. Click "Process".
  10. A message pops up that instructs you to access the "837 Delay Reason Code Assignment".
  11. Navigate to the *837 Delay Reason Code" tab.
  12. Select the file that was just created.
  13. Select "Client" in the "Display Claims By" field.
  14. Select the test client.
  15. Click "Select Claims To Assign Delay Reason Code" button.
  16. Select a claim(s) to attach a Delay Reason Code to.
  17. Set the "Delay Reason Code" dropdown to "Natural Disaster".
  18. Click "Assign To File".
  19. Open the "Electronic Billing" form.
  20. Open the "Dump File" that was just created in prior steps.
  21. Validate the CLM segment includes a 15 at the end for the "Natural Disaster" Delay Reason Code.
Topics
• Electronic Billing • Quick Billing
Update 70 Summary | Details
Avatar PM is modified for future functionality.
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Remittance Processing Widget
Scenario 1: Remittance Processing widget - Create/Edit/Delete Batch
Steps

Internal Testing Only.

Scenario 2: Remittance Processing Widget - SQL Table 'SYSTEM.remittance_batch' Validation.
Steps

Internal Testing Only
Topics
• NX • Spreadsheet Batch Remittance Posting • Widgets
Update 79 Summary | Details
Accounts Receivable Management – Guarantor has an ‘&’ in name
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • AR Console Configuration
  • AR Console User Defaults Setup
  • System Task Scheduler
  • Practitioner Numbers By Guarantor And Program
  • Create Interim Billing Batch File
  • Electronic Billing
  • Registry Settings (PM)
  • Dictionary Update (PM)
  • Service Codes
  • Program Maintenance
Scenario 1: AR Console User Defaults Setup - field validation
Specific Setup:
  • The following registry setting has a value of Y: Avatar PM->Billing->Accounts Receivable Management->->->Enable Accounts Receivable Management Functionality.
  • User Definition has been used to give the signed in user access to the form: Avatar PM / Billing / AR Management / AR Console User Defaults Setup.
  • View Definition / NX View Definition has been used to place the widget on the tester's home view.
  • Note the ID of at least two more users.
  • Guarantors/Payor: The 'Guarantor Name' & the 'Guarantor Name For Alpha Lookup' fields contain an '&'.
  • System Task Scheduler:
  • The 'Auto AR Batch Update' was processed after the claims were created.
Steps
  1. Open ‘AR Console User Defaults Setup’.
  2. Click ‘New Row’ and add a row for the signed in user, or if the signed in user exists in a row select the row.
  3. Click ‘All’ in the following fields: ‘Financial Class(es)’, ‘Guarantor(s)’, ‘Treatment Setting(s)’ ‘Program(s)’ and ‘Client Last Name Initials to be Worked’.
  4. Add desired value to ‘Aged Over # Days’. Note the value.
  5. Click ‘New Row’ and add a row for the first additional user from ‘Setup’, or if the user exists in a row select the row.
  6. Select desired values in ‘Financial Class(es)’, ‘Guarantor(s)’, ‘Treatment Setting(s)’ ‘Program(s)’, ‘Client Last Name Initials to be Worked’, and ‘Aged Over # Days’.
  7. Note the values of each field.
  8. Click ‘New Row’ and add a row for the second additional user from ‘Setup’, or if the user exists in a row select the row.
  9. Select desired values in ‘Financial Class(es)’, ‘Guarantor(s)’, ‘Treatment Setting(s)’ ‘Program(s)’, ‘Client Last Name Initials to be Worked’, and ‘Aged Over # Days’.
  10. Note the values of each field.
  11. Click [Submit].
  12. Open ‘AR Console User Defaults Setup’.
  13. Select the row for the signed in user.
  14. Validate that the following fields have every available item in the checklist selected: ‘Financial Class(es)’, ‘Guarantor(s)’, ‘Treatment Setting(s)’ ‘Program(s)’ and ‘Client Last Name Initials to be Worked’.
  15. Select the row for the first additional user.
  16. Validate that the values that were submitted were retained.
  17. Select the row for the second additional user.
  18. Validate that the values that were submitted were retained.
  19. Click [Discard].
  20. Open the 'Account Receivable Console' widget for the signed in user.
  21. Verify that the ‘Financial Class(es)’, ‘Guarantor(s)’, ‘Treatment Setting(s)’ ‘Program(s)’ and ‘Client Last Name Initials to be Worked' fields contain all available selections.
  22. Verify that ‘Aged Over # Days' contains the value entered above.
  23. Close the widget.
Scenario 2: Account Receivable Console - Copy Claim Follow-Up/Notes
Specific Setup:
  • Guarantors/Payors:
  • Guarantor 1: The 'Guarantor Name' & the 'Guarantor Name For Alpha Lookup' fields contain an '&'.
