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Avatar PM 2022 Update 109

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Product Update Form Description

The following issues are resolved: 1) Advanced billing event rules defined based on the Site Specific Treatment History table in the 'Advanced Billing Rule Definition' form are not properly evaluated for transferred services. 2) Posting a partial hospitalization worklist via the 'Post Partial Hospitalization/Day Worklist' form will not include the appropriate attending practitioner. 3) "[SUBSCRIPT]MULTRCO+6^HRADRSLD" error can occur when compiling a service code import file in the 'Service Code Upload Process' form. 4) Non-Covered Days Amount (2300-HI) field on the 837 Institutional bill might be incorrect for clients who had a leave inclusive of the bill period. Additionally, service selection logic on all Charge Input forms will now ensure that the service program matches the program specified on the 'Assigned Services' grid on the Treatment Plan form (Intervention section) when the CWS registry setting 'Enable Service Entry Restriction by Client Treatment Plan' is set to "E".

Included Updates

3, 9, 13, 18, 25, 34, 41, 48, 51, 55, 58, 59, 61, 62, 67, 73, 77, 84, 87, 88, 90, 91, 94, 95, 97, 99, 100, 103, 108

Required Updates

None

Details
NEW1 CHANGED0 FIXED4
New (1)
Service Entry - After Treatment Plan Intervention Assigned Services
An issue has been resolved where service entry doesn't restrict service entry by program in the Treatment Plan Intervention Services when the registry setting 'Enable Service Entry Restriction by Client Treatment Plan' is set to 'E'.
Value Added: Service Entry - Enable Service Entry Restriction by Client Treatment Plan
Topics
• Client Charge Input • NX • Treatment Plan
 
Fixed (4)
Advanced Billing Rules - Site Specific Section Modeling integer fields
The issue has been resolved where advanced billing event rules defined based on the Site Specific Treatment History table in the 'Advanced Billing Rule Definition' form are not properly evaluated for transferred services.
Topics
• Advanced Billing Rule Definition
 
Compile and Post Partial Hospitalization/Day Treatment
An issue has been resolved where a change in attending practitioner isn't reported correctly while posting a partial hospitalization worklist via the 'Post Partial Hospitalization/Day Worklist' form.
Topics
• Inpatient Worklist • NX
 
Service Code Upload - Error Handling
An error has been resolved in the "Service Code Upload" where invalid data is encountered in the import file and an error occurred when trying to complete a service code upload.
Topics
• NX • Registry Settings • Service Code Upload Process • Service Codes
 
Electronic Billing - 837 Institutional Non Covered Days
An issue has been resolved with the "Electronic Billing" form when an 837 Institutional file is created, where non covered days room and board step down detox to rehab are calculating incorrectly.
Topics
• Electronic Billing • Leaves • Service Code Upload Process
 
