Avatar PM 2023 Update 156

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Product Requirements and Recommendations

Avatar PM required
RADplus required

Recommended Update Level

Avatar PM 2023 Monthly Release 2023.04.00
RADplus 2023 Monthly Release 2023.04.00

Product Update Description

The following issues are resolved: 1)The CCBHC PPS Compile may incorrectly generate a second PPS service when the PPS service is edited. 2)The CCBHC PPS Compile may not generate a PPS service if the enumerated service is edited.

Required Updates

None

Included Updates

7, 10, 11, 16, 17, 18, 21, 25, 29, 31, 32, 33, 34, 35, 39, 44, 48, 56, 57, 58, 59, 62, 63, 64, 65, 66, 67, 72, 73, 76, 77, 78, 79, 82, 85, 86, 88, 89, 93, 94, 96, 98, 100, 101, 102, 103, 104, 105, 106, 109, 110, 115, 116, 119, 120, 121, 122, 125, 128, 129, 130, 133, 134, 135, 136, 139, 140, 143, 149, 153, 154

Details

NEW0 CHANGED0 FIXED2

Fixed (2)

AV-92117 Details \| User Acceptance Tests CCBHC PPS Compile - Edit PPS Service An issue is resolved in the 'CCBHC PPS Compile' process where multiple PPS-1 Services are created when a PPS-1 Service that was created is edited in any way in the system. KB0075129 v0.01	Topics • CCBHC

AV-92539 Details \| User Acceptance Tests CCBHC PPS Compile An issue is resolved in the 'CCBHC PPS Compile' process where it isn't posting the CCBHC service for all clients. KB0075128 v0.01	Topics • CCBHC • NX

Acceptance Tests

AV-92117 Summary | Details

CCBHC PPS Compile - Edit PPS Service

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

CCBHC PPS Compile
Client Charge Input
Client Ledger

Scenario 1: CCBHC PPS Compile - Edit PPS1 service.

Specific Setup:

Service Codes:
Service 1:
A PPS enumerated service code. This will be the service used in client charge input, and it will trigger Service 2 during the CCBHC PPS Compile.
Service 2:
A PPS non-enumerated service code.
CCBHC PPS Service definition:
PPS-1 definition:
The other definition would have an effective date that is the day after the end date in the PPS-2 definition.
PPS-1 Service Code is the enumerated service code (Service 1).
Review the dates before admitting the client so you know what admission date you want to use.
Dictionary Update:
For the 'Client' File type -> '(10006) Location' Data element, Pick a dictionary code of a location (Location 1) and set its value as 'Yes' for the Extended Dictionary Data Element-> 'CCBHC Location '
Guarantors/Payors:
Find an existing or create a Guarantor with the "CCBHC Guarantor" set as "Yes".
Client 1 has the following:
Is enrolled in a program on or after the CCBHC PPS Service Definition effective date.
A financial eligibility record for the CCBHC guarantor.