  • Guarantor 2: The 'Guarantor Name' & the 'Guarantor Name For Alpha Lookup' fields do not contain an '&’.
  • Clients:
  • Client A: Has a minimum of two outstanding claims for Guarantor 1. Note the client’s last name and the program.
  • Client B: Has a minimum of two outstanding claims for Guarantor 2. Note the client’s last name and the program.
  • Tester has access to the AR Console.
  • AR Console User Defaults Setup:
  • Tester has been given access to both Guarantors/Payors, the client’s last name initials, and the client programs.
  • System Task Scheduler:
  • The 'Auto AR Batch Update' was processed after the claims were created.
Steps
  1. Open the ‘Account Receivable Console’ widget.
  2. Validate that the ‘Guarantor’ field contains the selected guarantors, including the guarantor with the ‘&’ in the 'Guarantor Name' & the 'Guarantor Name For Alpha Lookup'
  3. Enter the ‘Client ID for Client A.
  4. Click [Search].
  5. Select a minimum of two claims in the ‘Claims with Outstanding Receivables’ gird.
  6. Click [Add Claim Follow-Up/Note].
  7. Validate the claim number in ‘Claim Follow-Up’.
  8. Go to the Follow-Up Notes’ section.
  9. Validate the note created by the AR Console exists.
  10. Click [New Row].
  11. Enter desired ‘Follow-Up Date’, ‘Comments’ and any other desired data.
  12. Click [File Updates].
  13. Click [OK].
  14. Select the row that was added above.
  15. Click [Copy Note].
  16. Select the claim to copy the note to in ‘Copy Follow-Up Note’.
  17. Click [Save].
  18. Select the claim number in ‘Claim Follow-Up’ that was selected in ‘Copy Follow-Up Note’.
  19. Validate that the copy note, and the note created by the AR Console exist in the ‘Claim Follow-Up’.
  20. Select the ‘AR List’ section.
  21. Repeat steps 3 - 20 for Client B.
  22. Close the widget.
Topics
• Accounts Receivable Management
Update 85 Summary | Details
'Maintain Hospital Bed File' - 'Bed' field
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Bed Management (View Only)
  • Avatar NX Report Viewer
  • Bed Reservation
Scenario 1: Maintain Hospital Bed File
Specific Setup:
  • Existing Units, Rooms, and Beds must be defined in 'Maintain Hospital Bed File'.
Steps
  1. Access the 'Maintain Hospital Bed File' form.
  2. Select the "Room/Bed Name Change" section.
  3. Select any value in the 'Unit' field.
  4. Select any value in the 'Room' field.
  5. Validate the 'New Room' field contains the current room name.
  6. Enter any new value in the 'New Room' field.
  7. Enter any new value in the 'New Bed' field.
  8. Leave the 'Bed' field blank.
  9. Click [Submit].
  10. Validate an error message is displayed stating: "Please select a bed first".
  11. Click [OK].
  12. Select any value in the 'Bed' field.
  13. Validate the 'New Bed' field contains the current bed name.
  14. Enter any new value in the 'New Bed' field.
  15. Click [Submit] and [Yes].
  16. Select the same value selected in the previous steps in the 'Unit' field.
  17. Select the same value selected in the previous steps in the 'Room' field.
  18. Validate the 'New Room' field contains the current room name.
  19. Select the same value selected in the previous steps in the 'Bed' field.
  20. Validate the 'New Bed' field contains the new bed name filed.
  21. Close the form.
Topics
• Maintain Hospital Bed File
Update 89 Summary | Details
Avatar PM is prepared for future functionality
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Delete Bed Assignment
  • CareFabric Monitor
Scenario 1: Validate 'Bed Assignment' and 'Delete Bed Assignment' on 'CareFabric Monitor' for PM
Specific Setup:
  • Inpatient client assigned to a room and bed (Client A).
Steps
  1. Open 'Bed Assignment'.
  2. Select 'Client A'.
  3. Assign a different 'Unit', 'Room' and 'Bed' and click [Submit].
  4. Open 'Delete Bed Assignment'.
  5. Select 'Client A' and the corresponding episode.
  6. Select the last 'Bed assignment' from the 'Bed Assignment to Delete' field.
  7. Click [Submit].
  8. Open 'CareFabric Monitor'.
  9. Enter the current date in the 'From Date' field.
  10. Enter the current date in the 'Through Date' field.
  11. Select 'Client A'.
  12. Click [View Activity Log].
  13. Verify the data is correct.
  14. Click [Click to View Record].
  15. Verify the data is correct.
Topics
• Bed Assignment • CareFabric Monitor • Delete Bed Assignment
Update 91 Summary | Details
Edit Service Information - Editing billing inhibited 'Open' service
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Inhibit Billing By Service
  • Dynamic Form - Inhibit Services - Please review your selections to Inhibit services
  • Dynamic Form - File Service Inhibit Information
  • Inhibited Services For Billing Report
  • Crystal Report Viewer
  • Dynamic Form - Un-Inhibit services - Please review your selections to Un-Inhibit service
Scenario 1: Edit Service Information - Editing an open service
Specific Setup:
  • Identify an existing client that has at least one existing open service.
