Avatar PM 2023 Quarterly Release 2023.01 Acceptance Tests

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Update 1 Summary \| Details Avatar PM 2023 is Installed Scenario 1: Validate Upgrading Avatar PM 2022 to 2023 is successful when 2022.04.00 is loaded Specific Setup: Latest Monthly Release is installed. Steps Open the "Product Updates" form. Select the appropriate [Namespace] from the Application dropdown list Click [Select Update/Customization Pack]. Browse to the location for the updates and select the Update 1. Click [OK] on the "File Upload Complete" window. Click [Review Update/Customization Pack Contents]. Verify Update 1 is included. Click [Install Update/Customization Pack]. Click [OK] when the install completes. Click [Close Form].	Topics • Upgrade
Update 2 Summary \| Details Roll-Up service definition - Component modifiers Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Compile/Edit/Post/Unpost Roll-Up Services Worklist Crystal Report Viewer Service Codes Admission (Outpatient) Financial Eligibility Roll-Up Services Definition Posting/Adjustment Codes Definition SQL Query/Reporting Scenario 1: Compile/Edit/Post/Unpost Roll-Up Services Worklist - 'Do Not Include Component Modifiers in Roll-Up Service' registry setting = 'Y' Specific Setup: Registry Setting: The 'Do Not Include Component Modifiers in Roll-Up Service' registry setting is set to 'Y'. Posting/Adjustment Code Definition: An existing Write off posting code is identified or a new posting code is created to use for Write-Off Posting code. Service Codes: At least one Roll-Up and two component service codes are created. Note the service codes. Service Fee/Cross Reference Maintenance: A fee definition is created for each service code. Admission: An existing client is identified or a new client is admitted. Note the client id, Admission date/program. Diagnosis: A diagnosis record is created for the client. Financial Eligibility: An existing guarantor is assigned to the client. Note the guarantor code/name. Roll-Up Definition: Edit an existing or create a new 'Roll-Up Services Definition' with the following criteria: A 'Roll-Up Description'. A 'Roll-Up Service'. Component Services. 'Is This Roll-Up Service Dependent On Units, Duration Or None' = None. A value is entered in 'Minimum Duration Required'. A value is entered in 'Maximum Duration' that is greater than the value in 'Minimum Duration Required'. A value is selected in 'Calculate Unit Charge By'. A value is entered in 'Component Service Date Rules'. 'Date Of First Component Service' is selected in 'Date Of Service For Roll-Up Service'. 'Date Of First Component Service' is selected in 'Date To Bill Roll-Up Service'. Client Charge Input: A minimum of two component services have been rendered with the same modifiers to the client that will meet the 'Component Service Date Rules'. Note the service date and service code. Client Ledger: The services distributed correctly to the guarantor assigned to the client. Steps Open ‘Compile/Edit/Post/Unpost Roll-Up Services Worklist’. Verify that the fields ‘Roll-Up Definitions’ and ‘Roll-Up Group’ are enabled. Enter the desired ‘From Date’ and ‘To Date’. Select a Roll-Up definition created during setup in the ‘Roll-Up Definitions’. Validate that no value can be selected in ‘Roll-Up Group’. Click [Compile Worklist]. Click [OK]. Close the form. Open ‘Compile/Edit/Post/Unpost Roll-Up Services Worklist’. Select the ‘Post Roll-Up Services Worklist’ section. Select the desired ‘Through Date’. Select the desired 'Write Off Posting Code’. Click [Post Worklist]. Click [OK]. Close the form. Open ‘Client Ledger’ for the desired client and date range. Select ‘Simple’ in the ‘Ledger Type’ Click [Process] and validate that the services for the rules within the rule group have the value of ‘Roll-Up’ in ‘CLAIM NUMBER’. Validate that the service created from the roll-up process has a value of ‘OPEN’ in ‘CLAIM NUMBER’. Close the report. Close the form. Open the 'Crystal Report' or any other SQL data viewer. Query the 'SYSTEM.billing_tx_history' table. Verify the modifiers included with the component service are not included with the Roll-Up service. Scenario 2: Compile/Edit/Post/Unpost Roll-Up Services Worklist - 'Do Not Include Component Modifiers in Roll-Up Service' registry setting = N Specific Setup: Registry Setting: The 'Do Not Include Component Modifiers in Roll-Up Service' registry setting is set to 'N'. Service Codes: At least one Roll-Up and two component service codes are created. Note the service codes. Service Fee/Cross Reference Maintenance: A fee definition is created for each service code. Admission: An existing client is identified or a new client is admitted. Note the client id, Admission date/program. Diagnosis: A diagnosis record is created for the client. Financial Eligibility: An existing guarantor is assigned to the client. Note the guarantor code/name. Roll-Up Definition: Edit an existing or create a new 'Roll-Up Services Definition' with the following criteria: A 'Roll-Up Description'. A 'Roll-Up Service'. Component Services. 'Is This Roll-Up Service Dependent On Units, Duration Or None' = None. A value is entered in 'Minimum Duration Required'. A value is entered in 'Maximum Duration' that is greater than the value in 'Minimum Duration Required'. A value is selected in 'Calculate Unit Charge By'. A value is entered in 'Component Service Date Rules'. 'Date Of First Component Service' is selected in 'Date Of Service For Roll-Up Service'. 'Date Of First Component Service' is selected in 'Date To Bill Roll-Up Service'. Client Charge Input: A minimum of two component services have been rendered to the client that will meet the 'Component Service Date Rules'. Desired value entered to the 'Modifier' field of all the component services. Note the service date/code and modifier entered for each of the service. Client Ledger: The services distributed correctly to the guarantor assigned to the client. Steps Open ‘Compile/Edit/Post/Unpost Roll-Up Services Worklist’. Verify that the fields ‘Roll-Up Definitions’ and ‘Roll-Up Group’ are enabled. Enter the desired ‘From Date’ and ‘To Date’. Select a Roll-Up definition created during setup in the ‘Roll-Up Definitions’. Validate that no value can be selected in ‘Roll-Up Group’. Click [Compile Worklist]. Click [OK]. Select the ‘Post Roll-Up Services Worklist’ section. Select the desired ‘Through Date’. Select the desired 'Write Off Posting Code’. Click [Post Worklist]. Click [OK]. Close the form. Open ‘Client Ledger’ for the desired client and date range. Select ‘Simple’ in the ‘Ledger Type’ Click [Process] and validate that the services for the rules within the rule group have the value of ‘Roll-Up’ in ‘CLAIM NUMBER’. Validate that the service created from the roll-up process has a value of ‘OPEN’ in ‘CLAIM NUMBER’. Close the report. Close the form. Open the 'Crystal Report' or any other SQL data viewer. Query the 'SYSTEM.billing_tx_history' table. Verify the modifiers included with the component service are included with the Roll-Up service when all the component services have same modifiers. Scenario 3: Compile/Edit/Post/Unpost Roll-Up Services Worklist - 'Do Not Include Component Modifiers in Roll-Up Service' registry setting - Group Roll-Up definition Specific Setup: Registry Setting: The 'Do Not Include Component Modifiers in Roll-Up Service' registry setting is set to 'Y'. Allow Roll-Up Rule Selection During Compile has a value of ‘2’. Service Codes: At least two Roll-Up and two component service codes for each roll-up service code are created. Note the service codes. Service Fee/Cross Reference Maintenance: A fee definition is created for each service code. Admission: An existing client is identified or a new client is admitted. Note the client id, Admission date/program. Diagnosis: A diagnosis record is created for the client. Financial Eligibility: An existing guarantor is assigned to the client. Note the guarantor code/name. Roll-Up Definition: Edit an existing or create at least two new 'Roll-Up Services Definition' with the following criteria. Open the 'Roll-Up Services Definition' section, select edit and note the value of 'Existing Roll-Up Definition' for at least two definition. A 'Roll-Up Description'. A 'Roll-Up Service'. Component Services. 'Is This Roll-Up Service Dependent On Units, Duration Or None' = None. A desired value is entered in 'Minimum Duration Required'. A desired value is entered in 'Maximum Duration' that is greater than the value in 'Minimum Duration Required'. A desired value is selected in 'Calculate Unit Charge By'. A desired value is entered in 'Component Service Date Rules'. A desired value is selected in 'Date Of Service For Roll-Up Service'. A desired value is selected in 'Date To Bill Roll-Up Service'. Open the 'Roll-Up Group Definition' section: A 'Roll-Up Group Definitions' is created. Select desired value in the ‘Post Roll-Up Rule Individually’. Client Charge Input: At a minimum, services that meet group roll-up definition exist for a minimum of one client. Note the client ID. Note the dates of service. Client Ledger: The services distributed correctly to the guarantor assigned to the client. Steps Open ‘Compile/Edit/Post/Unpost Roll-Up Services Worklist’. Verify that the only roll-up definitions that can be selected are group definitions. Enter the desired ‘From Date’ and ‘To Date’ for the group definition with a value of 'Yes' in ‘Post Roll-Up Rule Individually’. Select the group definitions with a value of 'Yes' in ‘Post Roll-Up Rule Individually’. Click [Compile Worklist]. Click [OK]. Based on the light bulb message when 'Yes' is in ‘Post Roll-Up Rule Individually’, each roll-up rule is compiled and posted in order of execution before the next roll-up rule is compiled. This means that the user does not use the 'Post Roll-Up Services Worklist' section of the form. Close the form. Open ‘Client Ledger’ for the desired client and date range. Select ‘Simple’ in the ‘Ledger Type’ Click [Process] and validate that the services for the rules within the rule group have the value of ‘Roll-Up’ in ‘CLAIM NUMBER’. Validate that the service created from the roll-up process has a value of ‘OPEN’ in ‘CLAIM NUMBER’. Close the report. Close the form. Open ‘Compile/Edit/Post/Unpost Roll-Up Services Worklist’. Enter the desired ‘From Date’ and ‘To Date’ for the group definition with a value of 'No' in ‘Post Roll-Up Rule Individually’. Select the group definitions with a value of 'Yes' in ‘Post Roll-Up Rule Individually’. Click [Compile Worklist]. Click [OK]. Based on the light bulb message when 'No' is in ‘Post Roll-Up Rule Individually’, each roll-up rule is compiled in the specified order of execution, then the entire compile is posted. Select the ‘Post Roll-Up Services Worklist’ section. Select the desired ‘Through Date’. Click [Post Worklist]. Close the form. Open ‘Client Ledger’ for the desired client and date range. Select ‘Simple’ in the ‘Ledger Type’ Click [Process] and validate that the services for the rules within the rule group have the value of ‘Roll-Up’ in ‘CLAIM NUMBER’. Validate that the service created from the roll-up process has a value of ‘OPEN’ in ‘CLAIM NUMBER’. Close the report. Close the form. Open the 'Crystal Report' or any other SQL data viewer. Query the 'SYSTEM.billing_tx_history' table. Verify the modifiers included with the component service are not included with the Roll-Up service. Scenario 4: Registry setting validation - Do Not Include Component Modifiers in Roll-Up Service Steps Open the 'Registry Setting' form. Set the 'Limit Registry Settings to the Following Search Criteria' input box to "Do Not Include Component Modifiers in R" Click [View Registry Settings]. Validate the Registry Setting input box contains "Avatar PM->Billing->Roll-Up Billing->->->Do Not Include Component Modifiers in Roll-Up Service" Validate the Registry Setting Details text area contains "[FACILITY SPECIFIC] -------------------------------------------------------------------------------When set to 'Y' Roll-Up Services will not include the component Modifiers. Select 'N' for the default functionality." Set the Registry Setting Value input box to "0". Verify the error dialog contains "The selected value is not valid in the current system code for the following reason: Invalid Response - Example: 'Y' or 'N'. Click the [OK]. Set the Registry Setting Value input box to "1". Validate the error dialog contains "The selected value is not valid in the current system code for the following reason: Invalid Response - Example: 'Y' or 'N'. Set the Registry Setting Value input box to "NO" Click [Submit]. Validate the error dialog contains 'The selected value is not valid in the current system code for the following reason: More than 1 characters'. Click [OK]. Set the Registry Setting Value input box to "Yes" Validate the error dialog contains 'The selected value is not valid in the current system code for the following reason: More than 1 characters'. Click [OK]. Set the Registry Setting Value input box to "X". Validate the error dialog contains "The selected value is not valid in the current system code for the following reason: Invalid Response - Example: 'Y' or 'N'. Click [OK]. Set the Registry Setting Value input box to "". Click [Submit]. Validate the Filing Error dialog contains "The following fields are missing: Registry Setting Value" Click [OK]. Set the Registry Setting Value input box to "N". Click [Submit]. Validate the Filing Results text area contains "Results filing value N to Avatar PM->Billing->Roll-Up Billing->->->Do Not Include Component Modifiers in Roll-Up Service Successful filing in System Code SBOX." Click [OK]. Set the Registry Setting Value input box to "Y". Click [Submit]. Validate the Filing Results text area contains "Results filing value N to Avatar PM->Billing->Roll-Up Billing->->->Do Not Include Component Modifiers in Roll-Up Service Successful filing in System Code SBOX." Click [OK]. Validate the Form Return dialog contains 'Registry Settings has completed. Do you wish to return to form?'. Click the [No].	Topics • Compile/Edit/Post/Unpost Roll-up Services Worklist • Roll-Up Services Definition • NX • Registry Settings
Update 5 Summary \| Details SYTEM.billing_guar_table - Require Subscriber Group Number Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Form and Table Documentation (PM) SQL Query/Reporting Admission (Outpatient) Financial Eligibility Service Codes Electronic Billing Crystal Report Viewer Scenario 1: 837 Professional - Validating ‘Require Group #’ workflow of the 'Guarantors/Payor' - Guarantor assignment through 'Financial Eligibility' form. Specific Setup: Guarantors/Payors: A new guarantor is created or an existing guarantor is identified. The 'Require Group #' field is set to "No". Note the guarantor code/name to be used during creating financial eligibility record for the client. Admission: The client is admitted to the outpatient program or an existing outpatient client is identified. Note client id/name and admission date/program. Diagnosis: An admission diagnosis record is created for the client. Financial Eligibility: The guarantor identified above is assigned to the client. The 'Subscriber Group #' field is not marked as a required field in the form for the guarantor. Leave the 'Subscriber Group #' field blank. Service Codes: An existing professional service code is identified. Note the service code. Service Fee/Cross reference maintenance: Make sure the fee definition is created for the service code and CPT code is assigned to the service code. Client Charge Input: A service is rendered to the client in the first episode. Be sure to use service codes that are covered by the benefit plan (insurance charge category). Note the date of the service. Close Charges: Charges are closed. Client Ledger: Verify the charges are correctly distributed to the desired guarantor, and they are in 'Unbill' status. Create Interim Billing Batch: An interim billing batch is created to cover the client, guarantor and services rendered to the client. Note the interim billing batch number and name. Steps Open an 'Electronic Billing' form. Compile an '837 Professional' bill for the interim batch created in the setup section. Verify the bill compiles successfully. Review the dump file. Verify the dump file includes the service(s) rendered to the client correctly. Open the 'Guarantors/Payor' form. Set the 'Require Group #' field to "Yes". Open an 'Electronic Billing' form. Compile an '837 Professional' bill for the interim batch created in the setup section. Verify the bill does not compile successfully. Review the error report. Verify the report displays the 'Missing Subscriber Group #' error on the report for the guarantor/client/service. Open the 'Financial Eligibility' form for the client. Verify the 'Subscriber Group #' field is marked as required field. Make sure the 'Subscriber Group #' field is empty. Submit the form. Verify the missing field error message for the 'Subscriber Group #' field. Enter desired group number in the 'Subscriber Group #' field. Submit the form. Open an 'Electronic Billing' form. Compile an '837 Professional' bill for the interim batch created in the setup section. Verify the bill compiles successfully. Claim the service. Review the dump file. Verify the dump file includes the service rendered to the client correctly. Verify the SBR segment contains the 'Subscriber Group #' assigned to the client from the 'Financial Eligibility' form. Close the form. Open the 'Crystal Report' or any other SQL data viewer. Query the 'SYSTEM.billing_guar_table' sql table. Verify the req_sub_group_num_code and req_sub_group_num_value columns are added to the table and displays correct data from the 'Guarantors/Payors' form for the identified guarantor. Query the 'SYSTEM.billing_guar_subs_data' table. Verify the 'subs_group' field populated with the 'Subscriber Group #' field from the 'Financial Eligibility' form. Program Transfer - Inpatient and outpatient episode Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Program Transfer Admission (Outpatient) Program Transfer (OutPatient) Scenario 1: Program Transfer - Validating program transfer for an inpatient and outpatient episode Specific Setup: Admission: A new inpatient client is admitted or an existing inpatient client is identified. Note the client id/name, admission date/admission program. A new outpatient client is admitted or an existing outpatient client is identified. Note the client id/name, admission date/admission program. Steps Select the 'Program Transfer' form. Select the inpatient client identified in the setup section. Validate the 'Program Transferred From' field contains the admission program of the client. Select desired program different from the admission program in the 'Program' field. Enter desired date in the 'Date Of Transfer' field. Enter desired time in the 'Time Of Transfer' field. Select desired 'Unit'. Select desired 'Room'. Select desired 'Bed' Click [Submit]. Verify the form submits successfully. Verify the client transferred to the correct program. Select the 'Program Transfer (Outpatient)' form. Select the outpatient client identified in the setup section. Validate the 'Program Transferred From' field contains the admission program of the client. Select desired program different from the admission program in the 'Program' field. Enter desired date in the 'Date Of Transfer' field. Enter desired time in the 'Time Of Transfer' field. Click [Submit]. Verify the form submits successfully. Verify the client transferred to the correct program.	Topics • Guarantor/Payors • Database Tables • Program Transfer