Acceptance Tests
AV-61554 Summary | Details
Service Entry - After Treatment Plan Intervention Assigned Services
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Registry Settings (PM)
  • Treatment Plan
  • Admission
  • Client Charge Input
  • Program Maintenance
  • Site Specific Section Modeling (CWS)
Scenario 1: Treatment Plan (Interventions) - "Assigned Services" grid functionality
Specific Setup:
  • Client must be admitted to an active episode. (Client A).
  • Registry setting 'Avatar CWS->Treatment Plan->->->->Enable Service Entry Restriction by Client Treatment Plan' must be enabled.
Steps
  1. Select "Client A" and access the 'Treatment Plan' form.
  2. Click [Add].
  3. Set the 'Plan Date' field to the current date.
  4. Select any value in the 'Plan Type' field.
  5. Select any value from 'Problem List'.
  6. Enter any value in the 'Strengths' field.
  7. Enter any value in the 'Weakness' field.
  8. Enter any value in the 'Discharge Planning' field.
  9. Select "Draft" in the 'Draft/Final' field.
  10. Click [Launch Plan].
  11. Select the problem from the 'Tree View'.
  12. Select any value from the 'Status' field.
  13. Click [Add New Goal].
  14. Enter any value in the 'Goal' field.
  15. Select any value from the 'Status' field.
  16. Click [Add New Objective].
  17. Enter any value in the 'Objective' field.
  18. Select any value from the 'Status' field.
  19. Click [Add New Intervention].
  20. Enter any value in the 'Intervention' text field.
  21. Select any value from the 'Status' field.
  22. Click [Add Service] in the 'Assigned Services' field.
  23. Populate the 'Service Program' field.
  24. Enter a search value in the 'Service Code' field to bring up the listing of service code values.
  25. Select any service code.
  26. Validate the service code field is populated as expected in the 'Service Code' field.
  27. Select any value in the 'Frequency' field.
  28. Select any value in the 'Duration' field.
  29. Click [Return To Plan].
  30. Click [Submit].
  31. Validate the plan submits successfully.
  32. Select "Client A" and access the 'Treatment Plan' form.
  33. Click to edit the row just submitted.
  34. Click [Launch Plan].
  35. Click the 'Interventions' item on the plan tree
  36. Click [Add New Intervention].
  37. Enter any value in the 'Intervention' text field.
  38. Select any value from the 'Status' field.
  39. In the 'Assigned Services' grid, click [Copy Service].
  40. In the 'Add Services From Other Intervention's' dialog, choose the service added in the intervention previous submitted.
  41. Click [Copy].
  42. Validate the 'Assigned Services' grid columns are populated with the service information, as expected.
  43. Select the 'Assigned Services' row just added.
  44. Click the [Delete Service] button.
  45. Validate the service row is removed from the 'Assigned Services' grid, as expected.
  46. Click [Return to Plan].
  47. Click [Submit].
  48. Validate the plan submits successfully.