Steps
  1. Open the 'Edit Service Information' form.
  2. Select the desired client in the 'Client ID' field.
  3. Select desired episode from the 'Episode Number' field.
  4. Click [Select Service(s) To Edit].
  5. Verify the 'Select Service(s) To Edit' dialog is displayed.
  6. Select desired service from the 'Select Service(s) To Edit' dialog.
  7. Enter a different value in the 'Duration (Minutes)' field.
  8. Select a new service code in the 'Service Code' field.
  9. Click [OK].
  10. Submit the form.
  11. Validate a "Form Return" message is displayed stating: Submitting has completed. Do you wish to return to form?
  12. Click [No].
  13. Query the 'SYSTEM.billing_tx_history' SQL table.
  14. Validate the 'PATID' column is equal to the correct client id identified in the setup.
  15. Validate the 'date_of_service' column is equal to correct date of service rendered to the client.
  16. Validate the 'Service Code' column contains correct service code submitted in the 'Edit Service Information' form.
  17. Validate the 'option_desc' column contains 'Edit Service Information'.
Scenario 2: Edit Service Information - Editing 'Open' service that is marked as billing inhibited / uninhibited
Specific Setup:
  • Guarantors/Payor:
  • An existing guarantor is identified. Note the guarantor's code / name.
  • Admission:
  • An existing client, in an outpatient episode, is identified or a new client is admitted to an outpatient program. Note the client ID, Admission date, and program.
  • Financial Eligibility:
  • The guarantor above is assigned to the client.
  • Client Charge Input:
  • A service is rendered. Note the service date.
  • Client Ledger:
  • The service is distributed to the guarantor assigned to the client and it is in 'Open' status.