Update 6 Summary \| Details The 'Disable Demographics Section On Discharge Form' registry setting Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Discharge Scenario 1: Registry Setting - Disable Demographics Section On Discharge Form Specific Setup: A client must have an active episode (Client A). Steps Access the 'Registry Settings' form. Enter "Disable Demographics Section on Discharge Form" in the 'Limit Registry Settings to the Following Search Criteria ' field. Click [View Registry Settings]. Validate that the 'Registry Setting' field is equal to "Avatar PM->Client Information->Client Demographics->->->Disable Demographics Section On Discharge Form". Enter "N" in the 'Registry Setting Value' field. Click [Submit] and close the form. Select "Client A" and access the 'Discharge' form. Enter the required details in the 'Discharge' section. Select the 'Demographics' section. Validate fields in the 'Demographics' section are not disabled. Close the form. Select "Client A" and access the 'Admission' form. Select the 'Demographics' section. Validate fields in the 'Demographics' section are not disabled. Close the form. Access the 'Registry Settings' form. Enter "Disable Demographics Section on Discharge Form" in the 'Limit Registry Settings to the Following Search Criteria' field. Click [View Registry Settings]. Validate that the 'Registry Setting' field is equal to "Avatar PM->Client Information->Client Demographics->->->Disable Demographics Section On Discharge Form". Enter "Y" in the 'Registry Setting Value' field. Click [Submit] and close the form. Log out of the application and log back in. Select "Client A" and access the 'Discharge' form. Select the 'Demographics' section. Validate all fields are disabled. Close the form. Select "Client A" and access the 'Admission' form. Select the 'Demographics' section. Validate fields in the 'Demographics' section are not disabled. Close the form.	Topics • Registry Settings • Admission • Discharge
Update 7 Summary \| Details Web services - WEBSVC.AppointmentScheduling V2 Scenario 1: Load & Go update - Verify successful installation Steps Internal Testing Only	Topics • Web Services • Problem List
Update 8 Summary \| Details Avatar PM 'Summary Trial Balance Report' Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Summary Trial Balance Report Scenario 1: 'Summary Trial Balance Report' - Verification of report results Steps Open Avatar PM 'Summary Trial Balance Report' form (under 'Avatar PM / Billing / Billing Reports / Monthly Closeout Reports' menu). Enter/select values for 'Summary Balance As Of ', 'Aging Category' and 'Include Bad Debt Information' report criteria fields. Click 'Process' button to run report/render result data. Ensure that 'Summary Trial Balance Report' results are rendered/displayed in the default report format within myAvatar/Avatar NX. In 'Summary Trial Balance Report' results display, ensure that the following information fields are present: 'Run Date' (current date) 'As Of' (from 'Summary Balance As Of' report criteria field) 'Revenue Group' 'Unbilled' report information 'Financial Class' 'In-House' (with dollar values) 'Disc' (discharged; with dollar values) 'Days' (with value) 'Total'/'Totals' (with dollar values) 'Billed' report information 'Financial Class' Aging Categories (default or custom entered/edited values as defined in 'Aging Category' report criteria field; '0', '30', '120', etc; with dollar values) 'Total'/'Totals' (with dollar values) Ensure that 'Summary Trial Balance Report' results display includes information/dollar values for all fields/groupings noted above with expected values based on unbilled/billed services and payments present in Avatar PM system for selected 'Summary Balance As Of' report criteria date, including 'Total'/'Totals' calculated values. Ensure that Summary Trial Balance Report' results display includes 'ALL' Revenue Group summary information (summary totals for report information); ensure that 'ALL' Revenue Group summary information includes information/dollar values for all fields/groupings noted above display with expected values based on unbilled/billed services and payments present in Avatar PM system for selected 'Summary Balance As Of' report criteria date, including 'Total'/'Totals' calculated values. In 'Summary Trial Balance Report' results display, click 'Print All Pages', 'Print Page', 'Export All Pages' and/or 'Export Page' button to print or export/save report data as desired. Click 'Close' button to close 'Summary Trial Balance Report' results display. Scenario 2: 'Summary Trial Balance Report' - Verification of .CSV format report results Steps Open Avatar PM 'Summary Trial Balance Report' form (under 'Avatar PM / Billing / Billing Reports / Monthly Closeout Reports' menu). Enter/select values for 'Summary Balance As Of ', 'Aging Category' and 'Include Bad Debt Information' report criteria fields. Ensure 'Export Detail Information to CSV' field is present in form, with 'Yes' checkbox/selection available. No selection in the 'Export Detail Information to CSV' field will render report results in the default report format Selecting 'Yes' in the 'Export Detail Information to CSV' field will display report results in CSV (comma-separated value) format (allowing user to export/save 'Summary Trial Balance Report' results for external use) Click 'Process' button to run report/render result data. If no value is selected in 'Export Detail Information to CSV' field, ensure that 'Summary Trial Balance Report' results are rendered/displayed in the default report format. If 'Yes' is selected for 'Export Detail Information to CSV' field, ensure that 'Summary Trial Balance Report' results are rendered/displayed in .CSV format within myAvatar/Avatar NX, with following header and individual data rows present: 'Summary Trial Balance Report' .CSV format data header (first row in report data results) will contain the following data elements: 'RRG' 'RRG Description' 'Financial Class' 'Financial Class Description' 'Unbilled In-House' 'Unbilled Disch' 'Days' Aging Categories (default or custom entered/edited values as defined in 'Aging Category' report criteria field; 'Aging 0', 'Aging 30', 'Aging 60', 'Aging 120', etc.) Header row examples: "RRG,RRG Description,Financial Class,Financial Class Description,Unbilled In-House,Unbilled Disch,Days,Billed/Aging Category 0,Billed/Aging Category 30,Billed/Aging Category 60,Billed/Aging Category 90,Billed/Aging Category 120,Total" "RRG,RRG Description,Financial Class,Financial Class Description,Unbilled In-House,Unbilled Disch,Days,Billed/Aging Category 5,Billed/Aging Category 10,Billed/Aging Category 20,Billed/Aging Category 30,Billed/Aging Category 40,Billed/Aging Category 50,Billed/Aging Category 60,Total" 'Total' 'Summary Trial Balance Report' .CSV format individual data rows (second and all subsequent rows in report data results) will contain report data for each element, one row per result. Data row examples: "5,Outpatient Substance Abuse,7,Medicare Part A,2397.15,0.00,0,1181.21,0.00,0.00,0.00,815.00,4393.36" "8,Outpatient Psychiatric,3,Blue Cross,1176903.89,0.00,0,1476.11,0.00,0.00,0.00,0.00,0.00,12365.15,1190745.15" "IP,Inpatient Psychiatric,10,Non-Recoverable,18635.12,6000.50,0,3360.52,88.00,1500.00,200.00,6526.80,40022.44" In 'Summary Trial Balance Report' results display, click 'Export All Pages' or 'Export Page' button to export/save .CSV format report data to file. Open/review exported .CSV format file, ensuring that data header and all individual data rows are present in file as displayed/defined above.	Topics • Summary Trial Balance Report
Update 9 Summary \| Details Quick Billing Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Purge Billing Files Quick Billing Rule Definition Quick Billing Scenario 1: Quick Billing workflow for existing unbilled services Specific Setup: Quick Billing Rule Definitions exist that allows the system to bill many services. Unbilled services exist in the system that can be billed through the definitions. Note the dates of service. Steps Open ‘Quick Billing’. Select ‘Add New’ in ‘Add New Or Edit Existing Quick Billing Batch’. Enter desired value in ‘First Date Of Service To Include’. Enter desired value in ‘Last Date Of Service To Include’. Select desired value in ‘Billing Rule Group To Execute’ or ‘Billing Rule To Execute’. Select values in ‘Quick Billing Tasks to Execute’. Click [Submit]. Validate that the ‘Compile Complete’ message is received. Print the 837 report and validate the data.	Topics • Quick Billing • NX
Update 10 Summary \| Details Avatar PM 'Enable Submitter Identification Definition' Registry Setting Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Submitter Identification Definition Electronic Billing Scenario 1: 'Submitter Identification Definition' - Form Verification Specific Setup: Avatar PM Registry Setting 'Enable Submitter Identification Definition' must be enabled/include value '3' Crystal Reports or other SQL reporting tool Steps Open Avatar PM 'Submitter Identification Definition' form (under 'Avatar PM / System Maintenance / System Definition' menu). Select value in 'Program' field. Select 'Add' in 'Add or Edit' field (or select 'Edit' and click 'Select Existing Submitter Identification Definition' button to select/view/update existing definition entry). Enter value for 'Effective Date' (and 'Expiration Date' if desired). Enter/select value in 'Guarantor' field. Enter/select value in 'Client' field if Submitter Identification Definition entry should be client-specific. If 'Client' value is defined, Submitter Identification Definition entry will apply only to services for selected client in Electronic Billing 837 file sorting/creation Ensure the following 'Authorization Number' Submitter Identification criteria field is present in 'Submitter Identification Definition' form where Avatar PM Registry Setting 'Enable Submitter Identification Definition' includes configuration value '3': Enter/select value in 'Authorization Number' field if Submitter Identification Definition entry should be Managed Care Authorization-specific or Payor Based Authorization-specific. If 'Authorization' value is defined, Submitter Identification Definition entry will apply only to services valid for selected Managed Care Authorization or Payor Based Authorization in Electronic Billing 837 file sorting/creation Note - Submitter Identification Definition requirement for Authorization is only applicable where Authorization is required for Electronic Billing service inclusion (via Avatar PM 'Guarantors/Payors' form 'Authorization Information' section for selected Guarantor). Enter/select service code(s) for Submitter Identification Definition in 'Service Code' field. Ensure the following 837 Submitter Identification Information fields are present in 'Submitter Identification Definition' form where Avatar PM Registry Setting 'Enable Submitter Identification Definition' includes configuration value '3': 'Program Taxonomy 2000A-PRV-03' 'Billing Provider Primary Identification Code Qualifier (2010AA-NM1-08)' 'Billing Provider Primary Identification # (2010AA-NM1-09)' 'Billing Provider Secondary Identification Number (2010BB-REF-02)' 'Facility Identification Code Qualifier (837P-2310C / 837P-2420C / 837I-2310E-NM1-08)' 'Facility Identification Code (837P-2310C / 837P-2420C / 837I-2310E-NM1-09)' 'Facility Reference Identification Qualifier (837P-2310C / 837P-2420C / 837I-2310E-REF-01)' 'Facility Reference Identification (837P-2310C / 837P-2420C / 837I-2310E-REF-02)' Enter desired values for 837 Submitter Identification Information fields listed above (as well as 'Submitter Identification Code Qualifier', 'Submitter Identification Number' and 'Billing Provider Secondary ID Code Qualifier' fields as required/desired). Click 'File Definition' button to file/save Submitter Identification Definition entry. Ensure user is presented with confirmation dialog noting 'Definition Filed'; click 'OK' button to return to form. Select same/previously used value in 'Program' and/or 'Guarantor' fields. Select 'Edit' in 'Add or Edit' field and click 'Select Existing Submitter Identification Definition' button to select/view previously filed Submitter Identification Definition entry. Ensure all fields are populated with/display previously entered and filed values (including Submitter Identification Information fields listed above). Click 'Display Submitter Identification Definitions' button to open report for display of Submitter Identification Definition entries (for selected Program and/or Guarantor if value selected in form, or for all Programs/Guarantors if no criteria values). In the 'Display Submitter Identification Definitions' report display/results, ensure that Submitter Identification Definition entry/information values are displayed as previously entered/filed in system. Open Crystal Reports or other SQL reporting tool. In Avatar PM SQL table 'SYSTEM.table_submitter_id_def', ensure that data row(s) are added/updated on filing of 'Submitter Identification Definition' form and contain values/information filed via form for all applicable fields (including Submitter Identification Information fields listed above). Scenario 2: 'Electronic Billing' - Verification Of 'Submitter Identification Definition' Values (837 Professional) Specific Setup: Avatar PM Registry Setting 'Enable Submitter Identification Definition' must be enabled/include value '3' Acceptance Testing Scenario includes 837 loops/segments for Registry Setting value '1&2&3' 'Guarantor/Program Billing Defaults' template/entry applicable to Guarantor/Program for 837 service inclusion where 'Provider Taxonomy Code to Display (2000A-PRV-03)' is set to 'Submitter Identification Definition' ('837 Professional' section) 'Guarantor/Program Billing Defaults' template/entry applicable to Guarantor/Program for 837 service inclusion where one or more of the following '837 Professional' section configuration fields are set to Dictionary Code value 'ZZZ': 'Billing Provider Primary Identification Code Qualifier (2010AA-NM1-08)' 'Other Tabled Files' Indirect, Dictionary Data Element 1187, Code 'ZZZ' must be defined 'Billing Provider Secondary Identification Code Qualifier' 'Other Tabled Files' Indirect, Dictionary Data Element 13535, Code 'ZZZ' must be defined 'Facility Identification Code Qualifier' 'Other Tabled Files' Indirect, Dictionary Data Element 12066, Code 'ZZZ' must be defined 'Facility Reference Identification Qualifier' 'Other Tabled Files' Indirect, Dictionary Data Element 12068, Code 'ZZZ' must be defined 'Submitter Identification Definition' record applicable to Program/Guarantor/service dates (and Client/Authorization if specified in the 'Submitter Identification Definition' record) One or more 837 Professional /HCFA 1500 service(s) eligible for Electronic Billing 837 inclusion Steps Open Avatar PM 'Electronic Billing' form. Note, acceptance testing may also be confirmed via Avatar PM 'Quick Billing' form/functionality Select '837 Professional' in the 'Billing Form' field. Select 'Sort File' in the 'Billing Options' field. Enter/select 837 Professional file sorting criteria. Click 'Process' button to sort/generate 837 Professional file. Select 'Dump File' in the 'Billing Options' field (or select 'Create File On Server' to review output file directly). Select 'Print' in the 'Print Or Delete Report' field. Select 837 Professional file sorted which includes services(s), and click 'Process' button to display 837 Professional outbound file data. Submitter Name Identification Code Qualifier/Code 1000A NM1-08/NM1-09 In Avatar PM 837 Professional format outbound electronic billing file data - ensure that 837 Professional includes Submitter Name Identification Code Qualifier/Code 1000A NM1-08/NM1-09 information as follows: Where 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Billing Provider Secondary Identification Code Qualifier' field, 1000A NM1-08/NM1-09 segments are populated from the 'Submitter Identification Code Qualifier' and 'Submitter Identification Number' fields in the 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified in the 'Submitter Identification Definition' record) In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is not found, claim(s)/service(s) will not be included in 837 Professional file sorting Where a value other than 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Billing Provider Secondary Identification Code Qualifier' field, 1000A NM1-08/NM1-09 segments are populated from Guarantor information and do not use values from 'Submitter Identification Definition' record Billing Provider Specialty Information Reference Identification 2000A PRV-03 In Avatar PM 837 