Steps

Open the 'Client Charge Input' form.
Set the 'Date Of Service' field with a date.
Select Client 1 in the 'Client ID' field.
Select 'Service 1' in the 'Service Code' field.
Select a practitioner from the 'Practitioner' field.
Select 'Location 1' from the 'Location' field.
Select [Submit].
Click [No].
Open 'Close Charges'.
Select 'Close Charges' from 'Liability Update Or Close Charges'.
Select 'T' to set today's date in the 'Thru Date' field.
Select 'Individual' from 'Individual, All, Or Interim Batch Cycle'.
Select 'Client 1' in the 'Client ID' field.
Select the episode from the 'Episode Number' field.
Select [Submit].
Open 'Client Ledger'.
Select 'Client 1' in the 'Client ID' field.
Select 'All Episodes' from 'Claim/Episode/All Episodes'.
Select 'Simple' from 'Ledger Type'.
Set 'From Date' and 'To Date' with the date of 'Service 1' used in Step 2.
Select [Process].
Validate that 'Service 1' is shown in the client's ledger.
Close the report.
Click [No].
Open 'CCBHC PPS Compile'.
Enter the first date of service with the date of 'Service 1' of 'Client 1' in 'Start Date' used in Step 2.
Enter the last date of service with the date of 'Service 1' of 'Client 1' in 'Start Date' used in Step 2.
Enter the 'Client ID' for 'Client 1'.
Click [Compile & Post Services].
Validate that the 'CCBHC Compile Complete' message is received.
Click [OK].
Select [Discard].
Click [Yes].
Open 'Client Ledger'.
Select 'Client 1' in the 'Client ID' field.
Select 'All Episodes' from 'Claim/Episode/All Episodes'.
Select 'Simple' from 'Ledger Type'.
Set 'From Date' and 'To Date' with the date of 'Service 1' used in Step 2.
Select [Process].
Validate that 'Service 2' is created by the 'CCBHC PPS Compile' process and shown in the client's ledger along with 'Service 1'.
Close the report.
Click [No].
Open 'Edit Service Information'.
Select 'Client 1' in the 'Client ID' field.
Validate that the Episode field is populated with the corresponding Episode.
Set the 'Service Start Date' and 'Service End Date' with the date of 'Service 1' used in Step 2.
Click [Select Service(s) To Edit].
Validate that we see both Service 1 and 2 in the 'Select Service(s) To Edit' grid.
Select 'Service 2' from the grid.
Click [OK].
Edit the 'Modifiers text' field and set it to any desired value.
Select [Submit].
Click [No].
Open 'CCBHC PPS Compile'.
Enter the first date of service with the date of Service 1 of 'Client 1' in 'Start Date' used in Step 2.
Enter the last date of service with the date of Service 1 of 'Client 1' in 'Start Date' used in Step 2.
Enter the 'Client ID' for 'Client 1'.
Click [Compile & Post Services].
Validate that the 'CCBHC Compile Complete' message is received.
Click [OK].
Select [Discard].
Click [Yes].
Open 'Client Ledger'.
Select 'Client 1' in the 'Client ID' field.
Select 'All Episodes' from 'Claim/Episode/All Episodes'.
Select 'Simple' from 'Ledger Type'.
Set 'From Date' and 'To Date' with the date of 'Service 1' used in Step 2.
Select [Process].
Validate that there are no new entries added for 'Service 2' by the 'CCBHC PPS Compile' process and make sure that we still have the Services 1 and 2 alone in the client's ledger.
Close the report.
Click [No].

Topics

• CCBHC

AV-92539 Summary | Details

CCBHC PPS Compile

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

CCBHC PPS Compile
Client Charge Input
Client Ledger
Delete Service
Open Closed Charges

Scenario 1: CCBHC PPS Compile - posting the CCBHC service.

Specific Setup:

Service Codes:
Service 1:
Is a PPS-enumerated service code. This will be the service used in client charge input, and it will trigger Service 2 during the CCBHC PPS Compile.
Service 2:
Is a PPS non-enumerated service code.
CCBHC PPS Service definition:
PPS-1 definition:
The other definition would have an effective date that is the day after the end date in the PPS-2 definition.
PPS-1 Service Code is the enumerated service code (Service 1).
Review the dates before admitting the client so you know what admission date you want to use.
PPS-2 definition:
Have this definition, with an effective date and end date.
Should contain data in the Service Code By Population section for the Population and Service Code at a minimum.
Dictionary Update:
For the 'Client' File type -> '(10006) Location' Data element, Pick a dictionary code of a location (Location 1) and set its value as 'Yes' for the Extended Dictionary Data Element-> 'CCBHC Location '
Guarantors/Payors:
Find an existing or create a Guarantor with the "CCBHC Guarantor" set as "Yes".
Client 1 has the following:
Is enrolled in a program on or after the CCBHC PPS Service Definition effective date.
A financial eligibility record for the CCBHC guarantor.