Steps
  1. Open the 'Edit Service Information' form.
  2. Select the desired client in the 'Client ID' field.
  3. Select desired episode from the 'Episode Number' field.
  4. Click [Select Service(s) To Edit].
  5. Verify the 'Select Service(s) To Edit' dialog is displayed.
  6. Select desired service from the 'Select Service(s) To Edit' dialog.
  7. Select a new service code in the 'Service Code' field.
  8. Click [OK].
  9. Submit the form.
  10. Validate a "Form Return" message is displayed stating: Submitting has completed. Do you wish to return to form?
  11. Click [No].
  12. Query the 'SYSTEM.billing_tx_history' SQL table.
  13. Validate the 'PATID' column is equal to the correct client id identified in the setup.
  14. Validate the 'date_of_service' column is equal to correct date of service rendered to the client.
  15. Validate the 'Service Code' column contains correct service code in the 'Edit Service Information' form.
  16. Validate the 'option_desc' column contains 'Edit Service Information'.
  17. Open the 'Inhibit Billing By Service' form.
  18. Select desired service from the 'Select Service(s) To Mark Billing-Inhibited' field.
  19. Click [File Updates].
  20. Validate a "Please review your selections" dialog is displayed.
  21. Click [OK].
  22. Validate a "File Service Inhibit Information" dialog is displayed stating: Continue Filing?
  23. Click [Yes].
  24. Validate a "Form Return" message is displayed stating: Submitting has completed. Do you wish to return to form?
  25. Click [No].
  26. Open the 'Edit Service Information' form.
  27. Select the desired client in the 'Client ID' field.
  28. Select desired episode from the 'Episode Number' field.
  29. Click [Select Service(s) To Edit].
  30. Verify the 'Select Service(s) To Edit' dialog is displayed.
  31. Select desired service from the 'Select Service(s) To Edit' dialog.
  32. Select a new service code in the 'Service Code' field.
  33. Click [OK].
  34. Submit the form.
  35. Validate a "Form Return" message is displayed stating: Submitting has completed. Do you wish to return to form?
  36. Click [No].
  37. Query the 'SYSTEM.billing_tx_history' SQL table.
  38. Validate the 'PATID' column is equal to the correct client id identified in the setup.
  39. Validate the 'date_of_service' column is equal to correct date of service rendered to the client.
  40. Validate the 'Service Code' column contains correct service code submitted in the 'Edit Service Information' form.
  41. Validate the 'option_desc' column contains 'Edit Service Information'.
  42. Open the 'Inhibit Billing By Service' form.
  43. Enter the practitioner associated to the logged in user in the 'Rendering Practitioner' field.
  44. Select desired service from the 'Select Service(s) To Mark Billing-Uninhibited' field.
  45. Click [File Updates].
  46. Validate a "Please review your selections" dialog is displayed.
  47. Click [OK].
  48. Validate a "File Service Inhibit Information" dialog is displayed stating: Continue Filing?
  49. Click [Yes].
  50. Validate a "Form Return" message is displayed stating: Submitting has completed. Do you wish to return to form?
  51. Click [No].
  52. Open the 'Edit Service Information' form.
  53. Select the desired client in the 'Client ID' field.
  54. Select desired episode from the 'Episode Number' field.
  55. Click [Select Service(s) To Edit].
  56. Verify the 'Select Service(s) To Edit' dialog is displayed.
  57. Select desired service from the 'Select Service(s) To Edit' dialog.
  58. Select a new service code in the 'Service Code' field.
  59. Click [OK].
  60. Submit the form.
  61. Validate a "Form Return" message is displayed stating: Submitting has completed. Do you wish to return to form?
  62. Click [No].
  63. Query the 'SYSTEM.billing_tx_history' SQL table.
  64. Validate the 'PATID' column is equal to the correct client id identified in the setup.
  65. Validate the 'date_of_service' column is equal to correct date of service rendered to the client.
  66. Validate the 'Service Code' column contains correct service code submitted in the 'Edit Service Information' form.
  67. Validate the 'option_desc' column contains 'Edit Service Information'.
Topics
• Edit Service Information • NX
Update 95 Summary | Details
Avatar PM is modified for future functionality.
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Client Charge Input Web Service
Scenario 1: Client Charge Input: Support UTC fields
Steps

Internal Testing Only

Scenario 2: Client Charge Input Web Service: Support UTC fields
Steps

Internal Testing Only
Topics
• Client Charge Input • NX • Recurring Client Charge Input • UTC Fields • Web Services
Update 96 Summary | Details
837 Institutional - Claim Frequency Code, Patient Status Code and Discharge Hour
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Discharge
  • Electronic Billing
Scenario 1: 837 Institutional - Validation of Claim Frequency Code (2300-CLM-05-3) and Patient Status Code (2300-CL1-03) fields and Discharge Hour segment if there are claimed services on the discharge date
Specific Setup:
  • Admit a new client into an inpatient episode.
  • Populate the Social Security Number field.
  • Establish a Financial Eligibility record for a select guarantor.
  • Using the "Diagnosis" form, enter a diagnosis for the client.
Steps
  1. Using the "Client Charge Input" form, enter in 2 room and board charges and 1 non room and board service on 3 consecutive days.
  2. Validate the charges were distributed to the correct guarantor using "Client Ledger".
  3. Discharge the client on the last of the 3 consecutive service dates from the first step.
  4. Using the "Close Charges" form, close all 3 charges.
  5. Using the "Electronic Billing" form to generate an 837 Professional file for the non room and board charge that was created.
  6. Validate the non room and board charge that was generated in previous steps is included on the bill and claim the bill.
  7. Using the "Electronic Billing" form to generate an 837 Institutional file for the 2 room and board charges.
  8. Validate the Claim Frequency Code (2300-CLM-05-3) is equal to "1" (Admit Through Discharge).
  9. Validate the Discharge Hour segment (2300-DTP-*96) is included in the output.
  10. Validate the Patient Status Code (2300-CL1-1-03) is equal to the value "Patient Status Over-Ride (2300-CL1-03) extended attribute based on the "Type of Discharge" value from the Discharge record.
Scenario 2: 837 Institutional - Validate Claim Frequency Code (2300-CLM-05-3) and Patient Status Code (2300-CL1-03) fields and Discharge Hour segment when there are unclaimed services on the discharge date
Specific Setup:
  • Admit a new client into an inpatient episode.
  • Populate the Social Security Number field.
  • Establish a Financial Eligibility record for a select guarantor.
  • Using the "Diagnosis" form, enter a diagnosis for the client.
Steps
  1. Using the "Client Charge Input" form, enter in 2 room and board charges and 1 non room and board service on 3 consecutive days.
  2. Validate the charges were distributed to the correct guarantor using "Client Ledger".
  3. Discharge the client on the last of the 3 consecutive service dates from the first step.
  4. Using the "Close Charges" form, close all 3 charges.
  5. Using the "Electronic Billing" form to generate an 837 Institutional file for the 2 room and board charges.
  6. Validate the Claim Frequency Code (2300-CLM-05-3) is equal to "1" (Admit Through Discharge).
  7. Validate the Discharge Hour segment (2300-DTP-*96) is included in the output.
  8. Validate the Patient Status Code (2300-CL1-1-03) is equal to the value "Patient Status Over-Ride (2300-CL1-03) extended attribute based on the "Type of Discharge" value from the Discharge record.
Topics
• 837 Institutional • NX