Professional format outbound electronic billing file data - ensure that 837 Professional includes Billing Provider Specialty Information Reference Identification 2000A PRV-03 information as follows: Where 'Submitter Identification Definition' is selected in the Guarantor/Program Billing Defaults 'Provider Taxonomy Code To Display (2000A-PRV-03)' field, 2000A PRV-03 segment is populated from the 'Program Taxonomy 2000A-PRV-03' field in the 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates(and Client/Authorization if specified in the 'Submitter Identification Definition' record) In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is not found, claim(s)/service(s) will not be included in 837 Professional file sorting In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is found but 'Program Taxonomy 2000A-PRV-03' value is not defined in Submitter Identification Definition information, 2000A PRV-03 segment is populated from Program or Guarantor/Program information Where 'Program Maintenance' or 'Guarantor/Program Billing Defaults' is selected in the Guarantor/Program Billing Defaults 'Provider Taxonomy Code To Display (2000A-PRV-03)' field, 2000A PRV-03 segment is populated from Program or Guarantor/Program information and does not use value from 'Submitter Identification Definition' record Billing Provider Name Identification Code Qualifier/Code 2010AA NM1-08/NM1-09 In Avatar PM 837 Professional format outbound electronic billing file data - ensure that 837 Professional includes Billing Provider Name Identification Code Qualifier/Code 2010AA NM1-08/NM1-09 information as follows: Where 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Billing Provider Primary Identification Code Qualifier (2010AA-NM1-08)' field, 2010AA NM1-08/NM1-09 segments are populated from the 'Billing Provider Primary Identification Code Qualifier (2010AA-NM1-08)' and 'Billing Provider Primary Identification # (2010AA-NM1-09)' fields in the 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified in the 'Submitter Identification Definition' record) In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is not found, claim(s)/service(s) will not be included in 837 Professional file sorting In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is found but 'Billing Provider Primary Identification Code Qualifier (2010AA-NM1-08)' / 'Billing Provider Primary Identification # (2010AA-NM1-09)' values are not defined in Submitter Identification Definition information, 2010AA NM1-08/NM1-09 segments are populated from Guarantor/Program, Program or Facility Defaults information Where a value other than 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Billing Provider Primary Identification Code Qualifier (2010AA-NM1-08)' field, 2010AA NM1-08/NM1-09 segments are populated from Guarantor/Program, Program or Facility Defaults information and do not use values from 'Submitter Identification Definition' record Payer Secondary Identification Code Qualifier/Code 2010BB REF-01/REF-02 In Avatar PM 837 Professional format outbound electronic billing file data - ensure that 837 Professional includes Payer Secondary Identification Code Qualifier/Code 2010BB REF-01/REF-02 information as follows: Where 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Billing Provider Secondary Identification Code Qualifier' field, 2010BB REF-01/REF-02 segments are populated from the 'Billing Provider Secondary ID Code Qualifier' and 'Billing Provider Secondary Identification Number (2010BB-REF-02)' fields in the 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified in the 'Submitter Identification Definition' record) Note - The 'Submitter Identification Definition' record 'Billing Provider Secondary Identification Number (2010BB-REF-02)' field/value will override the 'Submitter Identification Number' field/value in same record where '2' is selected/included in the 'Enable Submitter Identification Definition' Registry Setting In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is not found, claim(s)/service(s) will not be included in 837 Professional file sorting In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is found but 'Billing Provider Secondary Identification Number (2010BB-REF-02)' value is not defined in Submitter Identification Definition information, 2010BB REF-02 is populated from the 'Submitter Identification Number' field in the corresponding 'Submitter Identification Definition' record (where '2' is selected/included in the 'Enable Submitter Identification Definition' Registry Setting) or from Guarantor/Program information Where a value other than 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Billing Provider Secondary Identification Code Qualifier' field, 2010BB REF-01/REF-02 segments are populated from Guarantor/Program information and do not use values from 'Submitter Identification Definition' record Service Facility Location Name Identification Code Qualifier/Code 2310C and 2420C NM1-08/NM1-09 In Avatar PM 837 Professional format outbound electronic billing file data - ensure that 837 Professional includes Service Facility Location Name Identification Code Qualifier/Code 2310C and 2420C NM1-08/NM1-09 information as follows: Where 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Facility Identification Code Qualifier' field, 2310C and 2420C NM1-08/NM1-09 segments are populated from the 'Facility Identification Code Qualifier (837P-2310C / 837P-2420C...' and 'Facility Identification Code (837P-2310C / 837P-2420C...' fields in the 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified in the 'Submitter Identification Definition' record) In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is not found, claim(s)/service(s) will not be included in 837 Professional file sorting In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is found but 'Facility Identification Code Qualifier (837P-2310C / 837P-2420C...' / 'Facility Identification Code (837P-2310C / 837P-2420C...' values are not defined in Submitter Identification Definition information, 2310C and 2420C NM1-08/NM1-09 segments are populated from Guarantor/Program information Where a value other than 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Facility Identification Code Qualifier' field, 2310C and 2420C NM1-08/NM1-09 segments are populated from Guarantor/Program information and do not use values from 'Submitter Identification Definition' record Service Facility Location Secondary Identification Code Qualifier/Code 2310C and 2420C REF-01/REF-02 In Avatar PM 837 Professional format outbound electronic billing file data - ensure that 837 Professional includes Service Facility Location Secondary Identification Code Qualifier/Code 2310C and 2420C REF-01/REF-02 information as follows: Where 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Facility Reference Identification Qualifier', field, 2310C and 2420C REF-01/REF-02 segments are populated from the 'Facility Reference Identification Code Qualifier (837P-2310C / 837P-2420C...' and 'Facility Reference Identification (837P-2310C / 837P-2420C...' fields in the 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified in the 'Submitter Identification Definition' record) In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is not found, claim(s)/service(s) will not be included in 837 Professional file sorting In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is found but 'Facility Reference Identification Code Qualifier (837P-2310C / 837P-2420C...' and 'Facility Reference Identification (837P-2310C / 837P-2420C...' values are not defined in Submitter Identification Definition information, 2420C REF-01/REF-02 segments are populated from Program information Where a value other than 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Facility Reference Identification Qualifier' field, 2420C REF-01/REF-02 segments are populated from Program information and do not use values from 'Submitter Identification Definition' record Scenario 3: 'Electronic Billing' - Verification Of 'Submitter Identification Definition' Values (837 Institutional) Specific Setup: Avatar PM Registry Setting 'Enable Submitter Identification Definition' must be enabled/include value '3' Acceptance Testing Scenario includes 837 loops/segments for Registry Setting value '1&2&3' 'Guarantor/Program Billing Defaults' template/entry applicable to Guarantor/Program for 837 service inclusion where 'Provider Taxonomy Code to Display (2000A-PRV-03)' is set to 'Submitter Identification Definition' ('837 Institutional' section) 'Guarantor/Program Billing Defaults' template/entry applicable to Guarantor/Program for 837 service inclusion where one or more of the following '837 Institutional' section configuration fields are set to Dictionary Code value 'ZZZ': 'Billing Provider Primary Identification Code Qualifier (2010AA-NM1-08)' 'Other Tabled Files' Indirect, Dictionary Data Element 12009, Code 'ZZZ' must be defined 'Billing Provider Secondary Identification Code Qualifier (2010BB-REF-01)' 'Other Tabled Files' Indirect, Dictionary Data Element 12157, Code 'ZZZ' must be defined 'Facility Identification Code Qualifier (2310E-NM1-08)' 'Other Tabled Files' Indirect, Dictionary Data Element 12052, Code 'ZZZ' must be defined 'Facility Reference Identification Qualifier (2310E-REF-01)' 'Other Tabled Files' Indirect, Dictionary Data Element 12054, Code 'ZZZ' must be defined 'Submitter Identification Definition' record applicable to Program/Guarantor/service dates (and Client/Authorization if specified in the 'Submitter Identification Definition' record) One or more 837 Institutional / UB-04 service(s) eligible for Electronic Billing 837 inclusion Steps Open Avatar PM 'Electronic Billing' form. Note, acceptance testing may also be confirmed via Avatar PM 'Quick Billing' form/functionality Select '837 Institutional' in the 'Billing Form' field. Select 'Sort File' in the 'Billing Options' field. Enter/select 837 Institutional file sorting criteria. Click 'Process' button to sort/generate 837 Institutional file. Select 'Dump File' in the 'Billing Options' field (or select 'Create File On Server' to review output file directly). Select 'Print' in the 'Print Or Delete Report' field. Select 837 Institutional file sorted which includes services(s), and click 'Process' button to display 837 Institutional outbound file data. Submitter Name Identification Code Qualifier/Code 1000A NM1-08/NM1-09 In Avatar PM 837 Institutional format outbound electronic billing file data - ensure that 837 Institutional includes Submitter Name Identification Code Qualifier/Code 1000A NM1-08/NM1-09 information as follows: Where 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Billing Provider Secondary Identification Code Qualifier (2010BB-REF-01)' field, 1000A NM1-08/NM1-09 segments are populated from the 'Submitter Identification Code Qualifier' and 'Submitter Identification Number' fields in the 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified in the 'Submitter Identification Definition' record) In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is not found, claim(s)/service(s) will not be included in 837 Institutional file sorting Where a value other than 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Billing Provider Secondary Identification Code Qualifier' field, 1000A NM1-08/NM1-09 segments are populated from Guarantor information and do not use values from 'Submitter Identification Definition' record Billing Provider Specialty Information Reference Identification 2000A PRV-03 In Avatar PM 837 Institutional format outbound electronic billing file data - ensure that 837 Institutional includes Billing Provider Specialty Information Reference Identification 2000A PRV-03 information as follows: Where 'Submitter Identification Definition' is selected in the Guarantor/Program Billing Defaults 'Provider Taxonomy Code To Display (2000A-PRV-03)' field, 2000A PRV-03 segment is populated from the 'Program Taxonomy 2000A-PRV-03' field in the 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates(and Client/Authorization if specified in the 'Submitter Identification Definition' record) In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is not found, claim(s)/service(s) will not be included in 837 Institutional file sorting In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is found but 'Program Taxonomy 2000A-PRV-03' value is not defined in Submitter Identification Definition information, 2000A PRV-03 segment is populated from Program or Guarantor/Program information Where 'Program Maintenance' or 'Guarantor/Program Billing Defaults' is selected in the Guarantor/Program Billing Defaults 'Provider Taxonomy Code To Display (2000A-PRV-03)' field, 2000A PRV-03 segment is populated from Program or Guarantor/Program information and does not use value from 'Submitter Identification Definition' record Billing Provider Name Identification Code Qualifier/Code 2010AA NM1-08/NM1-09 In Avatar PM 837 Institutional format outbound electronic billing file data - ensure that 837 Institutional includes Billing Provider Name Identification Code Qualifier/Code 2010AA NM1-08/NM1-09 information as follows: Where 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Billing Provider Primary Identification Code Qualifier (2010AA-NM1-08)' field, 2010AA NM1-08/NM1-09 segments are populated from the 'Billing Provider Primary Identification Code Qualifier (2010AA-NM1-08)' and 'Billing Provider Primary Identification # (2010AA-NM1-09)' fields in the 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified in the 'Submitter Identification Definition' record) In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is not found, claim(s)/service(s) will not be included in 837 Institutional file sorting In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is found but 'Billing Provider Primary Identification Code Qualifier (2010AA-NM1-08)' / 'Billing Provider Primary Identification # (2010AA-NM1-09)' values are not defined in Submitter Identification Definition information, 2010AA NM1-08/NM1-09 segments are populated from Guarantor/Program, Program or Facility Defaults information Where a value other than 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Billing Provider Primary Identification Code Qualifier (2010AA-NM1-08)' field, 2010AA NM1-08/NM1-09 segments are populated from Guarantor/Program, Program or Facility Defaults information and do not use values from 'Submitter Identification Definition' record Payer Secondary Identification Code Qualifier/Code 2010BB REF-01/REF-02 In Avatar PM 837 Institutional format outbound electronic billing file data - ensure that 837 Institutional includes Payer Secondary Identification Code Qualifier/Code 2010BB REF-01/REF-02 information as follows: Where 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Billing Provider Secondary Identification Code Qualifier' field, 2010BB REF-01/REF-02 segments are populated from the 'Billing Provider Secondary ID Code Qualifier' and 'Billing Provider Secondary Identification Number (2010BB-REF-02)' fields in the 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified in the 'Submitter Identification Definition' record) Note - The 'Submitter Identification Definition' record 'Billing Provider Secondary Identification Number (2010BB-REF-02)' field/value will override the 'Submitter Identification Number' field/value in same record where '2' is selected/included in the 'Enable Submitter Identification Definition' Registry Setting In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is not found, claim(s)/service(s) will not be included in 837 Institutional file sorting In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is found but 'Billing Provider Secondary Identification Number (2010BB-REF-02)' value is not defined in Submitter Identification Definition information, 2010BB REF-02 is populated from the 'Submitter Identification Number' field in the corresponding 'Submitter Identification Definition' record (where '2' is selected/included in the 'Enable Submitter Identification Definition' Registry Setting) or from Guarantor/Program information Where a value other than 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Billing Provider Secondary Identification Code Qualifier' field, 2010BB REF-01/REF-02 segments are populated from Guarantor/Program information and do not use values from 'Submitter Identification Definition' record Service Facility Location Name Identification Code Qualifier/Code 2310E NM1-08/NM1-09 In Avatar PM 837 Institutional format outbound electronic billing file data - ensure that 837 Institutional includes Service Facility Location Name Identification Code Qualifier/Code 2310E NM1-08/NM1-09 information as follows: Where 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Facility Identification Code Qualifier (2310E-NM1-08)' field, 2310E NM1-08/NM1-09 segments are populated from the 'Facility Identification Code Qualifier (...837I-2310E-NM1-08)' and 'Facility Identification Code (...837I-2310E-NM1-09)' fields in the 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified in the 'Submitter Identification Definition' record) In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is not found, claim(s)/service(s) will not be included in 837 Institutional file sorting In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is found but 'Facility Identification Code Qualifier (...837I-2310E-NM1-08)' / 'Facility Identification Code (...837I-2310E-NM1-09)' values are not defined in Submitter Identification Definition information, 2310E NM1-08/NM1-09 segments are populated from Guarantor/Program information Where a value other than 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Facility Identification Code Qualifier' field, 2310E NM1-08/NM1-09 segments are populated from Guarantor/Program information and do not use values from 'Submitter Identification Definition' record Service Facility Location Secondary Identification Code Qualifier/Code 2310E REF-01/REF-02 In Avatar PM 837 Institutional format outbound electronic billing file data - ensure that 837 Institutional includes Service Facility Location Secondary Identification Code Qualifier/Code 2310E