‘Inhibit Billing By Service’ and ‘File Import'
Note - These testing guidelines assume the user is skilled in the use of, at a minimum, the following:
- Avatar NX Report Viewer
- Crystal Report Viewer
- Inhibit Billing By Service
- Inhibited Services For Billing Report
- Admission (Outpatient)
- Client Inhibited Services (Service Date Less Than 1 Year Old)
- Client Ledger
- Diagnosis
- Electronic Billing
- File Import
- Financial Eligibility
- Registry Settings (PM)
- Create Interim Billing Batch File
- Dynamic Form - Edit Service Fee Definition
- Service Codes
- Service Fee/Cross Reference Maintenance
Scenario 1: Inhibited Services For Billing Report
Specific Setup:
- Inhibit Billing by Service has been used to inhibit at least one service for a client. Note the field values.
Steps
- Open ‘Inhibited Services For Billing Report’.
- Process the report for the client.
- Validate that the correct data displays in the report.
- Close the report.
- Close the form.
Scenario 2: 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
- Open the 'File Import' form.
- Select the 'Client Charge Input' from the 'File Type' field.
- Upload the file Import file created in the setup section to mark a service as a billing inhibited.
- Compile the file.
- Verify that the file compiles successfully.
- Select the 'Print File' option.
- Review the information on compile report.
- Verify that all the information entered through the 'File Import' file displayed correctly in the specific field.
- Post the compiled file.
- Verify that the file posted successfully.
- Open the 'Crystal Report' or any other SQL data viewer.
- Run the query against SYSTEM.billing_tx_history table.
- Verify the 'billable_code' displays 'X'.
- Run the query against SYSTEM.inhibit_billing SQL table.
- Verify the inhibited service record is added in this table.
- Close the Crystal Report or the SQL Data Viewer.
- Locate to the 'CLIENT INHIBITED SERVICES (SERVICE DATE LESS THAN 1 YEAR OLD)' WIDGET.
- 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.
- Open the 'Inhibited Services For Billing report' form.
- Enter desired date in the 'Start Date' field.
- Enter desired date in the 'End Date' field.
- Select desired client in the 'Client' field.
- Click [Process Report].
- Verify the inhibited service record displays in the report correctly.
- Close the report.
Scenario 3: 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's 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
- Open the 'File Import' form.
- Select the 'Client Charge Input' from the 'File Type' field.
- Upload the file Import file created in the setup section to mark a service as a billing inhibited.
- Compile the file.
- Verify that the file compiles successfully.
- Select the 'Print File' option.
- Review the information on compile report.
- Verify that all the information entered through the 'File Import' file displayed correctly in the specific field.
- Post the compiled file.
- Verify that the file posted successfully.
- Open the 'Crystal Report' or any other SQL data viewer.
- Run the query against SYSTEM.billing_tx_history SQL table.
- Verify the 'billable_code' code column is blank for the service.
- Run the query against SYSTEM.inhibit_billing SQL table.
- Verify the table does not contain the non inhibited service record of the client.
- Close the Crystal Report or the SQL Data Viewer.
- Locate to the 'CLIENT INHIBITED SERVICES (SERVICE DATE LESS THAN 1 YEAR OLD)' WIDGET.
- 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.
- Open the 'Inhibited Services For Billing Report' form.
- Enter desired date in the 'Start Date' field.
- Enter desired date in the 'End Date' field.
- Select desired client in the 'Client' field.
- Click [Process Report].
- Verify the non inhibited service record does not display in the report.
- Close the report.
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Topics
• Database Tables
• File Import
• Inhibit Billing
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