'Eligibility Response (271)' File Posting
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- Eligibility Inquiry and Response (270/271) Report
- Eligibility Response (271)
- Eligibility Response (271) Report
Scenario 1: 'Eligibility Response (271)' Form - Verification of 271 Eligibility Response File Posting
Specific Setup:
- Avatar PM Registry Setting 'Enable 270/271 Transaction Sets' must be enabled
- 271 Eligibility Response File configurations must be defined (via Avatar PM 'Guarantors/Payors' form)
- Inbound 271 Eligibility Response file containing one or more valid entries for loading/compilation/posting
Steps
- Open Avatar PM 'Eligibility Response (271)' form (under 'Avatar PM / Billing / Electronic Submission' menu path).
- Select 'Load File' in 'Options' field, and enter 'File Path\Name' value for 271 Eligibility Response file to be loaded.
- Click 'Process File' button to load specified 271 Eligibility Response file.
- Select 'Compile File' in 'Options' field, and select loaded 271 Eligibility Response file to be compiled in 'Select File' field.
- Click 'Process File' button to compile selected 271 Eligibility Response file.
- In 'Eligibility Response (271)' Report results, ensure that one or more valid response entries are compiled and present in report (in 'Response Data' sub-report/section).
- Select 'Post File' in 'Options' field, and select compiled 271 Eligibility Response file to be posted in 'Select File' field.
- Click 'Process File' button to post selected 271 Eligibility Response file.
- In 'Eligibility Response (271)' Report results, ensure that one or more valid response entries are posted and present in report (in 'Response Data' sub-report/section).
- Open Avatar PM 'Eligibility Inquiry and Response (270/271) Report' form (under 'Avatar PM / Billing / Electronic Submission' menu path).
- Enter/select value for 'Client ID', 'Episode Number' and 'Guarantor' criteria fields (as well as 'Service Code' and 'CPT-4 Code' criteria fields where applicable).
- Click 'Display Report' button to view Eligibility Inquiry and Response (270/271) Report results.
- In Eligibility Inquiry and Response (270/271) Report results, ensure that inquiry/response entry/entries is/are present in report for selected Client/Episode/Guarantor (in 'Eligibility Inquiries and Responses (Verified)' sub-report/section).
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Topics
• Eligibility Response (271)
• NX
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