REF-01/REF-02 information as follows: Where 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Facility Reference Identification Qualifier (2310E-REF-01)', field, 2310E REF-01/REF-02 segments are populated from the 'Facility Reference Identification Code Qualifier (...837I-2310E-REF-01)' and 'Facility Reference Identification (...837I-2310E-REF-02)' fields in the 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified in the 'Submitter Identification Definition' record) In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is not found, claim(s)/service(s) will not be included in 837 Institutional file sorting In case where 'Submitter Identification Definition' record corresponding to Program/Guarantor/service dates (and Client/Authorization if specified) is found but 'Facility Reference Identification Code Qualifier (...837I-2310E-REF-01)' and 'Facility Reference Identification (...837I-2310E-REF-02)' values are not defined in Submitter Identification Definition information, 2310E REF-01/REF-02 segments are populated from Program information Where a value other than 'ZZZ' is defined/selected in the Guarantor/Program Billing Defaults 'Facility Reference Identification Qualifier (2310E-REF-01)' field, 2310E REF-01/REF-02 segments are populated from Program information and do not use values from 'Submitter Identification Definition' record Scenario 4: Avatar PM Registry Settings - Verification of 'Enable Submitter Identification Definition' Registry Setting Steps Open 'Registry Settings' form. Set 'Include Hidden Registry Settings' field to 'Yes'. Enter search value 'Enable Submitter Identification' and click 'View Registry Settings' button. Ensure Registry Setting is returned (under 'Avatar PM -> Billing -> Electronic Billing -> All 837 Submissions- > Enable Submitter Identification Definition' path). Ensure 'Registry Setting Details' field contains the following explanation text: "Enabling this functionality gives an end-user the ability to optionally specify identification information based on guarantor, program, service code, and client combination for a specific date range. This is accomplished by adding the 'Submitter Identification Definition' form under 'Avatar PM->System Maintenance->System Definition'. In addition, the following 837 logic is enabled: When generating a version 4010 837 bill, a check will be made to see if a value of 'ZZZ' is in 'Billing Provider Secondary Identification Code Qualifier 1 (2010AA-REF-01)', or 'Billing Provider Secondary Identification Code Qualifier 2 (2010AA-REF-01)' or 'Billing Provider Secondary Identification Code Qualifier 3 (2010AA-REF-01)' in the 'Guarantor/Program Billing Defaults' form. For version 5010, the system will check the 'Billing Provider Secondary Identification Code Qualifier (2010BB-REF)' field. If '1' is selected, the 'Submitter Primary Identification Qualifier (1000A-NM1-08)' and 'Submitter Primary Identification Number (1000A-NM1-09)' will be populated with the values specified in the 'Submitter Identification Code Qualifier' and 'Submitter Identification Number' fields of the above form respectively. This functionality is available in both version 4010 and 5010. If '2' is selected, for version 4010 the 'Billing Provider Secondary Identification Code Qualifier (2010AA-REF-01)' and 'Billing Provider Secondary Identification # (2010AA-REF-02)' will be populated with the values specified in the 'Billing Provider Secondary Identification Code Qualifier' and 'Submitter Identification Number' fields specified for any iteration that contains the 'ZZZ' dictionary code. For version 5010, the 'Billing Provider Secondary Identification Code Qualifier (2010BB-REF-01)' and 'Billing Provider Secondary Identification # (2010BB-REF-02)' will be populated with the same values specified for any iteration that contains the 'ZZZ' dictionary code. If '3' is selected the ability to optionally specify identification information based on authorization number is added and if "ZZZ" is selected in the following 'Guarantor/Program Billing Defaults' fields on the left then the appropriate 837 fields will be populated with the 'Submitter Identification Definition' fields on the right: 'Billing Provider Primary Identification Code Qualifier (2010AA-NM1-08)' -- 'Billing Provider Primary Identification Code Qualifier (2010AA-NM1-08)' and 'Billing Provider Primary Identification # (2010AA-NM1-09)' Note: The 'Submitter Identification Definition' 'Billing Provider Secondary Identification Number (2010BB-REF-02)' field will override the 'Submitter Identification Number' field that is used if "2" is selected. 'Facility Identification Code Qualifier'/'Facility Identification Code Qualifier (2310E-NM1-08)' -- 'Facility Identification Code Qualifier (837P-2310C / 837P-2420C / 837I-2310E-NM1-08)' and 'Facility Identification Code (837P-2310C / 837P-2420C / 837I-2310E-NM1-09)' 'Facility Reference Identification Qualifier'/'Facility Reference Identification Qualifier (2310E-REF-01)' -- 'Facility Reference Identification Qualifier (837P-2310C / 837P-2420C / 837I-2310E-REF-01)' and 'Facility Reference Identification (837P-2310C / 837P-2420C / 837I-2310E-REF-02)' 'Provider Taxonomy Code to Display (2000A-PRV-03)' -- 'Program Taxonomy 2000A-PRV-03' Note: The "ZZZ=Submitter Identification Definition" dictionary code/value will be added to the 'Provider Taxonomy Code to Display (2000A-PRV-03)' dictionary. For version 5010, the same code would need to be added to the 'Billing Provider Secondary Code Qualifier (2010BB-REF-01)'. This also necessitates that the bills will be sorted by submitter identification number. Selecting '1&2&3' will add all of the functionality listed above. Selecting '0' will remove the form from the menu and disable the 837 logic. Note: This functionality is used to meet a PA State requirement."	Topics • Registry Settings • Electronic Billing • NX • 837 Professional • 837 Institutional
Update 11 Summary \| Details Spreadsheet Batch Remittance Posting Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Service Codes Posting/Adjustment Codes Definition Claim Adjustment Group/Reason Code Definition Practitioner Enrollment Practitioner Numbers By Guarantor and Program Admission (Outpatient) Financial Eligibility Electronic Billing Spreadsheet Batch Remittance Posting Batch Remittance Posting Report Facility Defaults 835 Health Care Claim Payment/Advice (PM) Scenario 1: Spreadsheet Remittance Batch Posting - Validating financial eligibility data upon hover over the 'Transfer Guar' field. Specific Setup: Posting/Adjustment Codes Definition has been used to create desired definitions. Claim Adjustment Group/Reason Code Definition has been used to create desired definitions. An existing client is identified. Three or more guarantors are assigned to the client using 'Financial Eligibility' form. Note the liability order for the guarantors. Services are rendered to the client so that at least one of the guarantors has no liability. Client Ledger is used to validate that liability distributed to the guarantors based on the setup in the 'Financial Eligibility' form. An Interim billing batch is created in the 'Create Interim Billing Batch File' form which includes the client / guarantor and services. Steps Open the 'Spreadsheet Remittance Batch Posting' form. Select 'Create Batch' in the 'Create, Edit Or Delete Remittance Batch' field. Enter the 'Batch Description'. Select the interim billing batch created in the setup section in the 'Interim Batch Number' field. Enter desired date in the 'Posting Date' field. Enter desired date in the 'Date Of Receipt' field. If desired, enter/select values in 'Receipt'. If desired, enter/select values in 'Check #' If desired, enter/select values in 'Default Guarantor'. If desired, enter/select values in 'Default Payment Code'. If desired, enter/select values in 'Default Adjustment Code'. If desired, enter/select values in 'Default Transfer Code'. If desired, enter/select values in 'Service Start Date'. If desired, enter/select values in 'Service End Date'. Click [Launch Work Screen]. Validate that the 'Client' defaults. Validate that other entered/selected data defaults. Enter a 'Transfer Amount'. Enter a 'Transfer Code'. Hover over the 'Transfer Guar' field. Verify that a mini table will be displayed containing a list of guarantors that are assigned to the client's episode via 'Financial Eligibility' (excluding the current guarantor) and active for the selected date of service in the same order as they set up in the 'Financial Eligibility' form. Select the desired guarantor to transfer to in the mini table. Click [Accept]. Click [Submit]. Click [OK]. Click [No]. Open the 'Client Ledger' form. Select the 'Client ID' Select 'All Episodes' in 'Claim/Episode/All Episodes'. Enter the desired 'From Date'. Enter the desired 'To Date'. Select 'Simple' in 'Ledger Type'. Click [Process]. Validate the payment and transfer activity. Click [Dismiss]. Close the form. Scenario 2: Spreadsheet Batch Remittance Posting - Guarantor/Payors - 835 - Allow Adjustment Reversals' Specific Setup: Registry Settings: Avatar PM->Billing->Financial Eligibility->->->Enable Automatic Contractual Adjustment Based On Fee Table = 'O' or 'A'. Avatar PM->Billing->Remittance Processing->835 Health Care Claim Payment/Advice->->Compile But Don't Post Adjustments (CAS) = Y. Posting/Adjustment Codes Definition has been used to create desired definitions. Guarantors/Payors: Select a guarantor that will be the primary guarantor for the client. 'Contractual Guarantor Information' section: All required fields are enabled. Enable Modified Contractual Allowance Calculation has desired value. '835' section: 'Allow Adjustment Reversals' = Yes. Help message = If "Yes" is selected the '835 Health Care Claim Payment/Advice' and 'Spreadsheet Batch Remittance Posting' will: 1) Determine amount of any credit contractual allowance adjustments that were automatically posted for the Guarantor during liability distribution. 2) If there is a positive amount and a 'Contractual Adjustment Code (Debit)' code is selected in the 'Guarantors/Payors' (Contractual Guarantor Information) form a debit adjustment will be automatically posted to reverse the credit adjustments. Service Fee/ Cross Reference Maintenance: Identify a service code with a standard fee and a 'Guarantor Definition' for the above guarantor with the following: Standard Fee: Fee is active based on the dates in 'From Date' and 'End Date'. Note the fee. Guarantor Definition: Note the value in 'Maximum Amount To Distribute Per Service'. It should be less than the standard fee. Write-off Remaining Balance (Contract Guarantors Only) = Yes. A new client is added, or an existing client is identified. Note the Client ID/name. The financial eligibility record is created for the client. The client is assigned two or more guarantors. The primary guarantor is the guarantor that has the fee definition. Services are rendered to the client for the service code with the fee definitions. Note the service start / end date and service code used. The 'Client Ledger' report for the client is processed. Save the report for comparison. Note that a portion of each has service has been adjusted off. Close Charges is used to close the charges. The services do not have to be claimed to complete testing, however if preferred, create an interim billing batch, and use Electronic Billing to create claims. Steps Open the 'Spreadsheet Batch Remittance Posting' form. Select "Create Batch" in the 'Create, Edit Or Delete Remittance Batch' field. Enter a description in the 'Batch Description' field. Enter a date in the 'Posting Date' field. Note the date. Enter a date in the 'Date Of Receipt' field. If desired, enter a value in 'Receipt'. If desired, enter a value in 'Check #' If desired, select a value in 'Default Guarantor'. If desired, select a value in 'Default Payment Code'. If desired, select a value in 'Default Adjustment Code'. If desired, select a value in 'Default Transfer Code'. If desired, enter a value in 'Service Start Date'. If desired, enter a value in 'Service End Date'. Same service dates allow easier review of the Client Ledger. Click [Launch Work Screen]. Select the 'Client'. Select the 'EP #'. If desired, select the 'Claim'. Select the 'Payor' or verify it defaulted. Enter an 'Adjust Amount'. Select an 'Adjustment Code' of verify existence if a 'Default Adjustment Code' was selected. Click [Accept]. Click [Submit]. Validate that the message contains 'Remittance batch 'XX' posted'. Click [OK]. Click [No]. Open ‘Client Ledger’ for the client and process the report for the desired date range of services. Validate that the services that were adjusted contain a reversal of the original adjustment, and the new adjustment entered in 'Spreadsheet Batch Remittance Posting'. Close the report. Close the form. Open 'Guarantors/Payors'. Edit the guarantor that was selected as the primary guarantor in Setup. Select the '835' section'. Change the value of 'Allow Adjustment Reversals' to 'No'. Select the 'Guarantors/Payors' section. Click [File]. Close the form. Repeat steps 1 - 27. Validate that the services that were adjusted do not contain a reversal of the original adjustment and do contain the new adjustment entered in 'Spreadsheet Batch Remittance Posting'. Close the report. Close the form. Scenario 3: Spreadsheet Batch Remittance Posting - Allow Posting of Zero Dollar Payment Specific Setup: Registry Settings: Registry Setting: Avatar PM->Billing->Remittance Processing->->->Allow Posting of Zero Dollar Payment = No. Posting/Adjustment Codes Definition has been used to create desired definitions. A new client is added, or an existing client is identified. Note the Client ID/name. The financial eligibility record is created for the client. Services are rendered to the client. Note the service start / end date and service code used. The 'Client Ledger' report for the client is processed. Note the details of the report. An interim billing batch is created to include client, guarantor, and services. Electronic Billing is used to create claims. Steps Open the 'Spreadsheet Batch Remittance Posting' form. Select "Create Batch" in the 'Create, Edit Or Delete Remittance Batch' field. Enter a description in the 'Batch Description' field. Enter a date in the 'Posting Date' field. Note the date. Enter a date in the 'Date Of Receipt' field. If desired, enter a value in 'Receipt'. If desired, enter a value in 'Check #' Select a value in 'Default Guarantor'. If desired, enter a value in 'Service Start Date'. If desired, enter a value in 'Service End Date'. Click [Launch Work Screen]. Select the 'Client'. Select the 'EP #'. If desired, select the 'Claim'. Select the 'Payor' or verify it defaulted. Click the '+' object. Verify that the correct service rows display. Enter a 'Payment Amount' of '0.00'. Select a 'Payment Code'. Verify that 'Payment Amount' displays as required. Verify that the 'Accept button is disabled. Click [Cancel]. Click [Yes]. Close the form without submitting. Open 'Registry Settings' and change the 'Allow Posting of Zero Dollar Payment' setting to 'Y'. Click [Submit]. Click [OK]. Click [No]. Repeat steps 1 -19. Verify that 'Payment Amount' does not display as required Verify that the 'Accept button is enabled. Click [Accepts]. Click [Submit]. Click [OK]. Click [No]. Scenario 4: Spreadsheet Batch Remittance Posting - Distribute Claim/Service Level Adjustments (2100/2110-CAS) Across All Services Specific Setup: Registry Settings: Avatar PM->Billing->Remittance Processing->835 Health Care Claim Payment/Advice->->Distribute Claim/Service Level Adjustments (2100/2110-CAS) Across All Services = N. Avatar PM->Billing->Remittance Processing->835 Health Care Claim Payment/Advice->->Compile But Don't Post Adjustments (CAS) = Y. Posting/Adjustment Codes Definition has been used to create desired definitions. Claim Adjustment Group/Reason Code Definition has been used to create desired definitions. When the ‘Compile but do not post adjustments (CAS) associated with the indicated Claim Adjustment Group/Reason codes when processing an 835’ field has a value of 'Yes' the adjustment will not post. When the ‘Compile but do not post adjustments (CAS) associated with the indicated Claim Adjustment Group/Reason codes when processing an 835’ field has a value of 'No' the adjustment will post. Guarantors/Payors: Select a guarantor that will be the primary guarantor for the client. A new client is added, or an existing client is identified. Note the Client ID/name. The financial eligibility record is created for the client. The client is assigned two or more guarantors. The primary guarantor is the guarantor that has the fee definition. Services are rendered to the client. Note the service start / end date and service code used. The 'Client Ledger' report for the client is processed to validate that the services distributed liability correctly. Close Charges is used to close the charges. The services do not have to be claimed to complete testing, however if preferred, create an interim billing batch, and use Electronic Billing to create claims. Steps Open the 'Spreadsheet Batch Remittance Posting' form. Select "Create Batch" in the 'Create, Edit Or Delete Remittance Batch' field. Enter a description in the 'Batch Description' field. Enter a date in the 'Posting Date' field. Note the date. Enter a date in the 'Date Of Receipt' field. If desired, enter a value in 'Receipt'. If desired, enter a value in 'Check #' If desired, select a value in 'Default Guarantor'. If desired, select a value in 'Default Payment Code'. If desired, select a value in 'Default Adjustment Code'. If desired, select a value in 'Default Transfer Code'. If desired, enter a value in 'Service Start Date'. If desired, enter a value in 'Service End Date'. Same service dates allow easier review of the Client Ledger. Click [Launch Work Screen]. Select the 'Client'. Select the 'EP #'. If desired, select the 'Claim'. Select the 'Payor' or verify it defaulted. Click the ‘+’ item. Click [Enter CARCS]. Create Entries for adjustments and transfers: Select desired value in ‘CAS Adjustment Group Code’. Select desired value