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Avatar PM 2023 Update 25

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Product Requirements / Recommendations

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Product Update Form Description

Client Charge Input file import is updated to file data into 'SYSTEM.inhibit_billing' table for services that are marked inhibited from billing. Additionally, an issue is resolved where the 'SYSTEM.inhibit_billing' table is not updated during Change MR process.

Included Updates

None

Required Updates

None

Details
NEW1 CHANGED0 FIXED1
New (1)
File Import - Client Charge Input
A non-billable service imported through 'File Import' client charge input file with the 'Billable (Inhibit Billing)' field set to "N" is inhibited from billing correctly and the 'CLIENT INHIBITED FROM BILLING (SERVICE DATE LESS THAN 1 YEAR)' widget and the 'Inhibited Services For Billing report' is updated to display the client and inhibited service.
Value Added: The 'File Import' process for 'Client Charge Input' file type is updated to update the 'SYSTEM.inhibited.billing' SQL table with the imported non billable services.
Topics
• Database Tables • File Import • Inhibit Billing
 
Fixed (1)
SQL Table - SYSTEM.inhibit_billing
Resolves an issue to ensure that the SYSTEM.inhibit_billing sql table is updated with the updated client id when 'Change MR#' processed for the client.
Topics
• Inhibit Billing
 
Acceptance Tests
AV-64183 Summary | Details
SQL Table - SYSTEM.inhibit_billing
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Admission (Outpatient)
  • Change MR#
  • Client Charge Input
  • Client Ledger
  • Crystal Report Viewer
  • Diagnosis
  • Dynamic Form - Admission - Client
  • Dynamic Form - File Service Inhibit Information
  • Dynamic Form - Inhibit Services - Please review your selections to Inhibit services
  • Dynamic Form - Un-Inhibit services - Please review your selections to Un-Inhibit service
  • Dynamic form- Social Security Number
  • Electronic Billing
  • Financial Eligibility
  • Inhibit Billing By Service
Scenario 1: Inhibit Billing By Service - Validate billing inhibited / uninhibited service
Specific Setup:
  • A practitioner must be associated to the user that is logged into the application (Practitioner A).
  • Admission:
  • An existing client is identified in the system or create a new client. Note the client id, admission program/date.
  • Guarantors/Payors:
  • An existing guarantor is identified to be used as a primary guarantor. Note the guarantor code.
  • Financial Eligibility:
  • The guarantor identified above is assigned to the client as a primary guarantor.
  • Diagnosis:
  • Client has an admission diagnosis record.
  • Service Codes:
  • An existing service code is identified. Note the service codes / value.
  • Service fee/Cross Maintenance:
  • The fee definition is created for the service code to be used.
  • Client Charge Input:
  • A service is rendered to the client using the service code identified above.
  • Client Ledger:
  • The liability distributed to the primary guarantor of the client.
Steps
  1. Open the 'Inhibit Billing By Service' form.
  2. Enter the practitioner associated to the logged in user in the 'Rendering Practitioner' field.
  3. Select any value from the 'Select Service(s) To Mark Billing-Inhibited' field.
  4. Click [Submit].
  5. Validate a "Please review your selections" dialog is displayed.
  6. Click [OK].
  7. Validate a "File Service Inhibit Information" dialog is displayed stating: Continue Filing?
  8. Click [Yes].
  9. Validate a "Form Return" message is displayed stating: Submitting has completed. Do you wish to return to form?
  10. Click [No].
  11. Open the 'Crystal report' or any other SQL data viewer.
  12. Run the 'Select * from SYSTEM.billing_tx_history where PATID=604'.
  13. Verify the 'billable_code' field displays 'X'.
  14. Run the 'Select * from SYSTEM.inhibit_billing where PATID=604'.
  15. Verify the data is filed in this table for the client.
  16. Open the 'Change MR #' form.
  17. Perform a Change MR # for this client to assign a new MR #.
  18. Run the 'Select * from SYSTEM.inhibit_billing where PATID=604'.
  19. Verify the table is updated with the new MR #.
  20. Close the report.
Topics
• Inhibit Billing
AV-85196 Summary | Details
File Import - Client Charge Input
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Admission (Outpatient)
  • Client Inhibited Services (Service Date Less Than 1 Year Old)
  • Client Ledger
  • Crystal Report Viewer
  • Diagnosis
  • Electronic Billing
  • File Import
  • Financial Eligibility
  • Inhibited Services For Billing Report
  • Registry Settings (PM)
  • Service Codes
  • Service Fee/Cross Reference Maintenance
