Avatar PM 2023 Update 35

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Product Requirements / Recommendations

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Product Update Form Description

The following issues are resolved: 1) An incorrect Patient Status Code (2300-CL1-03) and might be included when billing a discharged client on an 837 Institutional bill. 2) Through date on the Statement Date (2300-DTP) might not include the discharge date for a discharged client on an 837 Institutional bill. Additionally, the date_to_bill_rollup_service field is added to the SYSTEM.billing_tx_history table.

Included Updates

None

Required Updates

None

Details

NEW0 CHANGED0 FIXED1

Fixed (1)

AV-86992 Details | User Acceptance Tests

837 Institutional

The '837 Institutional' has been modified for the following:
The ‘DTP434’ segment will include the admission date and the discharge date when the client is discharged one day after the last date of service.
The 'CL1-03' field will contain the extended dictionary value for 'Patient Status Over-Ride (2300-CL1-03)' for the discharge type of the discharged client. KB0072441 v0.01

In addition, the date_to_bill_rollup_service field is added to the SYSTEM.billing_tx_history table.

Topics

• 837 Institutional • NX

Acceptance Tests

AV-86992 Summary | Details

837 Institutional

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

Admission
Client Charge Input
Client Ledger
Diagnosis
Dictionary Update (PM)
Discharge
Electronic Billing
Fast Financial Eligibility
Guarantors/Payors

Scenario 1: 837 Institutional - Test Patient Status Code (2300-CL1-03) and Statement Date (2300-DTP)

Specific Setup:

Client A:
Client was admitted to an inpatient program. Note the admission date.
Client has a diagnosis record.
Client has a financial eligibility record.
Client has closed, unclaimed services that include Roll-Up services.
Client Ledger is used to note the dates of service, and the guarantor the liability distributed to.
Guarantor/Payors is used to note the financial class of the guarantor the liability distributed to.
Client was discharged from the episode on the day after the last day of service. Note the discharge date and type.
Dictionary Update:
Client file: Dictionary:970: Type Of Discharge
Print the dictionary and note the extended dictionary value for 'Patient Status Over-Ride (2300-CL1-03)' for the discharge type noted above.

Steps

Open ‘Electronic Billing’.
Select ‘837-Institutional’ in ‘Billing Form’.
Select the desired ‘Financial Class in ‘Type Of Bill’.
Select ‘Individual’ in ‘Individual Or All Guarantors’.
Select the desired guarantor in ‘Guarantor’.
Select ‘Inpatient’ in ‘Billing Type’.
Select ‘Sort File’ in ‘Billing Options’.
Enter the desired value in ‘File Description/Name’.
Select ‘All Clients’ in ‘All Clients Or Interim Billing Batch’.
Select desired value in ‘Program(s)’.
Select ‘No’ in ‘Create Claims’.
Enter the desired value in ‘First Date Of Service To Include’.
Enter the desired value in ‘Last Date Of Service To Include’.
Select ‘All in ‘Include Primary and/or Secondary Billing.
Click [Process].
Validate the ‘Processing Report’ message contains ‘Compile Complete’.
Click [OK].
Select ‘Dump File’ in ‘Billing Options’.
Select ‘Print’ in ‘Print Or Delete Report’.
Select the desired report in ‘File’.
Click [Process].
Validate that the ‘DTP*434*’ segment includes the admission date and the discharge date.
Validate that the ‘CL1’ segment contains the correct value in the third position.
Close the report.
Close the form.
Create an SQL query, specific to the client, for the 'SYSTEM.billing_tx_history table' and validate the date in the 'the date_to_bill_rollup_service' field.
Close the query.

Topics

• 837 Institutional • NX

Table Changes

Table	Column	Change
SYSTEM.billing_tx_histroy	date_to_bill_rollup_service	added