Avatar PM 2022 Update 130

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Product Requirements / Recommendations

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Product Update Form Description

An issue is resolved where the '2310A-PRV' segment may not be able to be suppressed on an 837I bill.

Included Updates

3, 9, 13, 18, 19, 21, 25, 26, 34, 41, 48, 51, 55, 58, 59, 61, 62, 67, 73, 75, 77, 78, 84, 87, 88, 90, 91, 94, 95, 97, 99, 100, 103, 107, 108, 109, 110, 114, 118, 120, 125

Required Updates

None

Details

NEW0 CHANGED1 FIXED0

Changed (1)

AV-83528 Details \| User Acceptance Tests Guarantor/Program Billing Defaults - Select Segments To Suppress The 2310A-PRV segment can be successfully suppressed from the 837 Institutional bill. KB0071128 v0.01 Value Added: The 'Select Segments to Suppress' option of the 'Guarantor/Program Billing defaults' form is modified to suppress the correct information from the bill.	Topics • 837 Institutional • NX

Acceptance Tests

AV-83528 Summary | Details

Guarantor/Program Billing Defaults - Select Segments To Suppress

Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:

Admission
Client Charge Input (Charge Fee Access and Diagnosis Entry)
Client Ledger
Create Interim Billing Batch File
Diagnosis
Dictionary Update (PM)
Electronic Billing
Financial Eligibility
Guarantors/Payors
Practitioner Enrollment
Practitioner Numbers By Guarantor And Program
Program Maintenance
Registry Settings (PM)

Scenario 1: Guarantor/Program Billing Defaults - 837 Institutional - Select Segments To Suppress

Specific Setup:

Practitioner Enrollment:
Create a new or identify an existing practitioner to be used as an attending practitioner. Note the Practitioner id, Name, NPI Number, Taxonomy Code.
Guarantors/Payors:
Identify an existing guarantor or create a new guarantor. Note the guarantor's code/name.
Program Maintenance:
Identify an existing inpatient program to be used for the client's admission. Note the program code/name.
Practitioner Numbers By Guarantor and Program:
Create a record using a practitioner, guarantor and program identified above.
Dictionary Update:
Add/ Edit dictionary code/value for the 'Attending Provider Specialty Information' segment which is 2310A-PRV.
Add/Edit dictionary code/value for the 'Attending Provider Name' segment which is 2310A-NM1.
Guarantor/Program Billing Defaults template:
Edit an existing template to assign the guarantor identified above. Note the template name.
837 Institutional section:
Select Segments To Suppress:
The 2310A-PRV (Attending Provider Specialty Information) segment and 2310A segments is available in the checklist.
Nothing is selected in the 'Select Segments To Suppress' dictionary
Admission:
A new client is admitted in the inpatient program with attending practitioner.
Financial Eligibility:
The guarantor assigned to the template configured in the 'Guarantor/Program Billing Defaults' is assigned to the client.
Recurring Client Charge Input:
5-6 room and board charges are rendered beginning on the admission date. A rendering practitioner is added for these charges.
Charges are closed.
An interim billing batch is created to include client, services, and guarantor.

Steps

Open the 'Electronic Billing' form.
Compile the 837 Institutional for the interim billing batch created in the setup section.
Verify the bill compiles successfully.
Review the dump file.
Verify the NM1*71 and PRV*AT segments display the attending provider identification information from the 'Practitioner Enrollment' form.
Close the report.
Close the form.
Open the 'Guarantor/Program Billing Defaults' form.
Go to '837 Institutional section'.
Select the 2310A-PRV (Attending Provider Specialty Information) segment in the 'Select Segments To Suppress' checklist.
Submit the form.
Close the form.
Open the 'Electronic Billing' form.
Compile the 837 Institutional for the interim billing batch created in the setup section.
Verify the bill compiles successfully.
Review the dump file.
Verify the NM1*71 segments display the attending provider identification information from the 'Practitioner Enrollment' form and suppress the PRV-AT segment to include in the bill.
Close the report.
Close the form.
Open the 'Guarantor/Program Billing Defaults' form.
Go to '837 Institutional section'.
Select the 2310A (Attending Provider Name) segment in the 'Select Segments To Suppress' checklist.
Submit the form.
Close the form.
Open the 'Electronic Billing' form.
Compile the 837 Institutional for the interim billing batch created in the setup section.
Verify the bill compiles successfully.
Review the dump file.
Verify the NM1*71 segment and PRV*AT segments are suppressed and not included in the bill.
Close the report.
Close the form.

Topics

• 837 Institutional • NX