Avatar PM 2022 Update 40

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Product Update Form Description

An issue is resolved where 'Natural Disaster' may not appear as a 'Delay Reason Code' within the 'Quick Billing' and 'Electronic Billing' forms.

Included Updates

None

Required Updates

None

Details

NEW0 CHANGED0 FIXED1

Fixed (1)

AV-65189 Details \| User Acceptance Tests Quick Billing/Electronic Billing - Natural Disaster added to the Delay Reason Code data dictionary An issue is resolved where the delay reason code 'Natural Disaster' (15) was not available in 'Electronic Billing' and 'Quick Billing'. KB0068056 v0.01	Topics • Electronic Billing • Quick Billing

Acceptance Tests

AV-65189 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:

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

Open the "Quick Billing" form.
Add a new Quick Billing batch.
Edit the quick billing batch just created, adding a delay reason.
Click "Launch Workscreen".
Select "Natural Disaster" in the "Delay Reason Code" to a row in the table.
Click "Save".
Click "Submit".
Using the preferred method, check the SQL table "SYSTEM.billing_qb_delay_reason.
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

Open the "Client Ledger" form and validate the charges are set to UNBILL.
Open "Close Charges" and close the charge.
Open the "Electronic Billing" form.
Generate a professional 837 bill. Don't create claims.
Validate the file using the "Dump File" "Billing Option".
Generate a professional 837 bill. This time create claims.
The "Clam Date" must be the current date.
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.
Click "Process".
A message pops up that instructs you to access the "837 Delay Reason Code Assignment".
Navigate to the *837 Delay Reason Code" tab.
Select the file that was just created.
Select "Client" in the "Display Claims By" field.
Select the test client.
Click "Select Claims To Assign Delay Reason Code" button.
Select a claim(s) to attach a Delay Reason Code to.
Set the "Delay Reason Code" dropdown to "Natural Disaster".
Click "Assign To File".
Open the "Electronic Billing" form.
Open the "Dump File" that was just created in prior steps.
Validate the CLM segment includes a 15 at the end for the "Natural Disaster" Delay Reason Code.

Topics

• Electronic Billing • Quick Billing