Scenario 2: Client Charge Input After Treatment Plan - Enable Service Entry Restrictions by Client Treatment Plan is enabled
Specific Setup:
  • Enable "Enable Service Entry Restriction by Client Treatment Plan" by setting it to "E".
  • After enabling the registry setting, log off Avatar and sign back in again.
  • Admit a test client into any program.
  • Using "Program Maintenance", edit the program the test client was admitted to, and set the "Enable Service Entry Restriction for Program" to "Yes".
  • Using "Program Maintenance", edit another program the test client is not admitted to and set the "Enable Service Entry Restriction for Program" to "Yes".
  • Using "Site Specific Section Modeling", add the "Assigned Services" to the Treatment Plan Interventions section.
Steps
  1. Open the "Treatment Plan" form.
  2. Begin a new treatment plan for the test client.
  3. Set it to Draft status.
  4. Add a problem, goal, objection, and intervention.
  5. In the intervention section, Click the "Add Services" button.
  6. Select the program the test client is enrolled in the "Service Program" field.
  7. Select a service code, frequency, duration, service mode, place of service, amount, agency, and staff responsible.
  8. Click "Add Services" button to add another row to the table.
  9. Select the program from setup that the client isn't enrolled in.
  10. Select a different service code than the first row.
  11. Fill out the rest of the fields.
  12. Click the "Return To Plan" button.
  13. Mark the plan as Final.
  14. Click "Submit" button.
  15. Sign or Sign and Route the document.
  16. If routed, sign on as the user document was routed to and from the "ToDos" widget, Accept the document.
  17. Open the "Client Charge Input" form.
  18. Select the test client.
  19. Set the "Service Code" field to the service code that was assigned to the program the test client is not enrolled in on the "Treatment Plan" form.
  20. Validate the drop down list doesn't contain the service code since it's not assigned to the program the client is enrolled in.
  21. Set the "Service Code" field to the service code that was assigned to the program the test client is enrolled in on the "Treatment Plan" form.
  22. Validate the service code listed in the drop down list is the one that is affiliated to the program the client is enrolled in.
  23. Complete the form by filling out all other required fields.
Topics
• Client Charge Input • NX • Treatment Plan
AV-67428 Summary | Details
Advanced Billing Rules - Site Specific Section Modeling integer fields
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Admission
  • Advanced Billing Rule Definition
  • Client Charge Input
  • Client Ledger
  • Financial Eligibility
  • Individual Cash Posting (PM)
  • Posting/Adjustment Codes Definition
  • Site Specific Section Modeling (PM)
Scenario 1: Advanced Billing Rule - based on Site Specific Section Modeling Integer value > 16
Specific Setup:
  • Add a Site Specific Section Modeling Treatment Integer field to the "Client Charge Input" form.
  • Admit a test client.
  • Add financial eligibility information to the client for two guarantors.
  • Using the "Advanced Billing Rule Definition" form, set up an advanced billing rule for a specific service code and a specific guarantor. It should be set up for all genders, not associated with age and select "Compliance" in the "Rule Defines Conditions" field. Then select the "Event Rules" section and select "Site Specific Treatment History" from the Event Table drop down, select the site specific field that was added to "Client Charge Input" via Site Specific Section Modeling in setup, and set the Specific Value (Other) to a threshold level Such as ">= 16",
  • Using the "Posting/Adjustment Codes Definition" form, set the "Adjustment, Payment or Transfer" field to "Transfer" and set the "Transfer Type" to "Redistribute - Open".
Steps
  1. Using the "Client Charge Input" form, add a service for the client from the advanced billing rule setup, be sure to populate the Site Specific Section Modeling Integer field added in setup with a value that is equal to or greater than the threshold established in setup.
  2. Using "Client Ledger", validate the service went to the guarantor #1 for the test client.
  3. Using "Individual Cash Posting", apply a payment and transfer the balance to the other guarantor that was set up for the test client using the transfer code from setup.
  4. Using "Close Charges", update the liability for the client.
  5. Using "Client Ledger", validate the balance of the service was transferred to the other guarantor.
Scenario 2: Advanced Billing Rule - based on Site Specific Section Modeling Integer value < 16
Specific Setup:
  • Add a Site Specific Section Modeling Treatment Integer field to the "Client Charge Input" form.
  • Admit a test client.
