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Avatar PM 2022 Update 52

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Product Requirements / Recommendations

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Product Update Form Description

The issue is resolved where service codes would not appear when selecting an 'Authorization Group' for an 'Admit Only' program in the form 'Managed Care Authorizations'.

Included Updates

None

Required Updates

None

Details
NEW1 CHANGED0 FIXED0
New (1)
Managed Care Authorizations - Authorization Group
Functionality for the 'Authorization Group' has been updated to process the selected 'Associated Service Program(s)' when the client is admitted to a program that has a Usage Type' of 'Admission. KB0069553 v0.01
Value Added: 'Associated Service Program(s)' are now able to be used with 'Admission' programs.
Topics
• Managed Care Authorizations • NX
 
Acceptance Tests
AV-75751 Summary | Details
Managed Care Authorizations - Authorization Group
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Admission (Outpatient)
  • App Dashboard
  • Authorization Group Definition
  • Dynamic Form - Admission - Client
  • Financial Eligibility
  • Managed Care Authorizations
  • Program Maintenance
  • Registry Settings (PM)
Scenario 1: Managed Care Authorizations - Authorization Groups - Program Usage Type = Admission
Specific Setup:
  • Registry Setting: ‘Avatar PM->System Maintenance->Program Maintenance->->->Enable 'Admission vs. Service Program' Functionality’ has a value of ‘Y’.
  • Program Maintenance:
  • Program 1: ‘Usage Type’ = Service. Desired service codes have been assigned to the program.
  • Program 2: ‘Usage Type’ = Admission. No service codes have been assigned to the program. Program 1 is selected in ‘Associated Service Programs’.
  • Authorization Group Definition has been used to create a group that has a minimum of two service codes.
  • Client: Is admitted to Program 2 and has a Financial Eligibility record.
Steps
  1. Open ‘Managed Care Authorizations’ for the client.
  2. Select the ‘Managed Care Authorization Data’ section.
  3. Click [Add New Item].
  4. Select the ‘Guarantor Number’.
  5. Enter desired ‘Authorization Number’.
  6. Enter desired ‘Authorization Start Date’.
  7. Enter desired ‘Authorization End Date’.
  8. Select ‘Program 1’ in ‘Associated Service Program(s)’.
  9. Select the ‘Authorization Group’ from Setup.
  10. Validate that the service codes in the group are selected in ‘Service Code(s)’.
  11. Select desired value in ‘U/R Staff Person’.
  12. Select desired value in ‘Type Of Authorization’.
  13. Optionally enter data for other fields.
  14. Click [Submit].
Scenario 2: Managed Care Authorizations - Authorization Groups - Program Usage Type = Both
Specific Setup:
  • Registry Setting: ‘Avatar PM->System Maintenance->Program Maintenance->->->Enable 'Admission vs. Service Program' Functionality’ has a value of ‘Y’.
  • Program Maintenance: ‘Usage Type’ = Both. Desired service codes have been assigned to the program.
  • Authorization Group Definition has been used to create a group that has a minimum of two service codes.
  • Client: Is admitted to above program and has a Financial Eligibility record.
Steps
  1. Open ‘Managed Care Authorizations’ for the client.
  2. Select the ‘Managed Care Authorization Data’ section.
  3. Click [Add New Item].
  4. Select the ‘Guarantor Number’.
  5. Enter desired ‘Authorization Number’.
  6. Enter desired ‘Authorization Start Date’.
  7. Enter desired ‘Authorization End Date’.
  8. Select the ‘Authorization Group’ from Setup.
  9. Validate that the service codes in the group are selected in ‘Service Code(s)’.
  10. Select desired value in ‘U/R Staff Person’.
  11. Select desired value in ‘Type Of Authorization’.
  12. Optionally enter data for other fields.
  13. Click [Submit].
Topics
• Managed Care Authorizations • NX