in ‘CAS Adjustment Reason Code’. Enter an ‘Adjustment Amount’. Verify that ‘Post’ is checked on unchecked based on the value of ‘ ‘Compile but do not post adjustments (CAS) associated with the indicated Claim Adjustment Group/Reason codes when processing an 835’. Highlight a row and click 'Copy/Paste Row'. Select desired value in ‘CAS Adjustment Group Code’. Select desired value in ‘CAS Adjustment Reason Code’, selecting a code that is not associated to the group code. Verify that an error message s received stating: The Group and Reason Codes highlighted are not currently setup and cannot be saved. Select the copied row and click 'Delete Row'. Confirm that a confirmation message is received. Click desired value to delete or retain the row. If the row is retained, change the ‘CAS Adjustment Reason Code’ to a code that is associated to the group code. Click [New Row]. Validate that the row is added. Delete the row or add data to it. Click [Close/Cancel]. Verify a 'Cancel Confirmation' is received. Click [No]. Click [Save] when all desired rows have been added Validate that the 'Adjust Amount' contains the total of all adjustments entered. Validate that the 'Transfer Amount' contains the total of all adjustments entered. Validate that the 'Adjust Amount' applies to the services rows, beginning with row 1, and pays each row in full until the full amount has been used. Validate that the 'Transfer Amount' applies to the services rows, beginning with the row that the 'Adjust Amounts' ended in if not paid in full. If it was paid in full the 'Transfer Amount' begins in the next row, and pays each row in full until the full amount has been used. If the 'Adjustment Code' was not defaulted, please select a value. If the 'Transfer Code' was not defaulted, please select a value. If the 'Transfer Guar' was not defaulted, please select a value. Enter a 'Payment Amount'. Validate that the 'Payment Amount' applies to the services rows, beginning with the row that the 'Transfer Amounts' ended in if not paid in full. If it was paid in full the 'Payment Amount' begins in the next row, and pays each row in full until the full amount has been used. Click [Accept]. Click [Submit]. Click [OK]. Click [No]. Open ‘Client Ledger’ for the client and process the report for the date range of services with activity. Validate the data for the services that were paid, adjusted, and transferred. Close the report. Close the form. Open 'Registry Settings'. Change the 'Distribute Claim/Service Level Adjustments (2100/2110-CAS) Across All Services' setting to Y. Click [Submit]. Click [OK]. Click [No]. Repeat steps 1 - 50. Note the validation for the 'Adjust Amount', Transfer Amount' and 'Payment Amount' will be different because the amount will be divided evenly among all service rows. The final row may contain an amount that is different by a few cents. Scenario 5: Spreadsheet Batch Remittance Posting - Select Client Specific Setup: Registry Settings: Avatar PM->Billing->Remittance Processing->835 Health Care Claim Payment/Advice->->Compile But Don't Post Adjustments (CAS) = Y. Posting/Adjustment Codes Definition has been used to create desired definitions. Claim Adjustment Group/Reason Code Definition has been used to create desired definitions. Note the value in 'Compile but do not post adjustments (CAS) associated with the indicated Claim Adjustment Group/Reason codes when processing an 835’. A value of 'No' allows the entry to be posted in the 'Enter CARCs' section of the 'Spreadsheet Batch Remittance Posting' form. A value of 'Yes' does not allow the entry to be posted in the 'Enter CARCs' section of the 'Spreadsheet Batch Remittance Posting' form. A new client is added, or an existing client is identified. Note the Client ID/name. The financial eligibility record is created for the client. The client is assigned two or more guarantors. Services are rendered to the client. Note the service start / end date and service code used. The 'Client Ledger' report for the client is processed. Note the details of the report. An interim billing batch is created to include client, guarantor, and services. Electronic Billing is used to create claims. Steps Open the 'Spreadsheet Batch Remittance Posting' form. Select "Create Batch" in the 'Create, Edit Or Delete Remittance Batch' field. Enter a description in the 'Batch Description' field. Enter a date in the 'Posting Date' field. Note the date. Enter a date in the 'Date Of Receipt' field. If desired, enter a value in 'Receipt'. If desired, enter a value in 'Check #' If desired, select a value in 'Default Guarantor'. If desired, select a value in 'Default Payment Code'. If desired, select a value in 'Default Adjustment Code'. If desired, select a value in 'Default Transfer Code'. If desired, enter a value in 'Service Start Date'. If desired, enter a value in 'Service End Date'. Click [Launch Work Screen]. Select the 'Client'. Select the 'EP #'. If desired, select the 'Claim'. Select the 'Payor' or verify it defaulted. Click [Enter CARCs]. Select a 'CAS Adjustment Group Code' to create an adjustment. Select a 'CAS Adjustment Reason Code' that is not associated to the 'CAS Adjustment Group Code'. Enter an 'Adjustment Amount'. Validate that an error is received stating: The Group and Reason codes highlighted are not currently setup and cannot be saved. Change the 'CAS Adjustment Reason Code' to one the is associated to the 'CAS Adjustment Group Code'. Validate that the 'Post' checkbox is checked when the group/reason code contains a 'No' in 'Compile but do not post adjustments (CAS) associated with the indicated Claim Adjustment Group/Reason codes when processing an 835’. Validate that the 'Post' checkbox is not checked when the group/reason code contains a 'Yes' in 'Compile but do not post adjustments (CAS) associated with the indicated Claim Adjustment Group/Reason codes when processing an 835’. Select a 'CAS Adjustment Group Code' to create a transfer. Select a 'CAS Adjustment Reason Code' that is associated to the 'CAS Adjustment Group Code'. Enter an 'Adjustment Amount'. Validate that the 'Post' checkbox contains the correct value for the group/reason code. If desired, enter additional adjustments and transfers. Note the total amounts for each. Click [Save]. Validate that 'Adjust Amount' contains the total adjustment amounts. Select an 'Adjustment Code' of verify existence if a 'Default Adjustment Code' was selected. Validate that 'Transfer Amount' contains the total transfer amounts. Select a 'Transfer Code' of verify existence if a 'Default Transfer Code' was selected. Validate that 'Transfer Guar' is required'. Hover over the 'Transfer Guar' field to view the table of the client's guarantors, excluding the current 'Payor'. Select the desired 'Transfer Guar'. Enter a 'Payment Amount'. Select a 'Payment Code' of verify existence if a 'Default Payment Code' was selected. Click [Accept]. Click [Submit]. Validate that the message contains 'Remittance batch 'XX' posted'. Click [OK]. Click [No]. Open ‘Client Ledger’ for the client and process the report for the date range of services with activity. Validate the data for the services that were paid, adjusted, or transferred. Close the report. Close the form. Scenario 6: Spreadsheet Batch Remittance Posting - Create Claim Follow-Up Specific Setup: User Definition has been used to give the user access to the Avatar Pm > Billing > Remittance Posting > Spreadsheet Batch Remittance Posting form. Identify at least one client with open claims. Posting/Adjustment Codes Definition: Create a transfer code that has values in ‘Claim Adjustment Group Code (837-2430-CAS)’ and ‘Claim Adjustment Reason Code (837-2430-CAS)’. Note the values of each field. Claim Adjustment Group/Reason Code Definition: Create an entry using the same 'Claim Adjustment Group Code', and 'Claim Adjustment Reason Code' used above. The ‘Compile but do not post adjustments (CAS) associated with the indicated Claim Adjustment Group/Reason codes when processing an 835’ field had a value of 'Yes'. Select desired values for the 'Transfer Guarantor Rules'. Steps Open the 'Spreadsheet Batch Remittance Posting' form. Select "Create Batch" in the 'Create, Edit Or Delete Remittance Batch' field. Enter a description in the 'Batch Description' field. Enter a date in the 'Posting Date' field. Note the date. Enter a date in the 'Date Of Receipt' field. If desired, enter a value in ‘Receipt'. If desired, enter a value in ‘Check #’. Note the value. Select a payment code in the 'Default Payment Code' field Select an adjustment code in the 'Default Adjustment Code' field Select the transfer from setup in the 'Default Transfer Code' field. Select a guarantor in the Default Trans. To Guarantor' field. If desired, enter a 'Service Start Date'. If desired, enter a 'Service End Date'. Click the "Launch Work Screen" button. Select the 'Client'. Select the 'Ep #'. Select the 'Claim'. Select the 'Payor'. Validate that 'Total Charges' contains a value. Validate that 'Liability' contains a value. Validate that 'Payment Amount' is '0.00'. Validate that 'Adjust Amount' is '0.00'. Validate that Transfer Amount' is '0.00'. Click [Enter CARC(s)]. Select the ’Claim Adjustment Group Code’ from setup. Select the ‘Claim Adjustment Reason Code' from setup. Enter an amount in ‘Adjustment’. Validate that the ‘Post’ checkbox is unchecked. Click [Save]. Click [Accept]. Click [Submit]. Click [Yes]. Click [OK]. Click [No]. Open ‘Claim Follow-Up’. Select the desired ‘Client’. Select ‘Edit’ in ‘Add, Edit Or Delete Claim Follow-Up’. Select the claim in ‘Select Claim Follow-Up To Edit Or Delete’. Validate that ‘Denial Type’ contains a value. Validate that the ‘Service(s) box contains service dates and there are checked. Validate the ‘Amount Billed’ equals the amount entered in ‘Adjustment’. Select ‘Edit’ in ‘Add, Edit Or Delete Row’. Select the desired row in ‘Select Row To Edit Or Delete’. Validate the ‘Comments’ contains ‘Spreadsheet Batch Remittance’. Validate the ‘Date Of Entry’ equals the current date. Click [Update Row]. Click [Submit]. Click [No]. Scenario 7: Spreadsheet Batch Remittance Posting - Security Level - Allow User To Continue Filing With Mismatch In Amounts To Post Specific Setup: Registry Setting: Allow User To Continue Filing With Mismatch In Amounts To Post = Y. Posting/Adjustment Codes Definition has been used to create desired definitions. User Definition: Signed in user has a security level of '2'. Client: Identify a client with unpaid claims. Note the dates of services and the guarantor liability has distributed to. Verify if the client has additional guarantors in the financial eligibility record. Steps Open the 'Spreadsheet Remittance Batch Posting' form. Select 'Create Batch' in the 'Create, Edit Or Delete Remittance Batch' field. Enter the 'Batch Description'. Enter desired date in the 'Posting Date' field. Enter desired date in the 'Date Of Receipt' field. If desired, enter/select values in 'Receipt'. If desired, enter/select values in 'Check #' If desired, enter/select values in 'Default Guarantor'. If desired, enter/select values in 'Default Payment Code'. If desired, enter/select values in 'Default Adjustment Code'. If desired, enter/select values in 'Default Transfer Code'. If desired, enter/select values in 'Service Start Date'. If desired, enter/select values in 'Service End Date'. Click [Launch Work Screen]. Select the 'Client'. Select the 'EP #'. Validate that other entered/selected data defaults. Click the '+' item. Review the balance due for the first service row. Enter a partial payment amount in 'Payment Amount', noting the amount. If not defaulted, select a 'Payment Code'. Enter a partial adjustment amount in 'Adjust Amount', noting the amount. If not defaulted, select a 'Adjust Code'. Enter a partial transfer amount in 'Adjust Amount', noting the amount. If not defaulted, select a 'Transfer Code'. If not defaulted, select a 'Transfer Guar'. Validate the amount in the 'New Balance' field. Click [Accept]. Select the 'Remittance Totals' section. Validate that 'Payment Amount Posted' contains the amount entered. Validate that 'Adjustment Amount Posted' contains the amount entered. Validate that 'Transfer Amount Posted' contains the amount entered. Enter a value that differs from the payment amount in 'Payment Amount Total'. Note the value in 'Payment Amount Remaining'. Enter a value that differs from the adjustment amount in 'Adjustment Amount Total'. Note the value in 'Adjustment Amount Remaining'. Enter a value that differs from the transfer amount in 'Transfer Amount Total'. Note the value in 'Transfer Amount Remaining'. Click [Submit]. Validate that the message dialog contains Remittance is not balanced. Do you wish to continue posting? Click [Yes]. Click [OK]. Click [No]. Open 'Registry Settings'. Set 'Limit Registry Settings to the Following Search Criteria' to 'Allow User To Continue Filing With'. Click [View Registry Settings]. Validate that the 'Registry Setting' contains 'Avatar PM->Billing->Remittance Processing->->->Allow User To Continue Filing With Mismatch In Amounts To Post'. Set the 'Registry Setting Value' to 'N'. Click [Submit]. Click [OK]. Click [No]. Repeat steps 2 - 39. Validate that the message dialog contains 'Remittance is not balanced'. Click [OK]. Click [Discard]. Click [Yes]. Open 'Registry Settings'. Set 'Limit Registry Settings to the Following Search Criteria' to 'Allow User To Continue Filing With'. Click [View Registry Settings]. Validate that the 'Registry Setting' contains 'Avatar PM->Billing->Remittance Processing->->->Allow User To Continue Filing With Mismatch In Amounts To Post'. Set the 'Registry Setting Value' to 'S'. Click [Submit]. Click [OK]. Click [No]. Repeat steps 2 - 39. Validate that the message dialog contains 'Remittance is not balanced'. Click [OK]. Click [Discard]. Click [Yes]. Scenario 8: Spreadsheet Batch Remittance Posting - Validate excluded posting codes are not included in the 'Payment Code' dropdown list. Specific Setup: An existing client with unpaid claims is identified (Client A). Note the guarantor that liability is distributed to. Posting/Adjustment Codes Definition: A payment posting code is defined to 'Exclude Guarantors' for the client's liability guarantor. Note the code/description. An additional payment posting code is defined to not exclude the client's liability guarantor. Note the code/description. User Definition': The user has access to the 'Spreadsheet Batch Remittance' form. Steps Open the 'Spreadsheet Batch Remittance Posting' form. Click the 'Create Batch' field. Enter the 'desired value' in the 'Batch Description' field. Select the 'desired value' in 'Default Payment Code' field. Enter the desired 'Posting Date'. Enter the desired 'Date Of Receipt'. Click [Launch Work Screen]. Select "Client A" in the 'Client' field. Select the 'desired episode'. Validate there is Liability to be remitted against. Select the "excluded" guarantor from the 'Payor' field. Enter the 'desired value' in the 'Payment Amount' field. Double Click the 'Payment Code' field and validate it does not contain the "excluded" payment code. Select the "non-excluded" payment code. Click [Accept]. Click [Submit]. Click [OK]. Click [Yes]. Scenario 9: Spreadsheet Batch Remittance Posting - Validating remittance batch posting using 'Interim Billing Batch' Specific Setup: Posting/Adjustment Codes Definition has been used to create desired definitions. Claim Adjustment Group/Reason Code Definition has been used to create desired definitions. A new client is added, or an existing client is identified. Note the Client ID/name. The financial eligibility record is created for the client. Note the Guarantor code/name. The client is assigned two or more guarantors. Services are rendered to the client. Note the service start / end date and service code used. The 'Client Ledger' report for the client is processed. Note the details of the report. An interim billing batch is created to include client, guarantor, and services. Electronic Billing is used to create claims. Steps Open the 'Spreadsheet Remittance Batch Posting' form. Select 'Create Batch' in the 'Create, Edit Or Delete Remittance Batch' field. Enter the 'Batch Description'. Select the interim billing batch created in the setup section in the 'Interim Batch Number' field. Enter desired date in the 'Posting Date' field. Enter desired date in the 'Date Of Receipt' field. Enter desired value in ‘Receipt’. Enter desired value in ‘Check #’. Select the ‘Default Guarantor’. Select the ‘Default Payment Code’. Select the ‘Default Adjustment Code. Select the ‘Default Transfer Code. If desired, enter a 'Service Start Date'. If desired, enter a 'Service End Date'. Click [Launch Work Screen]. Validate that the data from the interim batch defaults. Click [Enter CARC(s)]. Select desired value in 'CAS Adjustment Group Code'. Select desired value in 'CAS Adjustment Reason Code'. Enter an amount in 'Adjustment'. Validate that the 'Post' field is checked if the group/reason code has a value of 'No' in 'Compile but do not post adjustments (CAS) associated with the indicated Claim Adjustment Group/Reason codes when processing an 835. Enter additional CARC(s) as desired. Click [Save]. Validate that the 'Adjust Amount' contains the total of the adjustments. Validate that the 'Adjust Code' contains the default value. If a transfer CARC was added, validate that the 'Transfer Amount' contains the total of the transfers. Validate that the 'Transfer Code' contains the default value. Hover over the 'Transfer Guar' to validate the table displays the client's guarantors, excluding the guarantor in 'Payor'. Select a 'Transfer Guar'. Enter a 'Payment Amount'. Validate that the 'Payment Code' contains the default value. If desired, click the '+' item to display the individual services. Validate the payments, adjustments, and transfers within the individual services, noting the date range of services with activity. Click [Accept]. Click [Submit]. Validate that the message contains 'Remittance batch 'XX' posted'. Click [OK]. Click [No]. Open ‘Client Ledger’ for the client and process the report for the date range of services with activity. Validate the data for the services that were paid, adjusted, or transferred. Close the report. Close the form. Scenario 10: Batch Remittance Posting Report Specific Setup: User Definition has been used to give two users access to the Avatar Pm > Billing > Remittance Posting > Spreadsheet Batch Remittance Posting form and the Avatar PM > Billing > Billing Reports > Batch Remittance Posting Report form. Note the User IDs and User Descriptions. Posting/Adjustment Codes Definition has been used to create desired definitions. Claim Adjustment Group/Reason Code Definition has been used to create desired definitions. Identify at least one client with open claims. Spreadsheet Batch Remittance Posting has been used to create at least one batch per user. Use different values in 'Posting Date', and 'Check #'. Note the value and the signed in user. Note the details of the batches. 835 Health Care Claim Payment/Advice has been used to post at least one 835 file. Note the details of the file. Steps Open 'Batch Remittance Posting Report' form. Enter the desired value in the required 'Posting Date' field. If desired, enter a value in the 'Posting End Date' field. If desired, enter a value in the 'Check/EFT #' field. If desired, enter a value in the 'Remittance File By User'. Click [Process]. Validate that the 'Batch Remittance Posting Report' report opens and contains the following fields: Batch Status Posting Option Posting Date Check/EFT Number Description Filed By Patient Ep # Claim Payor Total Charges Liability Payment Amount Payment Code Adjust Amount Adjust Code Transfer Amount Transfer Code Transfer Guar New Balance. Validate that the data in the fields is correct based on the selection criteria. Close the report. Close the form.	Topics • Spreadsheet Batch Remittance Posting • Claim Follow-up