  • Add financial eligibility information to the client for two guarantors.
  • Using the "Advanced Billing Rule Definition" form, set up an advanced billing rule for a specific service code and a specific guarantor. It should be set up for all genders, not associated with age and select "Compliance" in the "Rule Defines Conditions" field. Then select the "Event Rules" section and select "Site Specific Treatment History" from the Event Table drop down, select the site specific field that was added to "Client Charge Input" via Site Specific Section Modeling in setup, and set the Specific Value (Other) to a threshold level. Such as "< 16",
  • Using the "Posting/Adjustment Codes Definition" form, set up a transfer code and set the "Adjustment, Payment or Transfer" field to "Transfer" and set the "Transfer Type" to "Redistribute - Open".
Steps
  1. Using the "Client Charge Input" form, add a service from the advanced billing rule from setup for the client, be sure to populate the Site Specific Section Modeling Integer field added in setup with a value that is less than the threshold.
  2. Using "Client Ledger", validate the service went to the guarantor #1 for the test client.
  3. Using "Individual Cash Posting", apply a payment and transfer the balance to the other guarantor that was set up for the test client using the transfer code from setup.
  4. Using "Close Charges", update the liability for the client.
  5. Using "Client Ledger", validate the balance of the service was transferred to the default guarantor (9999) because it was under the threshold for the Advanced Billing Rule from setup.
Topics
• Advanced Billing Rule Definition
AV-76540 Summary | Details
Compile and Post Partial Hospitalization/Day Treatment
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Admission
  • Attending Practitioner
  • Client Ledger
  • Compile Partial Hospitalization/Day Worklist
  • Diagnosis
  • Financial Eligibility
  • Post Partial Hospitalization/Day Worklist
Scenario 1: Compile Partial Hospitalization/Day Worklist - Validate change in practitioner
Specific Setup:
  • Using "Maintain Hospital Bed File", add a test room to an existing unit.
  • Admit a test client into a partial hospitalization or day treatment program.
  • Using the "Diagnosis" form, assign a diagnosis to the test client.
  • Using the "Financial Eligibility" form, assign a guarantor to the test client.
Steps
  1. Open the "Compile Partial Hospitalization/Day Worklist" form.
  2. Create a new worklist and validate the test client is included on the report.
  3. Open the "Post Hospitalization/Day Worklist" form.
  4. Select the program that test client is enrolled in.
  5. Validate the test client is included on the report generated.
  6. Change the attending practitioner to a different practitioner using the "Attending Practitioner" form.
  7. Open the "Compile Partial Hospitalization/Day Worklist" form.
  8. Create a new worklist for a different date range and validate the test client is included on the report.
  9. Open the "Post Hospitalization/Day Worklist" form.
  10. Select the program that test client is enrolled in.
  11. Validate the test client is included on the report generated.
  12. Open the "Client Ledger" form.
  13. Validate the charges generated are included on the client's ledger.
  14. Using the preferred method to validate SQL tables, validate the v_provider_name column of the SYSTEM.billing_tx_history table contains the name of the attending practitioner the client was switched to.
Scenario 2: Compile Partial Hospitalization/Day Worklist
Specific Setup:
  • Using "Maintain Hospital Bed File", add a test room to an existing unit.
  • Admit a test client into a partial hospitalization or day treatment program.
  • Using the "Diagnosis" form, assign a diagnosis to the test client.
  • Using the "Financial Eligibility" form, assign a guarantor to the test client.
Steps
  1. Open the "Compile Partial Hospitalization/Day Worklist" form.
  2. Create a new worklist and validate the test client is included on the report.
  3. Open the "Post Hospitalization/Day Worklist" form.
  4. Select the program that test client is enrolled in.
  5. Validate the test client is included on the report generated.
  6. Open the "Compile Partial Hospitalization/Day Worklist" form.
  7. Create a new worklist for a different date range and validate the test client is included on the report.
  8. Open the "Post Hospitalization/Day Worklist" form.
  9. Select the program that test client is enrolled in.
  10. Validate the test client is included on the report generated.
  11. Open the "Client Ledger" form.
  12. Validate the charges generated are included on the client's ledger.
Topics
• Inpatient Worklist • NX
AV-76634 Summary | Details
Service Code Upload - Error Handling
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Registry Settings (PM)
  • Service Code Upload Accepted Codes
