Avatar PM 2022 Update 5

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Avatar PM 2021 Update 41

Product Update Form Description

An issue that may occur in the 'CPT Place Of Service Override Report' where the '837 Professional' or the 'HCFA 24-B' columns will not display a value is resolved.

Included Updates

None

Required Updates

None

Details

NEW0 CHANGED0 FIXED1

Fixed (1)

AV-75637 Details \| User Acceptance Tests CPT Place of Service Override - System.table_cpt_place_override Resolves an issue to ensure that the 'CPT Place of Service Override' crystal report and system.table_cpt_place_override SQL table display the place of service for the 837 professional and HCFA 24-B when the values are entered in the 'CPT Place Of Service Override' form. KB0068062 v0.01	Topics • myAvatar/myAvatar NX • NX

Acceptance Tests

AV-75637 Summary | Details

CPT Place of Service Override - System.table_cpt_place_override

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

Admission (Outpatient)
Client Charge Input
CPT Place Of Service Override
Crystal Report Viewer
Diagnosis
Dynamic Form - Admission - Client
Electronic Billing
Financial Eligibility
Ok - Cancel Dialog
Program Maintenance
Registry Settings (PM)
Dynamic Form - Edit Service Fee Definition
Print Bill
Service Codes

Scenario 1: CPT Place of Service Override - Validating 'Crystal report' and SQL table 'System.table_cpt_place_override' - 837 Professional

Specific Setup:

Admission:
An existing outpatient client is identified, or a new client is admitted to the outpatient program. Note the client ID/name, admission program code/value, admission date.
Financial Eligibility:
An existing non contract guarantor is identified. Note the Guarantor name and ID.
Diagnosis:
A diagnosis record is created for the client.
Client Charge Input:
The professional service is rendered to the client. Make sure there is a practitioner for the services. Note the practitioner category of your test practitioner via the Practitioner Enrollment form (Categories/Taxonomy section). Note the service code, date of the service and place of service.
Client Ledger:
Verify the services distributed correctly to the guarantor assigned to the client.
Close Charges:
Close the charges rendered to the client.

Steps

Open the 'CPT Place of Service Override' form.
Select desired financial class(es) in the 'Financial Class Selection' field.
Select desired guarantor(s) in the 'Guarantor' field.
Select desired treatment setting(s) in the 'Treatment Setting Selection' field.
Select desired program(s) for the override in the 'Program' field. Note: This is the program of admission and not the program of service. Note the admission program code/value.
Select desired value in the 'All or Individual Service Code' field. Note: Specify whether the override should apply to all service codes or just one individual code. If Individual, select the specific code in the Service Code field. Note the code/value.
Select desired value in the 'All or Individual CPT Code' field. Note: Specify whether the override should apply to all CPT codes or just one individual code. If Individual, select the specific code in the CPT Code field. Note the CPT code/value.
Select desired value in the 'All or Individual Location' field, specify whether the override should apply to all locations or just one specific location. If Individual, select the same location that is used during rendering the service to the client from the setup section. Note the code/value.
Select the place of service for use on the paper HCFA bill in the 'Place of Service (HCFA 24-B)' field. Note the location code/value.
Select the place of service for use on the 837 Professional bill in the 'Place of Service (837 Professional)' field.
Click [Display CPT Place of Service Overrides].
Verify a CPT Place of Service Overrides report launched.
Review the report.
Verify the 'HCFA 24-B' and '837 Professional' fields display the correct data.
Click [Submit].
Open the 'Crystal Report' or any other 'SQL Data Viewer'.
Query the 'System.table_cpt_place_override' table.
Verify the 'HCFA 24-B' and '837 Professional' fields display the correct data.
Open the 'Electronic Billing' form.
Compile the 837 Professional bill for the interim billing batch created in the setup section.
Verify the file compiles successfully.
Dump the file.
Review an 837 professional file.
Verify the 2300-CLM 05 and 2400-SV1 05 segments displays the correct place of the service.
Close the file.
Close the form.

Scenario 2: CPT Place of Service Override - Validating 'Crystal report' and SQL table 'System.table_cpt_place_override' - HCFA 1500 - NPI version 1500

Specific Setup:

Admission:
An existing outpatient client is identified, or a new client is admitted to the outpatient program. Note the client id/name, admission program code/value, admission date.
Financial Eligibility:
An existing non contract guarantor is identified. Note the Guarantor name and ID.
Diagnosis:
A diagnosis record is created for the client.
Client Charge Input:
The professional service is rendered to the client. Make sure there is a practitioner for the services. Note the practitioner category of your test practitioner via the Practitioner Enrollment form (Categories/Taxonomy section). Note the service code, date of the service and place of service.
Client Ledger:
Verify the services distributed correctly to the guarantor assigned to the client.
Close Charges:
Close the charges rendered to the client.

Steps

Open the 'CPT Place of Service Override' form.
Select desired financial class(es) in the 'Financial Class Selection' field.
Select desired guarantor(s) in the 'Guarantor' field.
Select desired treatment setting(s) in the 'Treatment Setting Selection' field.
Select desired program(s) for the override in the 'Program' field. Note: This is the program of admission and not the program of service. Note the admission program code/value.
Select desired value in the 'All or Individual Service Code' field. Note: Specify whether the override should apply to all service codes or just one individual code. If Individual, select the specific code in the Service Code field. Note the code/value.
Select desired value in the 'All or Individual CPT Code' field. Note: Specify whether the override should apply to all CPT codes or just one individual code. If Individual, select the specific code in the CPT Code field. Note the CPT code/value.
Select desired value in the 'All or Individual Location' field, specify whether the override should apply to all locations or just one specific location. If Individual, select the same location that is used during rendering the service to the client from the setup section. Note the code/value.
Select the place of service for use on the paper HCFA bill in the 'Place of Service (HCFA 24-B)' field. Note the location code/value.
Select the place of service for use on the 837 Professional bill in the 'Place of Service (837 Professional)' field.
Click [Display CPT Place of Service Overrides].
Verify a CPT Place of Service Overrides report launched.
Review the report.
Verify the 'HCFA 24-B' and '837 Professional' fields display the values selected in the form correctly.
Click [Submit].
Open the 'Crystal Report' or any other 'SQL Data Viewer'.
Query the 'System.table_cpt_place_override' table.
Verify the 'hcfa_place_of_svc_value' and 'p837_place_of_svc_value' fields display the values selected in the form correctly.
Open the 'Print Bill' form.
Select 'No' in the 'Create Claims (Y/N)' field.
Select 'HCFA-1500 NPI Version' in the 'Print On What Form' field.
Select 'No' in the 'Print For Interim Batch'.
Select desired guarantor in the 'Guarantor #' field.
Select 'Individual' in the 'Print For An Individual Or All Clients' field.
Select desired client in the 'Client ID' field.
Select 'Yes' in the 'All Episodes' field.
Click [Process].
Review the report.
Verify the correct place of value displays on the bill.
Click [X].
Click [No].

Topics

• myAvatar/myAvatar NX • NX