Update 12 Summary \| Details 'Client Admission' web service Scenario 1: The 'ClientAdmission' - 'AddAdmission' web service: Admission of a new client Specific Setup: The 'Avatar PM->Client Information->Client Demographics->->->Client Demographics - Additional Fields' registry setting must be set to "3" to include 'Detailed Client Name'. Steps Access SoapUI for the 'ClientAdmission' - 'AddAdmission' web service. Enter the system code that will be used to log into Avatar in the 'SystemCode' field. Enter the user name that will be used to log into Avatar in the 'UserName' field. Enter the password that will be used to log into Avatar in the 'Password' field. Populate all required and desired fields. Enter the desired value in the 'ClientFirstName' field. Enter the desired value in the 'ClientLastName' field. Enter a value containing an invalid character in the 'ClientMiddleName' field. (Ex. T#ST!) Enter the corresponding name in the 'ClientName' field. Click [Run]. Validate the 'Message' field contains: "Middle name contains invalid characters. Valid symbols are '-_.". Enter the desired value in the 'ClientMiddleName' field, removing the invalid characters. Enter the corresponding name in the 'ClientName' field. Click [Run]. Validate the 'Confirmation' field contains a value such as: "Client Unique ID: # Unique ID: #". Validate the 'Message' field contains: "Client Admission web service has been filed successfully". Select the client filed in the previous steps and access the 'Admission' form. Select the record filed in the previous steps and click [Edit]. Validate all populated fields are displayed. Select the "Demographics" section. Validate the 'Client Last Name' field contains the value filed in the previous steps. Validate the 'Client First Name' field contains the value filed in the previous steps. Validate the 'Client Middle Name' field contains the value filed in the previous steps. Close the form.	Topics • Admission
Update 13 Summary \| Details SQL table - RADplus_IMO_Results table Scenario 1: Load & Go update - Verify successful installation Steps Internal Testing Only	Topics • Problem List
Update 14 Summary \| Details Claim Follow-Up Scenario 1: 'Claim Follow-Up' - Verification of Submission Specific Setup: Avatar PM Registry Setting 'Claim Follow-Up' must be enabled. Client with claim(s)/service(s) eligible for 'Claim Follow-Up' entry. Steps Open Avatar PM 'Claim Follow-Up' form; select client record for Claim Follow-Up entry. Select 'Add' in 'Add, Edit Or Delete Claim Follow-Up' field (or select 'Edit' for review/update of existing entry). Select value in 'Guarantor' field. Select value in 'Claim' field. Select value in 'Denial Type' field. Select value in 'Service(s)', 'Insurance Based Denial Reason' and '835 Denial Reason' if desired. Select value in 'Assign Claim For Electronic Re-Billing' field (and 'Claim Submission Reason Code' field if applicable). In Follow-Up Status/Comments form sub-section, select 'Add' in 'Add, Edit or Delete Row' field (or select 'Edit' for view/update of existing Follow-Up Status/Comments entry). Select value in 'Follow-Up Status' and 'Followed Up' fields. Enter/select values in 'Denial CRN#', 'Current CRN#', 'Next Follow-Up Date' and 'Completion Date' fields if desired. Enter value in 'Comments' field. Click 'Update Row' button to save Follow-Up Status/Comments entry. Click 'Submit' button to file 'Claim Follow-Up' form/record. Ensure filing confirmation dialog noting 'Claim Follow-Up has completed. Do you wish to return to form?' is presented; click 'Yes' button to return to 'Claim Follow-Up' form. Select 'Edit' in 'Add, Edit Or Delete Claim Follow-Up' field for review of existing entry. Select existing entry in 'Select Claim Follow-Up To Edit Or Delete' field. Ensure values for all fields are present in 'Claim Follow-Up' form as previously entered/field for selected entry, including rows/entries in the Follow-Up Status/Comments form sub-section.	Topics • Claim Follow-up
Update 15 Summary \| Details HCFA 1500 Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Financial Eligibility Client Charge Input With Diagnosis Entry Print Bill Referral Source Maintenance Scenario 1: Print Bill - HCFA-1500-NPI Version - Sorting Specific Setup: Registry Setting: Avatar PM->Billing->Paper Billing->HCFA-1500->->Enable Select Type Of Information To Include For Locator 17 = Y. Avatar PM->Billing->Client Charge Input->Fields To Retain After Filing->->Fields to Retain After Filing Client Charge Input = 18 at a minimum. Guarantor/Program Billing Defaults - ‘Paper HCFA-1500’ section: Include a value in ‘Referring Provider Or Other Source Code Qualifier (Form Locator 17)’. Select 'Referring Provider/Practitioner' in ‘Select Type Of Information To Include In Name Of Referring Physician Or Other Source (Form Locator 17)’. Select 'Referring Practitioner' in 'Sort Paper HCFA-1500 Claims By'. Note the guarantors and programs assigned to the template. Clients: Identify two clients with multiple unclaimed services that can be billed from the above template. Each client should have services that are provided by different practitioners. Note the last service date. Create Interim Billing Batch File is used to create a batch for the services. Close Charge is used to close the charges for the interim batch. Steps Open ‘Print Bill’. Enter the last service date in ‘Print Charges Thru’. Select ‘No’ in ‘Create Claims Y/N’. If the services were created with a diagnosis entry, select ‘HCFA-1500-NPI-Vesrion (Diagnosis Entry’ in ‘Print On What Form’. Select ‘Yes’ in ‘Print For Interim Batch’. Select the ‘Interim Batch Number’ created in Setup. Click [Process]. Verify that the bill contains the correct information and is sorted correctly. Close the report. Select ‘HCFA-1500-NPI-Vesrion (Sort By Practitioner/Service Consolidation/Diagnosis Entry)’ in ‘Print On What Form’. Click [Process]. Verify that the bill contains the correct information and is sorted correctly. Close the report. Select ‘HCFA-1500-NPI-Vesrion (Sort By Service Consolidation/Diagnosis Entry)’ in ‘Print On What Form’. Click [Process]. Verify that the bill contains the correct information and is sorted correctly. Close the report. If the services were created without a diagnosis entry, select ‘HCFA-1500-NPI-Vesrion (Sort By Practitioner)’ in ‘Print On What Form’. Click [Process]. Verify that the bill contains the correct information and is sorted correctly. Close the report. Select ‘HCFA-1500-NPI-Vesrion (Sort By Practitioner/Service Consolidation)’ in ‘Print On What Form’. Click [Process]. Verify that the bill contains the correct information and is sorted correctly. Close the report. Select ‘HCFA-1500-NPI-Vesrion (Sort By Service Consolidation)’ in ‘Print On What Form’. Click [Process]. Verify that the bill contains the correct information and is sorted correctly. Close the report. Close the form. Open 'Client Charge Input'. Create a service for a client that includes a referring practitioner with an ID code higher than '1'. Note the date of service. Create an additional service for the same client that includes a referring practitioner with an ID code that is lower than the ID code in the first service and the service date is after the first service date. Close the form. Create an 'Interim Billing Batch File' for the two services. Close the charges for the interim batch. Open 'Print Bill'. Enter the last service date in ‘Print Charges Thru’. Select ‘No’ in ‘Create Claims Y/N’. Select ‘HCFA-1500-NPI-Vesrion’ in ‘Print On What Form’. Select ‘Yes’ in ‘Print For Interim Batch’. Select the ‘Interim Batch Number’ created in Setup. Click [Process]. Verify that the bill contains the correct information and is sorted by the referring practitioner ID, starting with the lowest ID number. Close the report. Close the form.	Topics • Print Bill • NX
Update 16 Summary \| Details Progress Notes (Group and Individual) Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Financial Eligibility Payor Based Authorizations Practitioner Numbers By Guarantor And Program Electronic Billing Scenario 1: PM - Payor Based Authorization - Location Specific Setup: Registry Settings: Enable Payor Based Authorizations = 'Y'. Enable CPT Based Payor Authorizations = desired value. Require Authorizations At Guarantors/Payors Level = desired value. Dictionary Update: Client File (10006) Location = note active locations. Staff File (79) Practitioner Category = note active categories. Guarantors/Payors: Guarantor A: Identify a guarantor to be used with 'Payor Based Authorizations'. Note the values in the 'Authorization Section'. Verification Level For Authorizations For Client Charge Input and Verification Level For Authorizations For Appointment Scheduling: 'Disallow Service If Authorization Is Missing' will not allow the service to be submitted. 'Warn User If Authorization Is Missing' will allow the service to be submitted. Verification Level For Authorizations For 837 Electronic Billing: 'None' will allow services that were submitted and closed to be billed. 'Report As Error And Include On Bill' will allow services that were submitted and closed to be billed. An error message will be included in the 837 Billing report. 'Report As Error And Do Not Include On Bill' will not allow services that were submitted and closed to be billed Client A: Identify an active client that is assigned to the guarantor above. Payor Based Authorizations: Create or edit a definition to not include a 'Locations' and any other desired fields. An error message will be included in the 837 Billing report. Note the value of each field. Steps Open 'Payor Based Authorizations'. Create a new record that matches the record from setup. Validate that the following message displays: An authorization already exists for this date range. Overlapping authorizations are not allowed. Remove the 'Expiration Date'. Select a 'Location'. Enter an 'Expiration Date'. Submit the form and validate that it files successfully. Open ‘Scheduling Calendar’. Create an appointment for Client A. Validate that the appropriate submission event occurs based on the values in the ‘Guarantors/Payors’, 'Authorization Section'. Close the form. Open ‘Client Charge Input’. Create a service for Client A. Validate that the appropriate submission event occurs based on the values in the ‘Guarantors/Payors’, 'Authorization Section'. Close the form. Open 'Close Charges’ and close charges for Client A if submission was allowed. Close the form. Open ‘Electronic Billing’ if submission was allowed. Create the bill for Client A and validate that the appropriate billing action occurs based on the values in the ‘Guarantors/Payors’, 'Authorization Section'. Close the form. Open ‘Client Ledger’ for Client A if submission was allowed. Review the ‘Simple’, ‘Ledger Type’ to confirm the billing activity. Close the form.	Topics • Payor Based Authorizations • NX
Update 17 Summary \| Details The 'BedAssignment' web service Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Bed Availability Report SOAPUI - BedAssignment SOAPUI - BedAssignment - AddBedAssignment SOAPUI - BedAssignment - DeleteBedAssignment SOAPUI - BedAssignment - EditBedAssignment SOAPUI - BedAssignment - GetDictionaryItems Delete Bed Assignment Scenario 1: Validate the 'BedAssignment' - 'AddBedAssignment' web service Specific Setup: A client is enrolled in an existing inpatient episode (Client A). Steps Access SoapUI for the 'BedAssignment' - 'AddBedAssignment' web service. Enter the system code that will be used to log into Avatar in the 'SystemCode' field. Enter the user name that will be used to log into Avatar in the 'UserName' field. Enter the password that will be used to log into Avatar in the 'Password' field. Enter the desired date in the 'DateOfAssignment' field. Enter the desired time in the 'TimeOfAssignment' field. Enter the desired unit in the 'Unit' field. Enter the desired room in the 'Room' field. Enter the desired bed in the 'Bed' field. Enter the desired value in the 'RoomAndBoardBillingCode' field. Enter the desired value in the 'AdmissionChargeCode' field. Enter the desired value in the 'DailyChargeCode' field. Enter the desired value in the 'DailyChargeCode2' field. Enter the desired value in the 'DailyChargeCode3' field. Enter the desired value in the 'DailyChargeCode4' field. Enter the desired value in the 'DailyChargeCode5' field. Enter "Client A" in the 'ClientID' field. Enter the existing episode in the 'EpisodeNumber' field. Click [Run]. Validate the 'AddBedAssignmentResult' field contains the following: 'Confirmation' field containing a unique ID for the record. 'Message' field containing: Bed Assignment web service has been filed successfully. Select "Client A" and access the 'Bed Assignment' form. Validate the 'Date Of Bed Assignment' field contains the date filed in the previous steps. Validate the 'Time Of Bed Assignment' field contains the time filed in the previous steps. Validate the 'Unit' field contains the unit filed in the previous steps. Validate the 'Room' field contains the room filed in the previous steps. Validate the 'Bed' field contains the bed filed in the previous steps. Validate the 'Room And Board Billing Code' field contains the value filed in the previous steps. Validate the 'Admission Charge Code' field contains the value filed in the previous steps. Validate the 'Daily Charge Code' field contains the value filed in the previous steps. Validate the 'Daily Charge Code 2' field contains the value filed in the previous steps. Validate the 'Daily Charge Code 3' field contains the value filed in the previous steps. Validate the 'Daily Charge Code 4' field contains the value filed in the previous steps. Validate the 'Daily Charge Code 5' field contains the value filed in the previous steps. Close the form. Scenario 2: Validate the 'BedAssignment' - 'DeleteBedAssignment' web service Specific Setup: A client has an existing inpatient episode with a current & previous bed assignment record. The previous bed assignment must be available (Client A). Steps Select "Client A" and access the 'Bed Assignment' form. Validate the 'Unit' field contains the unit for the current bed assignment. Validate the 'Room' field contains the room for the current bed assignment. Validate the 'Bed' field contains the bed for the current bed assignment. Validate all other fields contain the values for the current bed assignment. Close the form. Access SoapUI for the 'BedAssignment' - 'DeleteBedAssignment' web service. Enter the system code that will be used to log into Avatar in the 'SystemCode' field. Enter the user name that will be used to log into Avatar in the 'UserName' field. Enter the password that will be used to log into Avatar in the 'Password' field. Enter "Client A" in the 'ClientID' field. Enter the existing episode number in the 'EpisodeNumber' field. Enter the unique ID for the current bed assignment record in the 'UniqueID' field. Click [Run]. Validate the 'DeleteBedAssignmentResult' field contains the following: 'Confirmation' field containing the unique ID for the deleted record. 'Message' field containing: Bed Assignment web service has been filed successfully. Select "Client A" and access the 'Bed Assignment' form. Validate the 'Unit' field contains the unit from the previous bed assignment. Validate the 'Room' field contains the room from the previous bed assignment. Validate the 'Bed' field contains the bed from the previous bed assignment. Validate all other fields contain the values from the previous bed assignment. Close the form. Scenario 3: Validate the 'BedAssignment' - 'EditBedAssignment' web service Specific Setup: A client is enrolled in an existing inpatient episode (Client A). Steps Access SoapUI for the 'BedAssignment' - 'EditBedAssignment' web service. Enter the system code that will be used to log into Avatar in the 'SystemCode' field. Enter the user name that will be used to log into Avatar in the 'UserName' field. Enter the password that will be used to log into Avatar in the 'Password' field. Enter the desired time in the 'TimeOfAssignment' field. Enter the desired value in the 'RoomAndBoardBillingCode' field. Enter the desired value in the 'AdmissionChargeCode' field. Enter the desired value in the 'DailyChargeCode' field. Enter the desired value in the 'DailyChargeCode2' field. Enter the desired value in the 'DailyChargeCode3' field. Enter the desired value in the 'DailyChargeCode4' field. Enter the desired value in the 'DailyChargeCode5' field. Enter "Client A" in the 'ClientID' field. Enter the existing episode in the 'EpisodeNumber' field. Enter the unique ID for the existing record in the 'UniqueID' field. Click [Run]. Validate the 'EditBedAssignmentResult' field contains the following: 'Confirmation' field containing the unique ID for the record. 'Message' field containing: Bed Assignment web service has been filed successfully. Select "Client A" and access the 'Bed Assignment' form. Validate the 'Time Of Bed Assignment' field contains the time filed in the previous steps. Validate the 'Room And Board Billing Code' field contains the value filed in the previous steps. Validate the 'Admission Charge Code' field contains the value filed in the previous steps. Validate the 'Daily Charge Code' field contains the value filed in the previous steps. Validate the 'Daily Charge Code 2' field contains the value filed in the previous steps. Validate the 'Daily Charge Code 3' field contains the value filed in the previous steps. Validate the 'Daily Charge Code 4' field contains the value filed in the previous steps. Validate the 'Daily Charge Code 5' field contains the value filed in the previous steps. Close the form. Scenario 4: Validate the 'BedAssignment' - 'GetDictionaryItems' web service Steps Access SoapUI for the 'BedAssignment' - 'GetDictionaryItems' web service. Enter the system code that will be used to log into Avatar in the 'SystemCode' field. Enter the user name that will be used to log into Avatar in the 'UserName' field. Enter the password that will be used to log into Avatar in the 'Password' field. Click [Run]. Validate the 'GetDictionaryItemsResponse' field is populated with the defined dictionary values for the 'Bed Assignment' form.	Topics • Bed Assignment • Web Services • Delete Bed Assignment