Scenario 1: File Import - 'Client Charge Input' file type - Render a service to the client that is marked as a billing inhibited
Specific Setup:
  • Registry Settings:
  • The registry setting 'Import File Delimiter' is set to desired value.
  • Home View:
  • The 'CLIENT INHIBITED FROM BILLING (SERVICE DATE LESS THAN 1 YEAR)' widget available on the home view.
  • Program Maintenance:
  • Identify an existing program code / name. Note the program code.
  • Admission:
  • An existing client is identified. Note the client id/name, admission date, admission program code/name.
  • A 'Client Charge Input' import file is created to render a service to the client and mark that service billing inhibited.
  • The predefined client, episode number, practitioner id, service code, admission program and cost of the service are entered in the file.
Steps
  1. Open the 'File Import' form.
  2. Select the 'Client Charge Input' from the 'File Type' field.
  3. Upload the file Import file created in the setup section to mark a service as a billing inhibited.
  4. Compile the file.
  5. Verify that the file compiles successfully.
  6. Select the 'Print File' option.
  7. Review the information on compile report.
  8. Verify that all the information entered through the 'File Import' file displayed correctly in the specific field.
  9. Post the compiled file.
  10. Verify that the file posted successfully.
  11. Open the 'Crystal Report' or any other SQL data viewer.
  12. Run the query against SYSTEM.billing_tx_history table.
  13. Verify the 'billable_code' displays 'X'.
  14. Run the query against SYSTEM.inhibit_billing SQL table.
  15. Verify the inhibited service record is added in this table.
  16. Close the Crystal Report or the SQL Data Viewer.
  17. Locate to the 'CLIENT INHIBITED SERVICES (SERVICE DATE LESS THAN 1 YEAR OLD)' WIDGET.
  18. Verify the 'Client Name' and 'Episode' column displays the client name and episode for the client for whom the inhibited service is rendered through file import.
  19. Open the 'Inhibited Services For Billing report' form.
  20. Enter desired date in the 'Start Date' field.
  21. Enter desired date in the 'End Date' field.
  22. Select desired client in the 'Client' field.
  23. Click [Process Report].
  24. Verify the inhibited service record displays in the report correctly.
  25. Close the report.
Scenario 2: File Import - 'Client Charge Input' file type - Render a service to the client that is marked as a billing non inhibited
Specific Setup:
  • Registry Settings:
  • The registry setting 'Import File Delimiter' is set to desired value.
  • Program Maintenance:
  • Identify an existing program code / name. Note the program code.
  • Admission:
  • An existing client is identified. Note the client id/name, admission date, admission program code/name.
  • A 'Client Charge Input' import file is created to render a service to the client and mark that service billing non inhibited. The predefined client, episode number, practitioner id, service code, admission program and cost of the service are entered in the file.
Steps
  1. Open the 'File Import' form.
  2. Select the 'Client Charge Input' from the 'File Type' field.
  3. Upload the file Import file created in the setup section to mark a service as a billing inhibited.
  4. Compile the file.
  5. Verify that the file compiles successfully.
  6. Select the 'Print File' option.
  7. Review the information on compile report.
  8. Verify that all the information entered through the 'File Import' file displayed correctly in the specific field.
  9. Post the compiled file.
  10. Verify that the file posted successfully.
  11. Open the 'Crystal Report' or any other SQL data viewer.
  12. Run the query against SYSTEM.billing_tx_history SQL table.
  13. Verify the 'billable_code' code column is blank for the service.
  14. Run the query against SYSTEM.inhibit_billing SQL table.
  15. Verify the table does not contain the non inhibited service record of the client.
  16. Close the Crystal Report or the SQL Data Viewer.
  17. Locate to the 'CLIENT INHIBITED SERVICES (SERVICE DATE LESS THAN 1 YEAR OLD)' WIDGET.
  18. Verify the 'Client Name' and 'Episode' column does not display the client name and episode for the client for whom the non inhibited service is rendered through file import.
  19. Open the 'Inhibited Services For Billing Report' form.
  20. Enter desired date in the 'Start Date' field.
  21. Enter desired date in the 'End Date' field.
  22. Select desired client in the 'Client' field.
  23. Click [Process Report].
  24. Verify the non inhibited service record does not display in the report.
  25. Close the report.
Topics
• Database Tables • File Import • Inhibit Billing