  • Service Code Upload Process
  • Service Codes
  • Crystal Report Viewer
  • Dynamic Form Service Code Upload
  • Service Code Upload Rejected Codes
Scenario 1: Service Code Upload - Validate Discipline string with an &
Specific Setup:
  • Create a test service code upload file that contains an extra "&" in the Discipline field, e.g. 10&11&. Designate this "File A".
  • Create a test service code upload file that contains the following in the Discipline field. e.g. 10&11. Designate this "File B".
  • Please refer to updated 'Avatar_PM_Service_Code_Upload_Layout.xls' document included in the zip file for this update.
Steps
  1. Open the "Service Code Upload Process" form.
  2. In the "Select File" drop down list, select the file designated as "File A".
  3. Select "Compile" in the "Compile or Post" field.
  4. Select "Yes" in the "Override Existing Service Codes" field.
  5. Click "Submit" button.
  6. Validate a "Filing Error" message displays indicating "No accepted data compiled. To view results review rejected report".
  7. Open the "Service Code Upload Rejected Codes" form.
  8. Select "File A" from the "Select Desired Service Code Import File Name" drop down list.
  9. Validate the report contains "Invalid Dictionary Code" error message.
  10. Exit the form.
  11. Open the "Service Code Upload Process" form.
  12. In the "Select File" drop down list, select the file designated as "File B".
  13. Select "Compile" in the "Compile or Post" field.
  14. Select "Yes" in the "Override Existing Service Codes" field.
  15. Click "Submit" button.
  16. Validate the message "Compile completed. To view results review accepted and rejected reports" displays.
  17. Open the "Service Code Upload Accepts Codes" form.
  18. Select "File B" from the "Select Desired Service Code Import File Name" drop down.
  19. Click "Process" button.
  20. Validate the report indicates the service codes that will be uploaded.
  21. Open the "Service Code Upload Process File" form.
  22. Select "File B" in the "Select File" field.
  23. Select "Post" in the "Compile or Post" field.
  24. Click "Submit".
  25. Validate the message displays that indicates "Posting Completed".
  26. Open the "Service Codes" Form.
  27. Click the "Service Code Report" section.
  28. Select a service code that was uploaded when the file was posted.
  29. Click "Display Service Codes" button.
  30. Validate the service code was uploaded.
Scenario 2: 'Service Code Upload Process' - Verification of Service Code Upload
Specific Setup:
  • Avatar State Forms Registry Setting 'Enable Texas TMHP Billing' must be enabled
  • Avatar PM Service Code Upload file containing one or more valid rows/entries including values for 'TMHP Type Of Service' field (Import File Segment/Location 134) and 'Line Item Control Number - Positions 5 to 20 (2400-REF)' (Import File Segment/Location135)
  • Please refer to updated 'Avatar_PM_Service_Code_Upload_Layout.xls' document included in the zip file for this update.
Steps
  1. Open Avatar PM 'Service Code Upload Process' form.
  2. Click 'Select File' button and select Avatar PM Service Code Upload file containing one or more valid rows/entries including values for 'TMHP Type Of Service' and 'Line Item Control Number - Positions 5 to 20 (2400-REF)' fields/segments.
  3. Select 'Compile' in 'Compile Or Post' field.
  4. Select Yes or No value for 'Override Existing Service Codes' field.
  5. Click 'Submit' button to file form/compile Service Code Upload file.
  6. Ensure that dialog noting 'Compile Completed' is presented; click 'OK' button to close dialog/proceed.
  7. Open Avatar PM 'Service Code Upload Accepted Codes' form.
  8. Select compiled file in 'Select Desired Service Code Import File Name' field.
  9. Click 'Process' button to file form/display Service Code Upload Accepted Codes report.
  10. Ensure 'TMHP Type Of Service' and 'Line Item Control Number - Positions 5 to 20 (2400-REF)' fields are included in Service Code Upload Accepted Codes report display, and contains value filed for 'TMHP Type Of Service'/'Line Item Control Number - Positions 5 to 20 (2400-REF)' fields/segments for valid compiled rows/entries.
  11. Close Service Code Upload Accepted Codes report.
  12. Return to Avatar PM 'Service Code Upload Process' form.
  13. Select 'Post' in 'Compile Or Post' field to post compiled Service Code Upload file row(s).
  14. Click 'Submit' button to file form/post Service Code Upload file.
  15. Ensure that dialog noting 'Posting Completed' is presented; click 'OK' button to close dialog/proceed.
  16. Return to Avatar PM 'Service Code Upload Accepted Codes' form.
  17. Select posted file in 'Select Desired Service Code Import File Name' field.
  18. Click 'Process' button to file form/display Service Code Upload Accepted Codes report.