Update 18 Summary \| Details SQL Table - SYSTEM.billing_tx_master_table Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Service Codes Form and Table Documentation (PM) Scenario 1: billing_tx_master_table - Validating field length of the 'discipline_code' field Specific Setup: Registry Setting: The 'Fields to Include in Client Charge Input' registry setting is set to the value that includes '2'. Service Codes: Create a new service code or identify an existing service code. Note the service code. Select all the disciplines in the discipline field. Note all the disciplines selected. Steps Open the 'Crystal Report' or any other SQL data viewer. Query the SYSTEM.billing_tx_master_table for the discipline_code. Verify the 'discipline_code' field displays all the discipline codes for the selected disciplines in the 'Service Codes' form. Verify the 'discipline_value' field displays all the discipline values for the selected disciplines in the 'Service Codes' form.	Topics • Database Tables • NX
Update 20 Summary \| Details Site Specific Section Modeling - Add-On Service fields Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Site Specific Section Modeling (CWS) Service Codes Progress Notes (Group and Individual) Clinical Document Viewer Scenario 1: Progress Note (Group and Individual) - Validating Add-On fields in the 'Site Specific Section Modeling' form when the 'Enable Multiple Add-On Code Per Primary Code Functionality' registry setting="Y". Specific Setup: The 'Enable Multiple Add-On Code Per Primary' registry setting is set to "Y". Using the "Service Codes" form, create 3 group service codes. Two of them must be primary add on codes and one of them must be a primary code. Admit a client into an outpatient episode. Steps Open the 'Site Specific Section Modeling (CWS)' form. Select 'CWSPN22000 (Progress Notes (Group and Individual)) Individual Progress Notes' in 'Site Specific Section'. Select the 'Prompt Definition' section. Select the 'Add-On Service' field. Click [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "Yes". Select the 'Add-On Duration' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "Yes". Select the 'Save Add-On Service' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "Yes". Select the 'Selected Add-On Services' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "Yes". Select the 'Select Add-On Service Entry to Edit/Remove' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "Yes". Select the 'Remove Add-On Service' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "Yes". Submit the form. Open the 'Progress Notes (Group and Individual)' form. Validate the 'Add-On Service' field doesn't exist. Validate the 'Add-On Duration' field doesn't exist. Validate the 'Remove Add-On Service Entry to Edit/Remove' field doesn't exist. Validate the 'Remove Add-On Service' field doesn't exist. Validate the 'Selected Add-On Services' field doesn't exist. Validate the 'Save Add-On Service' field doesn't exist. Open the 'Site Specific Section Modeling (CWS)' form. Select the 'Prompt Definition' section. Select the 'Add-On Service' field. Click [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "No". Select the 'Add-On Duration' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "No". Select the 'Save Add-On Service' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "No". Select the 'Selected Add-On Services' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "No". Select the 'Select Add-On Service Entry to Edit/Remove' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "No". Select the 'Remove Add-On Service' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is enabled. Set the 'Exclude from Data Collection Instrument' field to "No". Submit the form. Open the 'Progress Notes (Group and Individual)' form. Generate a "Group Default Note". Add the test client to the group using the Add Client fields on the form. File the Group Default Note. Select the test client from the "Select Group Note to Edit" field. Verify the 'Add-On Service' field exists. Verify the 'Add-On Duration' field exists. Verify the 'Select Add-On Service Entry to Edit/Remove' exists. Verify the 'Remove Add-On Service' button exists. Verify the 'Selected Add-On Services' field exists. Verify the 'Save Add-On Service' button exists. Individualize the progress note for the test client and populate the Add on service fields. Finalize and sign the document. Open the 'Progress Notes (Group and Individual)' form. Select the test client from the "Select Group Note to Edit" field. Verify the 'Add-On Service' field exists. Verify the 'Add-On Duration' field exists. Verify the 'Select Add-On Service Entry to Edit/Remove' exists. Verify the 'Remove Add-On Service' button exists. Verify the 'Selected Add-On Services' field exists. Verify the 'Save Add-On Service' button exists. Create the progress note for the test client and populate the Add on service fields. Finalize and sign the document. Using the "Client Ledger" form, validate the primary and add on services are on the client's ledger. Using the "Clinical Document Viewer" form, validate the documents display. Scenario 2: Progress Note (Group and Individual) - Validating Add-On fields in the 'Site Specific Section Modeling' form when the 'Enable Multiple Add-On Code Per Primary Code Functionality' registry setting="N" Specific Setup: The 'Enable Multiple Add-On Code Per Primary' registry setting is set to "N". Steps Open the 'Site Specific Section Modeling (CWS)' form. Select 'CWSPN22000 (Progress Notes (Group and Individual)) Individual Progress Notes' in 'Site Specific Section'. Select the 'Prompt Definition' section. Select the 'Add-On Service' field. Click [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is set to 'Yes' and disabled. Select the 'Add-On Duration' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is set to 'Yes' and disabled. Select the 'Save Add-On Service' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is set to 'Yes' and disabled. Select the 'Selected Add-On Services' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is set to 'Yes' and disabled. Select the 'Select Add-On Service Entry to Edit/Remove' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is set to 'Yes' and disabled. Select the 'Remove Add-On Service' field. Click the [Edit Selected Item]. Verify the 'Exclude from Data Collection Instrument' field is set to 'Yes' and disabled. Submit the form. Open the 'Progress Notes (Group and Individual)' form. Verify the 'Add-On Service' field does not exist. Verify the 'Add-On Duration' field does not exist. Verify the 'Select Add-On Service Entry to Edit/Remove' does not exist. Verify the 'Remove Add-On Service' button does not exist. Verify the 'Selected Add-On Services' field does not exist. Verify the 'Save Add-On Service' button does not exist. Click [Close Form].	Topics • Site Specific Section Modeling • Progress Notes
Update 22 Summary \| Details 'Account Receivable Console' widget - 'Claim Follow-Up Entry' section Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Admission (Outpatient) Financial Eligibility Practitioner Numbers By Guarantor And Program Electronic Billing System Task Scheduler Service Codes AR Console User Defaults Setup AR Console Configuration Scenario 1: Account Receivable Console - Copy Claim Follow-Up/Notes Specific Setup: Guarantors/Payors: Guarantor 1: The 'Guarantor Name' & the 'Guarantor Name For Alpha Lookup' fields contain an '&'. Guarantor 2: The 'Guarantor Name' & the 'Guarantor Name For Alpha Lookup' fields do not contain an '&’. Clients: Client A: Has a minimum of two outstanding claims for Guarantor 1. Note the client’s last name and the program. Client B: Has a minimum of two outstanding claims for Guarantor 2. Note the client’s last name and the program. Tester has access to the AR Console. AR Console User Defaults Setup: Tester has been given access to both Guarantors/Payors, the client’s last name initials, and the client programs. System Task Scheduler: The 'Auto AR Batch Update' was processed after the claims were created. Steps Open the ‘Account Receivable Console’ widget. Validate that the ‘Guarantor’ field contains the selected guarantors, including the guarantor with the ‘&’ in the 'Guarantor Name' & the 'Guarantor Name For Alpha Lookup' Enter the ‘Client ID for Client A. Click [Search]. Select a minimum of two claims in the ‘Claims with Outstanding Receivables’ gird. Click [Add Claim Follow-Up/Note]. Validate the claim number in ‘Claim Follow-Up’. Go to the Follow-Up Notes’ section. Validate the note created by the AR Console exists. Click [New Row]. Enter desired ‘Follow-Up Date’, ‘Comments’ and any other desired data. Click [File Updates]. Click [OK]. Select the row that was added above. Click [Copy Note]. Select the claim to copy the note to in ‘Copy Follow-Up Note’. Click [Save]. Select the claim number in ‘Claim Follow-Up’ that was selected in ‘Copy Follow-Up Note’. Validate that the copy note, and the note created by the AR Console exist in ‘Claim Follow-Up’. Select the ‘AR List’ section. Repeat steps 3 - 20 for Client B. Close the widget.	Topics • Accounts Receivable Management
Update 24 Summary \| Details Program Transfer & Program Transfer (Outpatient) Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Admission (Outpatient) Program Transfer (OutPatient) Service Codes Program Transfer Scenario 1: Edit Service Program - Editing the service information after program transfer - Enable 'Admission vs. Service Program' Functionality registry setting Specific Setup: Registry Setting: The "Enable 'Admission vs. Service Program' Functionality" registry setting is set to 'Y'. Program Maintenance: Two new outpatient admission programs are created such that there is no overlap of the associated service programs between the two admission programs. Note the admission programs and associated service programs. Admission (Outpatient): The client is admitted into the first admission program. Client Charge Input: A service is rendered to the client under one of the associated service programs. Note the service date and service code. Program Transfer (Outpatient): The client is transferred into the second admission program. Steps Open the 'Edit Service Information' form. Fill in all required fields. Click [Select Service(s) to Edit]. Verify the 'Select Service(s) to Edit' dialog box launched with all the services rendered to the selected client. Select desired service to edit. Verify the 'Program' field is populated with the service programs that was associated with the admission program at the time of service creation. Submit the form. Verify the form submits successfully. Scenario 2: Program Transfer and Re-Admission - Validate that a client can no longer be actively admitted to the same outpatient program more than once. Specific Setup: Client was admitted to an outpatient program and then transferred to another outpatient program. Note the program the client was transferred to and the date of transfer. Steps Open 'Admission (Outpatient)' for the client. Set the 'Preadmit/Admission Time' to a date before the transfer date. Set the 'Program' to the program the client was transferred to. An error is correctly received because the client is currently enrolled in the program. Set the 'Preadmit/Admission Time' to a date after the transfer date. Set the 'Program' to the program the client was transferred to. An error is correctly received because the client is currently enrolled in the program. Scenario 3: File the 'Program Transfer' form Specific Setup: A client must be enrolled in an existing episode (Client A). Steps Select "Client A" and access the 'Program Transfer' form. Validate a Pre-Display is displayed. Select "Episode 1" in the Pre-Display and click [OK]. Enter the current date in the 'Date Of Transfer' field. Enter the current time in the 'Time of Transfer' field. Validate the 'Program Transferred From' field contains the program "Client A" is enrolled in. Select any outpatient program in the 'Program' field. Click [Submit]. Access Crystal Reports or other SQL Reporting tool. Create a query, specific to "Client A", using the 'SYSTEM.history_program_transfer' table. Validate that the data in the query is correct. Close the report. Scenario 4: Program Transfer - Validating program transfer for an inpatient and outpatient episode Specific Setup: Admission: A new inpatient client is admitted, or an existing inpatient client is identified. Note the client’s id/name, admission date/admission program. A new outpatient client is admitted, or an existing outpatient client is identified. Note the client’s id/name, admission date/admission program. Steps Select the 'Program Transfer' form. Select the inpatient client identified in the setup section. Validate the 'Program Transferred From' field contains the admission program of the client. Select desired new program from the admission program in the 'Program' field. Enter desired date in the 'Date Of Transfer' field. Enter desired time in the 'Time Of Transfer' field. Select desired 'Unit'. Select desired 'Room'. Select desired 'Bed' Click [Submit]. Open the 'Admission form' for the client. Verify the client transferred to the correct program. Close the form. Select the 'Program Transfer (Outpatient)' form. Select the outpatient client identified in the setup section. Validate the 'Program Transferred From' field contains the admission program of the client. Select the new program from the admission program in the 'Program' field. Enter desired date in the 'Date Of Transfer' field. Enter desired time in the 'Time Of Transfer' field. Click [Submit]. Open the 'Admission' or 'Admission (Outpatient)' form for the client. Verify the client transferred to the correct program. Close the form.	Topics • Edit Service Information • Program Transfer
