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Avatar PM 2023 Update 57

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Product Requirements / Recommendations

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Product Update Form Description

Support is added for the Payer Identifier segment (2010BB-NM1-09) on the 837 Professional bills to be overridden by other product modules.

Included Updates

10

Required Updates

None

Details
NEW0 CHANGED0 FIXED1
Fixed (1)
837 Professional - Payer Identifier segment (2010BB-NM1-09)
Support is added for the Payer Identifier segment (2010BB-NM1-09) on the 837 Professional
Topics
• 837 Professional • NX
 
Acceptance Tests
AV-79057 Summary | Details
837 Professional - Payer Identifier segment (2010BB-NM1-09)
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
  • Admission (Outpatient)
  • Client Charge Input
  • Client Ledger
  • Diagnosis
  • Electronic Billing
  • Financial Eligibility
  • Guarantors/Payors
  • Practitioner Numbers By Guarantor And Program
  • Registry Settings (PM)
  • Service Codes
  • Service Fee/Cross Reference Maintenance
Scenario 1: 837 Professional - 2010BB
Specific Setup:
  • Registry Settings:
  • ‘Avatar PM->System Maintenance->Guarantors/Payors->->->Specify Report Only Guarantors’ = ‘Y’.
  • Guarantors/Payors: There is a minimum of two guarantors in the same ‘Financial Class’:
  • One guarantor has a value of ‘Yes’ in ‘Is This A Report Only Guarantor?’. Note the guarantor name.
  • The other guarantor has a value of ‘No’ in ‘Is This A Report Only Guarantor?’. Note the guarantor name.
  • Guarantor/Program Billing Defaults:
  • The 837 Professional Template has a value of ‘Yes’ in ‘Include This Guarantor and Program Combination For Report Only Guarantors’.
  • Client A:
  • Note the episode program.
  • Financial Eligibility: Is assigned the guarantor that has a value of ‘No’ in ‘Is This A Report Only Guarantor?’.
  • Services have been provided to the client.
  • Client Ledger: Is used to validate that the liability correctly distributed to the guarantor. Note the dates of service and guarantor.
  • Close Charges: Is used to close the charges.
  • Create Interim Billing Batch File to create a batch for the client, guarantor and service date range.
Steps
  1. Open ‘Electronic Billing’.
  2. Create an unclaimed bill for the 837 Professional using all guarantors in ‘Type of Bill’, the interim batch that was created, the service date range.
  3. Review the dump file to validate that the 2010BB contains the guarantor’s name for the guarantor with ‘Yes’ in ‘Is This A Report Only Guarantor?’.
  4. Close the report.
  5. Change the Type of Bill’ to ‘Individual’ and select the guarantor with ‘No’ in ‘Is This A Report Only Guarantor?’.
  6. Process the bill.
  7. Review the dump file to validate that the 2010BB contains the guarantor’s name for the guarantor with ‘No’ in ‘Is This A Report Only Guarantor?’.
  8. Close the report.
  9. Close the form.
Topics
• 837 Professional • NX