Steps

Open the 'Client Charge Input' form.
Set the 'Date Of Service' field with a date.
Select 'Client 1' in the 'Client ID' field.
Select 'Service 1' in the 'Service Code' field.
Select a practitioner from the 'Practitioner' field.
Select 'Location 1' from the 'Location' field.
Select [Submit].
Click [No].
Open 'Close Charges'.
Select 'Close Charges' from 'Liability Update Or Close Charges'.
Select 'T' to set today's date in the 'Thru Date' field.
Select 'Individual' from 'Individual, All, Or Interim Batch Cycle'.
Select 'Client 1' in the 'Client ID' field.
Select the episode from the 'Episode Number' field.
Select [Submit].
Open 'Client Ledger'.
Select 'Client 1' in the 'Client ID' field.
Select 'All Episodes' from 'Claim/Episode/All Episodes'.
Select 'Simple' from 'Ledger Type'.
Set 'From Date' and 'To Date' with the date of 'Service 1' used in Step 2.
Select [Process].
Validate that 'Service 1' is shown in the client's ledger.
Close the report.
Click [No].
Open 'CCBHC PPS Compile'.
If using a PPS-1 definition, enter the date range of services in the service date fields.
If using a PPS-2 definition, enter the first and last date of the month in the service date fields.
Enter the 'Client ID' for 'Client 1'.
Click [Compile & Post Services].
Validate that the 'CCBHC Compile Complete' message is received.
Click [OK].
Select [Discard].
Click [Yes].
Open 'Client Ledger'.
Select 'Client 1' in the 'Client ID' field.
Select 'All Episodes' from 'Claim/Episode/All Episodes'.
Select 'Simple' from 'Ledger Type'.
Set 'From Date' and 'To Date' with the date of 'Service 1' used in Step 2.
Select [Process].
Validate that 'Service 2' is created by the 'CCBHC PPS Compile' process and shown in the client's ledger along with 'Service 1'.
Close the report.
Click [No].
Open 'Open Closed Charges'.
Select 'Individual Client' from 'Individual Client Or Interim Batch'.
Select 'Client 1' in the 'Client ID' field.
Select the episode from the 'Episode Number' field.
Set 'Start Date' and 'End Date' with the date of 'Service 1' used in Step 2.
Click [Select Charges To Open].
Validate that the 'Open Closed Charges' window contains 'Service 1'.
Select 'Service 1'.
Click [OK].
Select [Submit].
Click [Yes].
Click [No].
Open 'Edit Service Information'.
Select 'Client 1' in the 'Client ID' field.
Validate that the Episode field is populated with the corresponding Episode.
Set the 'Service Start Date' and 'Service End Date' with the date of 'Service 1' used in Step 2.
Click [Select Service(s) To Edit].
Validate that we see both Service 1 and 2 in the 'Select Service(s) To Edit' grid.
Select 'Service 1' from the grid.
Click [OK].
Edit the 'Modifiers text' field and set it to any desired value.
Select [Submit].
Click [No].
Open 'Close Charges'.
Select 'Close Charges' from 'Liability Update Or Close Charges'.
Select 'T' to set today's date in the 'Thru Date' field.
Select 'Individual' from 'Individual, All, Or Interim Batch Cycle'.
Select 'Client 1' in the 'Client ID' field.
Select the episode from the 'Episode Number' field.
Select [Submit].
Open 'Delete Service'.
Select 'Client 1' in the 'Client ID' field.
Set the 'Start Date' and 'End Date' with the date of 'Service 1' used in Step 2.
Click [Display Client].
Validate that we see 'Service 2' in the 'Service Delete' window.
Select 'Service 2' from the grid.
Click [OK].
Click [Delete].
Validate that a 'The following services will be deleted.' window displays with the 'Service 2' we selected in Step 78.
Click [OK].
Click [Yes].
Click [OK].
Select [Discard].
Click [Yes].
Open 'Client Ledger'.
Select 'Client 1' in the 'Client ID' field.
Select 'All Episodes' from 'Claim/Episode/All Episodes'.
Select 'Simple' from 'Ledger Type'.
Set 'From Date' and 'To Date' with the date of 'Service 1' used in Step 2.
Select [Process].
Validate that Services 1 and 2 are shown in the client's ledger, with 'Service 2' marked as 'DELETE' under the 'SERV' column of the report.
Close the report.
Click [No].
Open 'CCBHC PPS Compile'.
If using a PPS-1 definition, enter the date range of services in the service date fields.
If using a PPS-2 definition, enter the first and last date of the month in the service date fields.
Enter the 'Client ID' for 'Client 1'.
Click [Compile & Post Services].
Validate that the 'CCBHC Compile Complete' message is received.
Click [OK].
Select [Discard].
Click [Yes].
Open 'Client Ledger'.
Select 'Client 1' in the 'Client ID' field.
Select 'All Episodes' from 'Claim/Episode/All Episodes'.
Select 'Simple' from 'Ledger Type'.
Set 'From Date' and 'To Date' with the date of 'Service 1' used in Step 2.
Select [Process].
Validate that a new row is created for the 'PPS Service 2' by the 'CCBHC PPS Compile' process and shown in the client's ledger along with 'Service 1'.
Close the report.
Click [No].

Topics

• CCBHC • NX