Update 27 Summary \| Details Default Guarantor Assignment - Cross Episode Financial Eligibility Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Admission (Outpatient) Family Registration Family Financial Eligibility Financial Eligibility Cross Episode Financial Eligibility Default Guarantor Assignment Financial Eligibility Web Service Scenario 1: Registry Setting - Enable Default Guarantor Assignment Specific Setup: Registry Setting - Enable Default Guarantor Assignment = N. Family Registration: Family 1 has no ‘Family Financial Eligibility’ record. Family 2 has a Family Financial Eligibility’ record. Note the assigned guarantors. Client: Client 1: Is admitted in one episode and has no ‘Financial Eligibility’ record. Client 2: Is admitted in one episode and has a Financial Eligibility’ record. Note the assigned guarantors. Client 3: Is admitted in multiple episodes and has no ‘Cross Episode Financial Eligibility’ record. Client 4: Is admitted in multiple episodes and has a ‘Cross Episode Financial Eligibility’ record. Note the assigned guarantors. Guarantors/Payors: Guarantors are identified that will be added to ‘Guarantor Order’ in the ‘Default Guarantor Assignment’ form. The guarantors that were noted in the financial eligibility records will be added and guarantors that were not in the financial eligibility records will also be added. Steps 1. Open ‘Registry Settings’. 2. Add a value of ‘Y’ to the ‘Enable Default Guarantor Assignment’ setting. 3. Click [Submit]. 4. Close the form. 5. Open ‘Default Guarantor Assignment’. 6. Click [Clear Guarantor Oder], if the ‘Guarantor Order’ text box contains data. 7. In ‘Select Guarantor to Default‘ field select guarantors in the order that will default into the financial eligibility records. Note the values. 8. Select ‘Entry to Financial Eligibility Forms’ in ‘Default the Guarantor(s) During’. 9. Select ‘Family Financial Eligibility’ in ‘Add the Guarantor(s) to Which Form’. 10. Select ‘None Exists’ in ‘Default the Guarantor(s) Only If’. 11. Click [Submit]. 12. Open ‘Family Financial Eligibility’ for Family 1. 13. Select the ‘Guarantor Selection’ item. 14. Validate that a ‘Guarantor Selection’ row exists for each of the guarantors in the ‘Guarantor Order’ and that row 1 contains the first guarantor in the order, row 2 contains the second guarantor in the order, and so forth. 15. If desired, select the ‘Guarantor Assignment’ item and assign desired guarantors to the family members. 16. Close the form. 17. Open ‘Default Guarantor Assignment’. 18. Select ‘Not a Part of Financial Eligibility/Cross Episode Financial Eligibility/Family Financial Eligibility’ in ‘Default the Guarantor(s) Only If’. 19. Open ‘Family Financial Eligibility’ for Family 2. 20. Select the ‘Guarantor Selection’ item. 21. Validate that a ‘Guarantor Selection’ row exists for each of the guarantors in the ‘Guarantor Order’ and that the existing guarantor is in row 1. 22. If desired, select the ‘Guarantor Assignment’ item and assign desired guarantors to the family members. It will be necessary to click [Clear Current Assignments] after selecting the family member. 23. Close the form. 24. Repeat steps 4 - 22 for the 'Financial Eligibility’ form and Client 1, and Client 2. 25. Repeat steps 4 - 22 for the 'Cross Episode Financial Eligibility’ form and Client 3, and Client 4. 26. Open ‘Default Guarantor Assignment’. 27. Select 'Filing of Admission' in 'Default the Guarantor(s) During' 28. Select 'Financial Eligibility' in 'Add the Guarantor(s) to Which Form'. 29. Click [Submit]. 30. Enroll Client 1 in a new episode. 31. Open ‘Financial Eligibility’ for Client 1. 32. Validate that a ‘Guarantor Selection’ row exists for each of the guarantors in the ‘Guarantor Order’ and that row 1 contains the first guarantor in the order, row 2 contains the second guarantor in the order, and so forth. 33. Click [Discard]. 34. Open 'Cross Episode Financial Eligibility' for Client 3. 35. Delete all guarantors. 36. Click [Submit]. 37. Open ‘Default Guarantor Assignment’. 38. Select 'Filing of Admission' in 'Default the Guarantor(s) During' 39. Select 'Cross Episode Financial Eligibility' in 'Add the Guarantor(s) to Which Form'. 40. Click [Submit]. 41. Enroll Client 3 into another episode, 42. Open 'Cross Episode Financial Eligibility'. 43. Validate that a ‘Guarantor Selection’ row exists for each of the guarantors in the ‘Guarantor Order’ and that row 1 contains the first guarantor in the order, row 2 contains the second guarantor in the order, and so forth. 44. Click [Discard]. Scenario 2: PM - Financial Eligibility Web Service - Verification of web service filing Specific Setup: Client A: Has one or more episodes eligible for a Financial Eligibility record. The 'FinancialEligibility' web services has been used to add a Financial Eligibility record and used to update the added record. Note the field values when the record is added. Validate that a successful filing message is received. Change at least one field. Note the field values for all changed fields. Validate that a successful filing message is received. Steps Open ‘Financial Eligibility’ for Client A, selecting the episode if needed. Verify that the guarantor order is correct. Select the ‘Guarantor Selection’ section. Select the desired guarantor in ‘Guarantor Information’ Click [Edit Selected Item]. Verify that the values filed in the web service application are correct, and that the fields that were changed contain the new value. Repeat steps 4 & 5 for additional guarantors if more than one guarantor was added through the web service request. Close the form. Financial Eligibility - Web Services Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Cross Episode Financial Eligibility Web Service Cross Episode Financial Eligibility Scenario 1: 'CrossEpisodeFinancialEligibility' Web Service - Verification of 'AddCrossEpFinancialElig' Filing Specific Setup: Application utilizing the Avatar PM 'CrossEpisodeFinancialEligibility' web service. Steps Using Avatar PM 'CrossEpisodeFinancialEligibility' web service, submit request to 'AddCrossEpFinancialElig' method to create new Avatar PM Cross Episode Financial Eligibility record. Confirm 'CrossEpisodeFinancialEligibility' web service responds with confirmation data on successful filing of 'AddCrossEpFinancialElig' method. Example: "<Confirmation>Unique ID: 123~POR.00001</Confirmation>" Confirm 'CrossEpisodeFinancialEligibility' web service responds with confirmation message on successful filing of 'AddCrossEpFinancialElig' method. Example: "<Message>Cross Episode Financial Eligibility web service has been filed successfully.</Message>" Confirm 'CrossEpisodeFinancialEligibility' web service responds with successful status value on successful filing of 'AddCrossEpFinancialElig' method. Example: " <Status>1</Status>" Open Avatar PM 'Cross Episode Financial Eligibility' form and select client filed via web service for view/update. Confirm new Cross Episode Financial Eligibility record is created in Avatar PM, with values/data submitted via web service. Scenario 2: 'CrossEpisodeFinancialEligibility' Web Service - Verification of 'UpdateCrossEpFinancialElig' Filing Specific Setup: Application utilizing the Avatar PM 'CrossEpisodeFinancialEligibility' web service. Steps Using Avatar PM 'CrossEpisodeFinancialEligibility' web service, submit request to 'UpdateCrossEpFinancialElig' method to update existing Avatar PM Cross Episode Financial Eligibility record. Confirm 'CrossEpisodeFinancialEligibility' web service responds with confirmation data on successful filing of 'UpdateCrossEpFinancialElig' method. Example: "<Confirmation>Unique ID: 123~POR.00001</Confirmation>" Confirm 'CrossEpisodeFinancialEligibility' web service responds with confirmation message on successful filing of 'UpdateCrossEpFinancialElig' method. Example: "<Message>Cross Episode Financial Eligibility web service has been filed successfully.</Message>" Confirm 'CrossEpisodeFinancialEligibility' web service responds with successful status value on successful filing of 'UpdateCrossEpFinancialElig' method. Example: " <Status>1</Status>" Open Avatar PM 'Cross Episode Financial Eligibility' form and select client filed via web service for view/update. Confirm Cross Episode Financial Eligibility record is updated in Avatar PM, with values/data submitted via web service.	Topics • Registry Settings • Financial Eligibility • NX • Default Guarantor Assignment • Web Services • Cross Episode Financial Eligibility
Update 28 Summary \| Details Admission - 'Activate Program/Service Code Filter' registry setting Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Admission (Outpatient) Scenario 1: Admission - Validate the 'Activate Program/Service Code Filter' registry setting Specific Setup: The 'Activate Program/Service Code Filter' registry setting is set to "Y". An inpatient program is defined with associated services in the 'Program Maintenance' form (Program A). Steps Access the 'Admission' form. Verify the 'Select Client' dialog is displayed. Enter any new value in the 'Last Name' and 'First Name' fields. Select any value in the 'Sex' field. Click [Search]. Validate a "Search Results" message is displayed stating: No matches found. Click [New Client]. Validate a "Client" message displays indicating "Auto Assign Next ID Number?" Click [Yes]. Enter the current date in the 'Preadmit/Admission Date' field. Enter the current time in the 'Preadmit/Admission Time' field. Select "Program A" in the 'Program' field. Select any value in the 'Type Of Admission' field. Select any value in the 'Source Of Admission' field. Enter the desired practitioner in the 'Admitting Practitioner' field. Enter the desired practitioner in the 'Attending Practitioner' field. Select the 'Inpatient/Partial/Day Treatment' section. Select any value in the 'Unit' field. Select any value in the 'Room' field. Select any value in the 'Bed' field. Select any value in the 'Licensed/Unlicensed' field. Validate only services assigned to "Program A" display in the 'Room And Board Billing Code' field. Validate only services assigned to "Program A" display in the 'Daily Charge Code' field. Validate only services assigned to "Program A" display in the 'Admission Charge Code' field. Click [Submit]. Select the client admitted in the previous steps and access the 'Admission' form. Validate the new episode is displayed and click [Edit]. Validate all previously filed admission data is displayed. Close the form.	Topics • Registry Settings • Admission
Update 37 Summary \| Details Women's Health History Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: HomeView.Women's Health History SQL Query/Reporting Tool Women's Health History Scenario 1: Women's Health History - Master Patient Index Historic Sync Specific Setup: User with Provider credentials User with access to Women's Health History form Female Client with "expected due date" filed via the "Admission" form Steps Log into Avatar with a Provider login. Open "Women's Health History" form. Enter values for the following fields (Pregnancy Status, Expected Due Date, and Lactating Status). Add desired values to the 'Para and Gravida' section. Click [Add/Update]. Click [File Para Records]. Click [Submit]. Click [Yes]. Open "Women's Health History" form. Select 'Edit' on the record that was added. Validate that all the data that was entered displays correctly in the form. Close the form. Open 'Crystal Reports' or another SQL reporting tool. Execute the query: 'SELECT * FROM SYSTEM.client_condition_preg where PATID=client id AND assessment_date =current date'. Validate the table cells "pregnancy_status", "expected_due_date", "lactating_status" match the inputted values from the "Women's Health History" form. Open 'Crystal Reports' or another SQL reporting tool. Execute the query: 'SELECT * FROM SYSTEM.patient_demographic_history where PATID=client id'. Validate the table cells "pregnancy_status", "expected_due_date", "lactating_status" match the values from the ‘SYSTEM.client_condition_preg' table.	Topics • Women's Heath History
Update 39 Summary \| Details Disclosure Management - Filter document images Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Disclosure Management Disclosure Management Configuration Create New Treatment Plan Document Routing Setup (PM) Treatment Plan Clinical Document Viewer Progress Notes (Group and Individual) Treatment Plan Number 8 Scenario 1: Disclosure Management - Field Validations Specific Setup: Using the "Disclosure Management Configuration" form, set up the first page image, watermark, and forms to associate to set up Disclosure Management. Steps Open the "Disclosure Management" form. Populate all required and desired fields in the request, authorization, and the disclosure sections. Select "Electronic" in the "Disclosure Method" field. Click the "Process" button. Validate the appropriate items are included in the disclosure packet. Click "Disclose". Click the PDF download icon. Browse to the location to store the file on the server. Provide the file name with a .pdf file extension. Click the "Save" button. Scenario 2: Disclosure Management - Apply Filter to Document Images Specific Setup: Using the "Create New Treatment Plan" form, create a non episodic copy of the Treatment Plan form. Using the "Document Routing Setup" form, enable the new Treatment Plan form for document routing, the Treatment Plan and Progress Notes (Group and Individual) forms. Using "User Definition" ensure the user has access to the above forms. Admit or select a test client into multiple episodes. Generate a couple of Non Episode Treatment Plans for different dates. Finalize and route to an approver. Log in as the approver and approve the document by signing. Generate a couple of episodic Treatment Plans for different dates and different episodes. Finalize and route to an approver. Log in as the approver and approve the document by signing. Generate a couple of Progress Notes (Group and Individual) for different dates and different episodes. Finalize and route to an approver. Log in as the approver and approve the document by signing. Using the "Document Management Configuration" form, set up disclosure management by setting up an image to include in each packet, a disclosure statement, a watermark and to identify valid types of forms to attach to a disclosure. An Organization must be created in the 'Disclosure Management' form (Organization A). Steps Open the 'Disclosure Management' form for the same client selected above. Click [Add] if this form has ever been filed for the client before. Set the 'Request Date' field to the current date. Select desired episode(s) from the 'Request Episode(s)' field. Select desired chart items from the 'Requested Chart Items' field. Validate non episodic forms are included regardless of the episode selected. Click [Apply Filter To Document Images]. Validate the Document Images listed in the "Requested Document Images" are filtered by the episode(s) and Request Start/End dates. Set the 'Requesting Organization or Individual' field to "Organization A" Select the 'Authorization' section. Set the 'Authorization Start Date' field to desired date. Set the 'Authorization End Date' field to desired date. Select the episode(s). Click [Apply Filter To Document Images]. Validate the Document Images listed in the "Requested Document Images" are filtered by the episode(s) and Authorization Start/End dates. Select "Yes" in "Default all Chart Items to Yes". Click [Update Chart Items Authorized for Disclosure]. Validate the 'Authorized' cell for all rows is set to "Y". Click [Save]. Click [Refresh Chart Items]. Verify the Chart Items Authorized for Disclosure' field is updated. Click [Apply Filter to Document Images]. Select "Yes" in "Default all Document Images to Yes". Click [Update Chart Items Authorized for Disclosure]. Validate the 'Authorized' cell for all rows is set to "Y". Click [Save]. Select the 'Disclosure' section. Set the 'Disclosure Date' field to the current date. Select all chart items and all document images. Select the method to report. Click [Process]. Click [View]. Verify the chart items and document images to be included are the items that were chosen. Verify the disclosure file includes the image, disclosure statement, watermark and the chosen chart items and document images. Disclosure Management - Items for Disclosure with no data Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following: Disclosure Management Disclosure Management Configuration Create New Treatment Plan Document Routing Setup (PM) Treatment Plan Clinical Document Viewer Progress Notes (Group and Individual) Treatment Plan Number 8 Scenario 1: Disclosure Management - Field Validations Specific Setup: Using the "Disclosure Management Configuration" form, set up the first page image, watermark, and forms to associate to set up Disclosure Management. Steps Open the "Disclosure Management" form. Populate all required and desired fields in the request, authorization, and the disclosure sections. Select "Electronic" in the "Disclosure Method" field. Click the "Process" button. Validate the appropriate items are included in the disclosure packet. Click "Disclose". Click the PDF download icon. Browse to the location to store the file on the server. Provide the file name with a .pdf file extension. Click the "Save" button. Scenario 2: Disclosure Management - Apply Filter to Document Images Specific Setup: Using the "Create New Treatment Plan" form, create a non episodic copy of the Treatment Plan form. Using the "Document Routing Setup" form, enable the new Treatment Plan form for document routing, the Treatment Plan and Progress Notes (Group and Individual) forms. Using "User Definition" ensure the user has access to the above forms. Admit or select a test client into multiple episodes. Generate a couple of Non Episode Treatment Plans for different dates. Finalize and route to an approver. Log in as the approver and approve the document by signing. Generate a couple of episodic Treatment Plans for different dates and different episodes. Finalize and route to an approver. Log in as the approver and approve the document by signing. Generate a couple of Progress Notes (Group and Individual) for different dates and different episodes. Finalize and route to an approver. Log in as the approver and approve the document by signing. Using the "Document Management Configuration" form, set up disclosure management by setting up an image to include in each packet, a disclosure statement, a watermark and to identify valid types of forms to attach to a disclosure. An Organization must be created in the 'Disclosure Management' form (Organization A). Steps Open the 'Disclosure Management' form for the same client selected above. Click [Add] if this form has ever been filed for the client before. Set the 'Request Date' field to the current date. Select desired episode(s) from the 'Request Episode(s)' field. Select desired chart items from the 'Requested Chart Items' field. Validate non episodic forms are included regardless of the episode selected. Click [Apply Filter To Document Images]. Validate the Document Images listed in the "Requested Document Images" are filtered by the episode(s) and Request Start/End dates. Set the 'Requesting Organization or Individual' field to "Organization A" Select the 'Authorization' section. Set the 'Authorization Start Date' field to desired date. Set the 'Authorization End Date' field to desired date. Select the episode(s). Click [Apply Filter To Document Images]. Validate the Document Images listed in the "Requested Document Images" are filtered by the episode(s) and Authorization Start/End dates. Select "Yes" in "Default all Chart Items to Yes". Click [Update Chart Items Authorized for Disclosure]. Validate the 'Authorized' cell for all rows is set to "Y". Click [Save]. Click [Refresh Chart Items]. Verify the Chart Items Authorized for Disclosure' field is updated. Click [Apply Filter to Document Images]. Select "Yes" in "Default all Document Images to Yes". Click [Update Chart Items Authorized for Disclosure]. Validate the 'Authorized' cell for all rows is set to "Y". Click [Save]. Select the 'Disclosure' section. Set the 'Disclosure Date' field to the current date. Select all chart items and all document images. Select the method to report. Click [Process]. Click [View]. Verify the chart items and document images to be included are the items that were chosen. Verify the disclosure file includes the image, disclosure statement, watermark and the chosen chart items and document images.	Topics • Disclosure

Avatar_PM_2023_Quarterly_Release_2023.01_Details.csv