  19. Ensure 'TMHP Type Of Service' and 'Line Item Control Number - Positions 5 to 20 (2400-REF)' fields are included in Service Code Upload Accepted Codes report display, and contains value filed for 'TMHP Type Of Service'/'Line Item Control Number - Positions 5 to 20 (2400-REF)' fields/segments for valid/posted rows/entries.
  20. Open Avatar PM 'Service Codes' form.
  21. Select 'Edit Existing' action and select Service Code filed via 'Service Code Upload Process' file posting.
  22. Ensure that value for 'TMHP Type Of Service' field is present/selected in form as defined in Service Code Upload file row/entry.
  23. Ensure that value for 'Line Item Control Number - Positions 5 to 20 (2400-REF)' field is present/selected in form as defined in Service Code Upload file row/entry.
Topics
• NX • Registry Settings • Service Code Upload Process • Service Codes
AV-78014 Summary | Details
Electronic Billing - 837 Institutional Non Covered Days
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Admission
  • Client Charge Input
  • Client Ledger
  • Create Interim Billing Batch File
  • Diagnosis
  • Dictionary Update (PM)
  • Discharge
  • Electronic Billing
  • Financial Eligibility
  • Leaves
Scenario 1: 837 Institutional - Non Billable Leave Days
Specific Setup:
  • Using the "Dictionary Update" form under the PM namespace, edit the "Client" data element "Type of Leave From", add desired dictionary code, and a value similar to "Non-Billable Leave".
  • Set the Extended Dictionary Data Element "(10031) Chargeable Leave Y/N" to "No".
  • Admit a client into an inpatient program. Note the admission date.
  • Using the "Financial Eligibility" form, add a guarantor for the client.
  • Using the "Diagnosis" form, enter an admission diagnosis for the client.
  • Using "Client Charge Input", enter in 10 days of partial hospitalization/day charges. (Example: 8/01 - 8/10).
  • Using "Client Ledger", validate there are 10 days of partial hospitalization/day charges.
  • Using the "Leaves" form, put the client on non billable leave on the day after the 10 hospitalization/day charges. (Example: 8/11).
  • Open the "Return From Leaves" form and set the return date to 4 days after the Leave Date. (Example: 8/15).
  • Using the "Discharge" form, discharge the client on the day they are returning from leave (Example: 8/15).
  • Using the "Close Charges" form, close the charges for the date range (Example: 8/1 - 8/15).
  • Using the "Create Interim Billing Batch File" form, create an interim billing batch for the test client.
Steps
  1. Open the "Electronic Billing" form.
  2. Process an 837 Institutional bill for the guarantor, program and test client that was put on non-billable leave and subsequently discharged on the date of return from leave.
  3. The date range would be from the day the client was admitted until to the day the client was discharged. (Example 8/1 - 8/15).
  4. Print the dump file for the 837 Institutional and validate the file contains a line similar to "HI*BE:80:::10*BE:81:::4" with 4 being the days of non billable leave.
Scenario 2: 837 Institutional - Billable Leave Days
Specific Setup:
  • Using the "Dictionary Update" form under the PM namespace, edit the "Client" data element "Type of Leave From", add a dictionary code, and a value would similar to Billable Leave".
  • Set the Extended Dictionary Data Element "(10031) Chargeable Leave Y/N" to "Yes".
  • Admit a client into an inpatient program. Note the admission date.
  • Using the "Financial Eligibility" form, add a guarantor for the client.
  • Using the "Diagnosis" form, enter an admission diagnosis for the client.
  • Using "Client Charge Input", enter in 10 days of partial hospitalization/day charges. (Example: 8/01 - 8/10)
  • Using "Client Ledger", validate there are 10 days of partial hospitalization/day charges.
  • Using the "Leaves" form, put the client on billable leave on the day after the 10 hospitalization/day charges. (Example: 8/11).
  • Open the "Return From Leaves" form and set the return date to 4 days after the Leave Date. (Example: 8/15).
  • Using the "Discharge" form, discharge the client on the day they are returning from leave (Example: 8/15).
  • Using the "Close Charges" form, close the charges for the date range (Example: 8/1 - 815).
  • Using the "Create Interim Billing Batch File" form, create an interim billing batch for the test client.
Steps
  1. Open the "Electronic Billing" form.
  2. Process an 837 Institutional bill for the guarantor, program and test client that was put on billable leave and subsequently discharged on the date of return from leave.
  3. The date reange will bw from the day the client was admitted until to the day the client was discharged. (Example 8/1 - 8/15).
  4. Print the dump file for the 837 Institutional and validate the file contains a line similar to "HI*BE:80:::10*BE:81:::0" with 0 being the days of non billable leave.
Topics
• Electronic Billing • Leaves • Service Code Upload Process